Summary

Naya Taylor was a transgender woman living in Mattoon, Illinois. Dr. Aja Lystila had been Ms. Taylor’s primary care physician, but when Ms. Taylor asked to start hormone replacement therapy (HRT) as part of her medically necessary, transition-related health care to treat her gender dysphoria, Dr. Lystila refused. Dr. Lystila first claimed she was not experienced in providing hormones to transgender people even though hormone therapy is regularly provided to non-transgender patients in a variety of settings every day. Later the clinic told Ms. Taylor that it “does not have to treat people like you.” HRT is one of the vital life-saving treatments used to treat gender dysphoria, a recognized, serious medical condition.

The Affordable Care Act is the first federal civil rights law to prohibit health care providers that receive federal funds, such as Dr. Lystila’s medical practice, from discriminating against any individual on the basis of sex for purpose of providing health services. That prohibition extends to discrimination based on gender identity or failure to conform to stereotypical notions of masculinity or femininity, regardless of the actual or perceived gender identity of the individuals involved.

History