Tragic Health Care Discrimination Case Sheds Light on the Future of Anti-Discrimination Measures
by Sarah Gehring
Kyler Prescott’s story is important, but may be difficult for some to read, as it involves self-harm and suicide.
The loss of a child by suicide is like an earthquake: devastating anyone at the epicenter, and sending shockwaves through the world at large.
A child’s suicide is always tragic — but even more so in cases when we know that, if it weren’t for anti-transgender hostility, that child could have gotten the help they needed. Kyler Prescott’s story is one such case. Kyler was a victim of illegal discrimination at Rady Children’s Hospital, and his mother Katharine has gone to court on his behalf.
Even if the government won’t protect transgender people, many courts will still uphold the law.
Katharine’s lawsuit, brought by advocates at the Transgender Law Center and the National Center for Lesbian Rights, claims that the hospital violated Section 1557 of the Affordable Care Act, which bars sex discrimination by most health providers (like hospitals and clinics) and insurance companies. This law doesn’t explicitly mention transgender people, but the vast majority of courts that have looked at the issue have said that sex discrimination includes anti-transgender discrimination — and last Wednesday, the District Court for the Southern District of California agreed and allowed Katharine’s lawsuit to go forward.
The court’s decision comes at a time when President Donald Trump’s administration is promoting anti-trans discrimination — sending a message to trans people that even if their government won’t protect them, many courts will still uphold the law. Kyler’s story is just one heartbreaking example of the kinds of discrimination and harm this administration is actively promoting.
Kyler’s story
When 14-year-old Kyler experienced suicidal thoughts and self-harming behaviors related to his gender dysphoria, his supportive mother Katharine took him to Rady Children’s Hospital in San Diego, where she believed he would receive competent medical assistance.
Instead, hospital staff inflamed Kyler’s distress even further. Even though they knew that Kyler was a transgender boy and that — particularly in this vulnerable point in his life — recognizing his gender identity was critical for his health and wellbeing, the staff refused to treat him like a boy. Instead, they reminded him again and again that, as far as they were concerned, he was a girl, repeatedly and intentionally calling him “she” even after his mother begged them to stop putting her son’s wellbeing in danger. One employee, for example, told him, “Honey, I would call you ‘he,’ but you’re such a pretty girl.”
Because of the staff’s mistreatment was so severe, his doctors decided that Kyler needed to be released from the hospital early, even though he was still dealing with suicidal thoughts.
About five weeks later, on May 18, 2015, Kyler took his own life.
What happens next?
The court’s recent decision says that anti-transgender discrimination is a form of sex discrimination under Section 1557 of the Affordable Care Act. This means that now — despite the hospital’s objections — Katharine will be able to make her case and explain to the court why the hospital’s behavior was a type of discrimination made illegal under Section 1557. Now, the court will look at the evidence to decide if the hospital’s mistreatment of Kyler violated Section 1557.
This court is now one of many that has said that sex discrimination includes anti-trans discrimination. Under President Barack Obama, the Department of Health and Human Services (HHS) recognized this near-consensus in the courts and it released an important regulation that makes it clear that anti-trans discrimination is prohibited under Section 1557. This regulation didn’t change the law, but it made it much easier for people like Katharine to address anti-trans health care discrimination in and out of the courts.
But now, under President Trump, HHS is trying to reverse that life-saving progress. From day one, President Trump’s administration has been working to promote anti-trans discrimination, including by undoing that regulation that was passed during the Obama administration. In the coming weeks, HHS plans to try to rewrite these regulations in a way that explicitly excludes trans people. Former Secretary Tom Price just resigned, but the Trump administration will likely continue on this path without him.
No matter how the government’s regulations interpret the law, the meaning of the law itself protects trans people from discrimination.
Still, we have a chance to fight back — for Katharine and Kyler, and for so many other trans people and their families who have faced discrimination and barriers to getting the health care they need.
In Katharine and Kyler’s case, the court said that, no matter how the government’s regulations interpret the law, the meaning of the law itself — along with decades of past court decisions — protects trans people from discrimination. That’s something the Trump administration can’t change on its own. But if the administration rewrites the regulation, it can make it harder for people to succeed in court and to prevent discrimination to begin with. We’re going to do everything we can to stop them from rewriting that regulation — and we’re going to need the whole community’s help to do it.
Our hearts go out to Katharine. We thank her and the teams at the Transgender Law Center and the National Center for Lesbian Rights for bravely fighting for a better future for transgender youth like Kyler.
How can you help?
Right now, the best way to help is by sharing your health care stories with NCTE. If you’ve faced discrimination in health care, you can get legal help. And get ready for more opportunities to take action when HHS releases its rewrite of the nondiscrimination regulation.
Sarah Gehring is a legal intern with NCTE.
Sign up to receive NCTE’s emails, and follow NCTE on Twitter, Facebook, and Medium for the latest news on issues affecting the transgender community. Visit transequality.org for in-depth resources and information on what you can do to support the transgender people in your life.
