Family says Catholic medical clinic denied transgender girl care

A 14-year-old girl says a Catholic medical clinic in Ann Arbor denied her mental health care after learning she was transgender. Tiffinny Moutardier and her mom, Jean Oorbeck, say a doctor at Emmaus Health Partners told them he couldn’t care for her due to the clinic’s “religious affiliation.”

The clinic denies the allegation. “We do not discriminate against patients based on gender identity nor do we refuse to provide care,” the clinic’s executive director said in an emailed statement.

The family has filed a complaint with the state Department of Civil Rights. But even after the expansion of Michigan’s Elliott-Larsen Civil Rights Act in March to include protections for sexual orientation and gender identity, there’s still a big unanswered question: Will religious medical providers be allowed to claim exemptions from the law, and refuse care to transgender patients?

“‘We don’t see transgendered patients in this clinic’” 

Tiffinny Moutardier is just starting the ninth grade. At 14, she can be quiet and watchful in moments, letting her more gregarious family members have center stage. But she’s a deliberate and thoughtful speaker, her eyes crinkling into a soft smile when she laughs.

Sitting on the back deck of her home, overlooking the chicken coop on her family’s farm near Ann Arbor, Tiffinny recalled coming out as transgender to her mom at age eight. “I was just like, ‘OK, I don’t really feel like I’m a boy. I feel like I’m a girl. And like, how I look doesn’t represent how I feel. So I want to change that.’”

As an honor roll student with a packed schedule, she juggles music, art and sports. Lately she and her parents have wondered whether she might have ADHD.

Kate Wells

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Michigan Radio

So in May, her mom Jean made an appointment at a local clinic, Emmaus Health Partners. It offered mental health care, accepted their insurance, and many of the online reviews were glowing. It was only when they arrived for Tiffinny’s appointment that they realized Emmaus is a Catholic health clinic. “I noticed a lot of paintings on the wall, and they were all very religious,” Tiffinny said.

A medical assistant took Tiffinny’s health history, including her prescription for estrogen. Then Dr. Scott Waclawik, a family medicine physician, walked into the exam room.

Almost immediately, it just seemed off,” Tiffinny said. The doctor asked what brought them in, and Jean explained about their ADHD concerns. Waclawik asked again what medications Tiffinny was on.

“He goes, ‘I see Vitamin D…’” Jean recalled. “He didn’t say estrogen. And I said, ‘Well, your medical assistant should have told you, she’s also taking estrogen.’”

Jean then told him about Tiffinny’s possible ADHD symptoms: She makes stations for herself at home, moving from one to the next throughout the day. And she makes what Tiffinny describes as “funny noises” to help herself focus or self-soothe.

But the doctor said he couldn’t help.

“‘I don’t think we have the means to help what seems to be such an extreme case’” of ADHD, Jean recalled the doctor saying, and asked Jean to talk with him in his office.

With her daughter left behind in the exam room, Jean said Waclawik told her Emmaus is a religious health clinic, and “‘we don't feel comfortable with Tiffinny's presence in our office.’”

“‘We don't see transgendered patients in this clinic,’” Jean said he told her. Outraged, she accused him of denying her daughter medical care. At that point, Jean recalled, he seemed to backtrack: We’d be happy to see your daughter if she had a cold, he told her.

Michigan Radio reached out to Emmaus Health Partners for an interview, and provided them with a copy of the complaint Jean subsequently filed with the Michigan Department of Civil Rights. (The department confirmed to Michigan Radio that it had received the complaint.) Michigan Radio also sent Emmaus a response Jean received in June from the Michigan Department of Licensing and Regulatory Affairs, regarding an additional complaint she filed with them and directing her on next steps.

When reached by a reporter, Waclawik declined to comment. Emmaus Health Partners’ executive director, Amanda McMillan sent a statement:

"We have not received notice from any agency that a complaint has been filed against us. In fact, we contacted the Attorney General’s office, LARA and MDCR and none of them have been able to provide us with details of any case against us or any details of any pending case. Thus, we cannot comment on a specific allegation.

“Also, we cannot comment on any specific patient related matter. While we do not have the expertise to provide hormonal management for transgender patients, we do not discriminate against patients based on gender identity nor do we refuse to provide care.”

But Tiffinny didn’t come to the clinic for hormone therapy. She was seeking treatment for ADHD symptoms.

Lawsuits seek religious exemptions from Michigan’s trans civil rights laws

Emmaus Health Partners is not seeking a religious exemption to the Elliott-Larsen Civil Rights Act. But the clinic does follow the Catholic church’s guidance on medical issues, including not providing patients with birth control or abortions.

And the U.S. Conference of Catholic Bishops has signaled it could soon revise its guidance to ban gender-affirming care (including hormone therapy and surgical procedures) in Catholic hospitals and clinics — writing in March that such treatments are “not morally justified” and “do not respect the fundamental order of the human person.” (If the Conference does ban gender-affirming care, that could also apply to 24 Catholic hospitals in Michigan. Nationally, more than one in seven patients receive care from Catholic hospitals.)

Photo courtesy of Whitmer's office.

Meanwhile, three other religious organizations have already filed lawsuits claiming the state’s civil rights protections for transgender people violate their religious freedoms. One of those is Christian Healthcare Centers in Grand Rapids, which argues Michigan’s transgender civil rights protections will either force the Centers to shut down or go against their beliefs:

“...Michigan’s laws require Christian Healthcare Centers to hire people who do not share their faith and to provide cross-sex hormones contrary to its religious beliefs and medical judgment and address people with pronouns that are inconsistent with their biological sex,” reads a press release from the attorneys representing the Centers. “All of this violates the ministry’s religious beliefs and undermines its ability to provide safe and affordable healthcare to the needy and the rest of the community.”

Marcelina Trevino, the director of enforcement in the Michigan Department of Civil Rights, said it’s unclear how much leeway, if any, the courts will give religious organizations that don’t want to provide medical care for transgender people.

Court decisions and Michigan’s civil rights law expansion have made it illegal for individual citizens or secular business owners to deny services, housing, employment, or other public goods to someone based on their gender identity — even if it violates their religious beliefs. But religious organizations, like schools and clinics, are another issue.

“We are in court, and the Attorney General’s office is representing us, in matters where religious organizations have gone to court arguing their religious exemption or exception or protections in these matters,” Trevino said. “However, it's unknown still how the courts will make a determination on that.”

The judge in the Christian Health Centers case recently dismissed the complaint, along with two others brought by a Catholic school and parish. But the court didn’t actually decide whether religious health care providers can refuse medical care to transgender people.

Instead, Judge Jane Beckering of the U.S. District Court of Western Michigan ruled that Christian Healthcare Centers didn’t have legal standing to sue. Because exemptions have been granted to religious groups in the past, the judge said Christian Healthcare Centers couldn’t prove it would necessarily be denied exemptions in this case, too.

Reached for comment, Christian Healthcare Centers referred Michigan Radio to its attorneys at the Alliance Defending Freedom. ADF did not respond to Michigan Radio’s interview request, other than to note they are moving forward with an appeal.

The impacts of health care discrimination 

Transgender people have long experienced discrimination from the health care system. According to a 2021 poll from the Center for American Progress, half of all transgender respondents said they’d experienced “mistreatment or discrimination” from a health provider in the past year.

“There's a pretty significant number of people in the LGBT community who don't go for regular doctor's appointments and don't go to take care of their health, because they've been traumatized by prior care,” said Roz Gould Keith, the executive director and founder of Stand with Trans, a Michigan-based nonprofit that offers support groups and resources for transgender youth and their families.

That day at Emmaus Health Partners, Tiffinny anxiously waited in the exam room while her mom and doctor talked in the other room.

When her mom and the doctor finally returned, Jean explained what the doctor had told her. ”I felt disgust,” Tiffinny said. “It was just so bad. Like it just made me feel like, what a terrible place.”

At first, Tiffinny said, she hesitated to talk publicly about what happened. Her biggest fear was that someone at school would find out. At the time of the appointment in May, Tiffinny was just finishing 8th grade and was not out at school.

But over the summer, Tiffinny changed her mind. For one, she knew she wanted to come out in high school, to finally be her “true self” in every part of her life, she said. And her parents convinced her that talking publicly about what happened could help others, and “raise awareness to how these bad things happen,” she said.

Tiffinny is now in her second week of high school. But she still hasn’t been treated for ADHD. In the months after the appointment at the clinic, Jean said she noticed a change in her daughter: Tiffinny no longer seemed eager to talk to a doctor, or any other medical professional, about her symptoms.

For now, Jean doesn’t want to push it. She’s just keeping an eye out, trying to take her daughter’s lead.