Penn State Health St. Joseph canceled a non-binary patient's scheduled mastectomy citing Catholic doctrine

On July 23, 2024, administrators at Penn State Health St. Joseph Medical Center in Reading, Pennsylvania called EJ Stiles, a 23-year-old non-binary Pennsylvanian, to cancel their scheduled double mastectomy less than 24 hours before the procedure — approximately 13 hours beforehand, according to the ACLU. Hospital staff told Stiles the gender-affirming surgery was "not in alignment with directives of the Catholic Church," despite the facility regularly performing comparable procedures on cisgender patients. Stiles had spent months preparing for the surgery: referred to a surgeon with operating privileges at St. Joseph, they completed all required pre-surgical steps before the abrupt cancellation.

Penn State Health acquired St. Joseph Medical Center in 2015, bringing the formerly private Catholic hospital into a public university hospital system. Even after the acquisition, Penn State Health permitted the facility to continue operating under Catholic healthcare directives that forbid abortions, contraceptives, and interventions that "transform sexual characteristics of a human body." As a hospital within a network governed by Pennsylvania State University — a public institution — Penn State Health St. Joseph is bound by the Pennsylvania Equal Rights Amendment, equal protection provisions of the state constitution, and the Pennsylvania Human Relations Act. The ACLU argues that Penn State Health's decision to honor religious doctrine at a publicly funded hospital also violated the Pennsylvania Constitution's religious freedom provisions by using state authority to enforce church directives.

The cancellation caused lasting harm to Stiles. While waiting months for a new surgical appointment — ultimately obtained at Penn State Health Hampden Medical Center — Stiles's diagnosed gender dysphoria worsened. Extended chest binding caused costochondritis, an inflammation severe enough to require emergency room treatment. Stiles later said the experience "was a devastating eye-opener" that exposed how public institutions' religious policies can deny gender-diverse patients equal access to medically necessary care.

Updates

2025-01 — ACLU of Pennsylvania filed PHRC complaint on behalf of EJ Stiles [1]

The ACLU of Pennsylvania filed a complaint with the Pennsylvania Human Relations Commission on behalf of Stiles, alleging Penn State Health's cancellation of the scheduled mastectomy constituted unlawful sex discrimination. The PHRC ultimately dismissed Stiles's complaint.

2025 — Penn State Health sued PHRC in Commonwealth Court to block anti-discrimination jurisdiction [1]

Penn State Health filed suit against the PHRC in Commonwealth Court, seeking a religious exemption from anti-discrimination protections and asking the court to invalidate PHRC regulations defining sex discrimination to include gender identity. The hospital pressed ahead with its lawsuit even after the PHRC dismissed Stiles's complaint.

2026-07-22 — ACLU of Pennsylvania filed civil lawsuit against Penn State Health in Dauphin County court [1, 2]

The ACLU of Pennsylvania and Patterson Belknap Webb & Tyler LLP filed a lawsuit in the Court of Common Pleas of Dauphin County against Penn State Health, Penn State Health St. Joseph, and Pennsylvania State University on behalf of Stiles, seeking monetary damages, attorneys' fees, and an injunction barring the hospital from enforcing Catholic healthcare directives.