Why Catholic nuns are suing over transgender care and religious freedom

• The April 6 lawsuit alleges that New York's LGBTQ Long-Term Care Facility Residents' Bill of Rights infringes on the First Amendment.
• Among other provisions of the law, care facilities cannot refuse a transgender resident’s request to be assigned a room or be allowed to use a restroom that aligns with their gender identity.
• The New York State Department of Health said it does not comment on pending litigation but that it is "committed to following state law," including provisions barring discrimination based on gender.

A group of nuns who operate a nursing facility in New York are suing the state over a law that requires them to provide care for transgender patients in a way they say violates their Catholic faith.

The new lawsuit is challenging New York on First Amendment grounds and raising questions about how different religious groups are treated by the state.

In the April 6 complaint filed in U.S. District Court for the Southern District of New York, the Dominican Sisters of Hawthorne and Rosary Hill Home, a licensed care facility they operate in the New York metropolitan area, alleged that the state’s LGBTQ Long-Term Care Facility Residents’ Bill of Rights infringes on their religious beliefs.

Among other provisions of the law, long-term care facilities cannot refuse a transgender resident’s request to be assigned a room that aligns with their gender identity, nor can they prohibit them from using a restroom that reflects their gender identity. They are also barred from "willfully and repeatedly failing to use a resident’s preferred name or pronouns" after being made aware of such preferences.

These requirements contradict the sisters’ religious beliefs by compelling them to "act against central, unchangeable and architectural teachings of the Catholic faith," the complaint said.

"The implications are so much greater than whether to utter the words 'he' or 'she,'" it said. "Indeed, to demand that a Catholic deny another’s sex is to require him or her to affirm another religious worldview."

There are Catholic-led organizations, such as DignityUSA, that affirm transgender people and others within the LGBTQ+ community.

Democratic New York Gov. Kathy Hochul and various leaders of the New York State Department of Health are listed as defendants. The Catholic Benefits Association, which advocates for Catholic employers’ rights to provide a workplace and benefits in line with their religious beliefs, is supporting the nuns in the case.

The complaint also alleged that Christian Scientists, who promote metaphysical healing over medical intervention, are exempt through a provision saying such requirements don’t apply to a facility "whose teachings include reliance on spiritual means through prayer alone for healing in the practice of the religion of such organization and where services are provided in accordance with those teachings."

The Dominican Sisters of Hawthorne submitted an exemption request to the state but did not receive a response, according to the Catholic Benefits Association. After two weeks, they filed the federal lawsuit.

Without a legal exemption, the complaint said, the sisters "face imminent fines and license revocation if they continue their current religious practices."

"They have not complied and do not intend to comply," the complaint said.

Cadence S. Acquaviva, a New York State Department of Health spokesperson, told USA TODAY the department does not comment on pending litigation but said it is "committed to following state law, which provides nursing home residents certain rights protecting against discrimination including, but not limited to, gender identity or expression."

USA TODAY reached out to Hochul’s office for comment.

 BrieAnna Frank is a First Amendment reporter at USA TODAY. Reach her at [email protected]. 

USA TODAY's coverage of First Amendment issues is funded through a collaboration between the Freedom Forum and Journalism Funding Partners. Funders do not provide editorial input.