SAN FRANCISCO (CNA)—A group of five Catholic hospitals in California is being sued by a woman who identifies as a transgender man after one of its locations, St. Joseph Hospital, Eureka, refused to perform a hysterectomy.

Oliver Knight is suing St. Joseph Health of Northern California, alleging that she was refused the surgery because of her “gender orientation.”

The suit was filed in the Humboldt County Superior Court on Thursday, March 21. In the lawsuit, Knight says that workers at the hospital canceled the surgery because she identifies as transgender. Knight had identified herself as “male” for a period of four years before the surgery, which was initially scheduled for Aug. 30, 2017.

Prior to the scheduled hysterectomy, Knight had begun cross-sex hormone therapy and undergone a mastectomy.

After the surgery at St. Joseph was denied, Knight underwent a hysterectomy at a hospital unaffiliated with the St. Joseph Health of Northern California system, 30 minutes away.

Knight’s lawsuit suit claims that by denying the surgery St. Joseph Health caused “severe anxiety and emotional turmoil.”

Knight’s doctor prescribed the hysterectomy as treatment for gender dysphoria. Gender dysphoria is a condition in which a person believes themselves to have been “misassigned” their gender at birth.

St. Joseph Health said in a statement reported March 25 that hysterectomies are only performed at their facilities when they have been deemed “medically necessary,” and not for purposes of sterilization. The teaching of the Catholic Church recognizes such procedure as licit when there is a grave and present danger to the life or health of the mother, and when the intention of the procedure is not to prevent the possibility of conception.

In January 2019, the Congregation for the Doctrine of the Faith issued an authoritative response which explained the circumstances under which a hysterectomy could be morally licit.

A 2016 letter to the Centers for Medicare & Medicaid Services signed by the general counsel for the United States Conference of Catholic Bishops, together with other groups, affirmed that the denial of surgery to someone seeking to change their gender would not be discriminatory, noting that in such cases there would be nothing medically wrong with otherwise healthy organs to be removed.

“It is not ‘discrimination’ when a hospital provides care it considers appropriate, declines to perform procedures destructive to patients’ welfare and well-being, or declines to take actions that undermine the health, safety, and privacy of other patients,” the letter said.

“A hospital does not engage in “discrimination” when, for example, it performs a mastectomy or hysterectomy on a woman with breast or uterine cancer, respectively, but declines to perform such a procedure on a woman with perfectly healthy breasts or uterus who is seeking to have the appearance of a man.”

Knight is being represented in part by the ACLU. The suit requests unspecified damages. She also claims to have been repeatedly “mis-gendered” by workers at St. Joseph Hospital, and was allegedly given a pink hospital gown to wear instead of a blue one.

In California, “gender identity” based discrimination is illegal, but the application of the statute in cases involving religious organizations remains disputed.

In 2017, a woman sued California’s largest chain of hospitals, Dignity Health, after doctors declined to perform a scheduled hysterectomy at Mercy San Juan Medical Center. The defendant in that case also claimed that she was denied the procedure due to gender identity.

The case Minton v. Dignity Health was decided in favor of Dignity Health, but an appeal has been filed.