The Supreme Court turned down the chance to consider whether a Catholic hospital can be sued over refusing a transgender patient treatment the hospital says would violate its core religious beliefs.

A California court said Evan Minton could pursue his lawsuit after a hospital canceled a scheduled hysterectomy upon learning days before that he was transgender. The operation was part of his treatment for gender dysphoria, a condition in which an individual’s gender identity does not conform to the sex they were assigned at birth. Justices Clarence Thomas, Samuel A. Alito Jr. and Neil M. Gorsuch said they would have accepted the case.

Minton was scheduled to receive the operation in 2016 at Mercy San Juan Medical Center near Sacramento, a hospital in the Dignity Health chain. After complaints from his physician and media reports about the denial, the operation was performed several days later at a Methodist hospital that is part of the chain. Minton sued, and the California Court of Appeals said he could go forward with his claim that Mercy’s actions violated the state’s civil rights law, which protects LGBTQ people.

The California court said Minton had shown adequately for purposes of a lawsuit that the hospital denied him treatment because he is transgender, and thus denied him the “full and equal” access to medical care that California law requires. The judges turned aside the hospital’s claim that it was protected by the Constitution’s guarantee of free exercise of religion and free speech.

“Upholding Minton’s claim does not compel Dignity Health to violate its religious principles if it can provide all persons with full and equal medical care at comparable facilities not subject to the same religious restrictions.” But Mercy’s decision was based on Minton’s gender identity, and it did not offer an accommodation, the court said. The court said allowing a physician to perform a medical procedure it had allowed before did not compel “speech” by the hospital in violation of the First Amendment.

Lawyers for the hospital said the decision “poses a profound threat to faith-based health-care institutions’ ability to advance their healing ministries consistent with the teachings of their faith.”

“Mercy does not allow its facilities to be used for a limited number of procedures — primarily abortion, sterilization, and euthanasia — that are contrary to the Catholic faith,” the brief said. “Respondent seeks to compel Mercy to allow its facilities to be used for surgical procedures that directly contravene Catholic teachings and doctrines.”

But Minton’s lawyers said the hospital does allow medically necessary hysterectomies — Minton’s physician, Lindsey Dawson, scheduled Minton’s at Mercy because she has performed the procedure there.

“Mr. Minton does not allege impermissible discrimination because he was denied a hysterectomy based on neutral religious directives,” says Minton’s brief, filed by the American Civil Liberties Union. “Rather, he alleges he was intentionally discriminated against because he is transgender. He alleges that he was denied the same procedure that Dignity Health permits many other non-transgender patients to undergo, at the same facility, in a host of other, comparable circumstances.”

The ACLU argued it was premature for the Supreme Court to get involved because there has not been a final judgment in the case.

Minton’s case was one of those cited when the Trump administration’s Health and Human Services Department issued the Refusal of Care Rule, which aimed to support religious entities that said their beliefs would be violated by providing certain care to LGBTQ people.

A judge stopped the rule before it went into effect, and the Biden administration has disavowed it.

The case is Dignity Health, Inc. v. Minton.

Surveillance court transparency

The court also declined to decide whether the public has at least a limited right to review the decisions of a largely secret federal surveillance court whose influence has been growing.

The justices turned down a request from the ACLU and others to review a ruling that denied access to decisions of the Foreign Intelligence Surveillance Court (FISC). That court said it lacked authority even to consider a public claim under the First Amendment to its secret decision-making.

Justices Gorsuch and Sonia Sotomayor said they would have taken the case.

“On the government’s view, literally no court in this country has the power to decide whether citizens possess a First Amendment right of access to the work of our national security courts,” Gorsuch wrote, adding:

“If these matters are not worthy of our time, what is?”

The case is ACLU v. United States.