Hospital chain sued for refusing to cover sex reassignment’s cost

A transgender nurse sued California’s largest private hospital chain, Dignity Health of San Francisco, on Monday for denying him insurance coverage for hormone therapy and sex-reassignment surgery, which the company attributed to a “personality disorder.”

Joe Robinson, an operating-room nurse at Chandler Regional Medical Center in Chandler, Ariz., filed the suit in federal court in San Francisco, saying Dignity Health’s stated policy of refusing coverage to its employees for all treatment “leading to sex-transformation surgery” violates federal laws against sex discrimination.

“I was shocked when Dignity, which is supposed to be in the business of healing and holds itself out to the public as a bastion of ‘humankindness,’ told me they would not authorize insurance coverage for my doctor-prescribed treatment,” Robinson, 50, said in a statement through his attorneys at the American Civil Liberties Union.

Deposit forfeited

Because of the insurance denial, he said, he has had to pay for his own hormone therapy, and paid $7,450 for a double mastectomy last August. Robinson had planned to undergo sex-reassignment surgery in March but had to cancel it because he lacked insurance, his lawyers said. They said Robinson forfeited his deposit and is trying to reschedule the surgery.

Dignity Health said its policy is to not comment on lawsuits.

Dignity, the nation’s fifth-largest hospital owner, operates 39 medical facilities in California, Arizona and Nevada, more than half of them affiliated with the Catholic Church. In separate cases, the ACLU is suing the company in a California court for its refusal to allow women to have tubal ligations in its Catholic hospitals because of the church’s opposition to sterilization.

‘Religious directives’

But the 243-bed Chandler hospital, where Robinson has worked since January 2014, is not church-affiliated. When Robinson’s fiancee asked Dignity Health in September to reconsider its denial of coverage, the company responded that it had considered its “ethical and religious directives,” but concluded the denial had another legitimate basis: the insurance plan’s exclusion of coverage for treatment of “personality disorders, including sexual/gender identity.”

That was a shocking response from a health care provider, said ACLU attorney Josh Block.

“Every major medical association has affirmed that transition-related health care for transgender people is medically necessary,” Block said.

The lawsuit seeks unspecified damages and a court order requiring insurance coverage. ACLU lawyers said the Dignity Health policy amounts to sex discrimination under the 1964 Civil Rights Act and also violates regulations, announced by the U.S. Department of Health and Human Servicers last month, prohibiting health companies that receive federal aid from denying insurance for “health services related to gender transformation.”

Block said it was the first suit in the nation to rely on the new federal regulations.

Bob Egelko is a San Francisco Chronicle staff writer. Email: begelko@sfchronicle.com Twitter: egelko