U.S. District Judge Stefan R. Underhill has ruled that a transgender doctor could go forward with her sex discrimination claim under Title VII of the Civil Rights Act of 1964 against a Connecticut hospital. Noting a split of authority among federal circuit courts of appeals and the lack of a controlling ruling from the U.S. Supreme Court or the Court of Appeals for the 2nd Circuit, Judge Underhill found more persuasive the more recent opinions finding that “sex” in the Civil Rights Act should be broadly construed to include gender identity, as opposed to older rulings rejecting such an argument. Fabian v. Hospital of Central Connecticut, 2016 U.S. Dist. LEXIS 34994 (D. Conn., March 18, 2016).
According to her complaint, Dr. Deborah Fabian had applied and was very nearly hired as an on-call orthopedic surgeon at the Hospital of Central Connecticut. She was recruited for the position by Delphi Healthcare Partners, a third-party provider of physicians and management services to health care institutions. Fabian, who initially presented herself in the hiring process as Dr. David Fabian, claims that she was “all but hired” and had even been sent a proposed contract, which she had signed, and that she considered the final interview with hospital officials to be a “formality.” Indeed, relying on representations from Delphi, she and her wife sold their home in Massachusetts, contemplating the move to Connecticut. During the interview she disclosed that she was a transgender woman in the process of transition and would be reporting to begin work as Dr. Deborah Fabian. She was later informed that she would not be hired.
She took her discrimination claim and the hospital and Delphi to the EEOC, alleging a violation of the federal sex discrimination statute as well as Connecticut’s statute. At the time, Connecticut’s statute had not yet been amended to add an explicit prohibition of discrimination because of gender identity, so under both statutes her claim was that the employer failed to hire her due to her gender identity and that this was sex discrimination.
In moving for summary judgment, the hospital focused on several lines of attack. It argued that she was not being considered for a staff employee position, but rather to be an independent contractor retained through Delphi, and thus in effect a subcontractor of a subcontractor. Since the anti-discrimination laws apply only to employment, the hospital argued that they did not apply to this case. Secondly, the hospital argued that its decision not to hire her was based on its conclusion from the interview that she was reluctant to take late-night calls to the Emergency Department, was uncomfortable with their new electronic records system, and that she wanted a job that involved performing more surgery. Finally, and cutting to the chase, the hospital argued that gender identity discrimination claims are not actionable under Title VII or under the Connecticut state law as it was when this case arose.
Attacking the subcontractor point, Judge Underhill found that many factual issues would have to be resolved before determining whether Dr. Fabian was applying to be an employee of the hospital. Formal titles and contractual arrangements are less significant in these types of cases than a broad array of factors that the Supreme Court has identified in determining whether somebody is an employee or an independent contractor. In the health care field, companies frequently try to structure their relationship with professional staff in such a way as to avoid the legal entanglements of an employment relationship, and some health care professionals may prefer the autonomy of not being full-time employees. The Supreme Court has identified more than a dozen distinct factors to consider in making this determination, with particular emphasis on the degree to which the alleged employer controls the work of the employee. The court found that there were enough disputed factual issues here to preclude making a determination based on a pre-trial motion without the benefit of an evidentiary hearing. The judge found that Fabian’s factual allegations were sufficient to create a material factual issue on such questions as “control,” so denied the motion on this ground. The judge also found that factual issues would need to be resolved concerning the hospital’s contentions, disputed by Fabian, about her willingness to handle late-night calls, deal with the information system, or enthusiastically take the job despite the amount of surgery involved.
The main question, to which the judge devoted most of his opinion, was whether Fabian was alleging a kind of discrimination covered by these statutes. Judge Underhill reviewed the history of the inclusion of sex in Title VII and its subsequent interpretation, noting that for many decades after the statute went into effect in 1965 the Equal Employment Opportunity Commission (EEOC) and the courts had taken the view that gender identity claims were not covered. However, things began to change after the Supreme Court’s 1989 decision in Price Waterhouse v. Hopkins, where the Court accepted the plaintiff’s contention that her promotion had been denied because various of the firm’s partners objected to her failure to conform to their stereotyped views about how a “woman partner” should act, groom and dress. With sex stereotyping accepted as evidence of a sex-discriminatory motivation, courts began to accept the argument that discrimination against transgender persons involves sexual stereotypes in violation of Title VII. By early in the 21st century, some federal circuit courts had adopted this view, which was finally embraced by the EEOC in a 2010 decision involving federal employment, which was subsequently endorsed by the Justice Department.
Judge Underhill stated his agreement with the courts “that have held that %Price Waterhouse% abrogates the narrow view” that had been taken in earlier decisions. “The narrower view relies on the notion that the word ‘sex’ simply and only means ‘male or female,’” he continued. “That notion is not closely examined in any of the cases, but it is mistaken. ‘Male or female’ is a relatively weak definition of ‘sex’ for the same reason that ‘A, B, AB, or O’ is a relatively weak definition of ‘blood type’: it is not a formulation of meaning, but a list of instances. It might be an exhaustive list, or it might not be, but either way it says nothing about why or how the items in the list are instances of the same thing; and the word ‘sex’ refers not just to the instances, but also to the ‘thing’ that the instances are instances of. In some usages, the word ‘sex’ can indeed mean ‘male or female,’ but it can also mean the distinction between male and female, or the property or characteristic (or group of properties or characteristics) by which individuals may be so distinguished. Discrimination ‘because of sex,’ therefore, is not only discrimination because of maleness and discrimination because of femaleness, but also discrimination because of the distinction between male and female or discrimination because of the properties or characteristics by which individuals may be classified as male or female.” The judge cited historical references to support his contention that such broader understandings of sex date back as far as 1755, in Dr. Samuel Johnson’s dictionary of the English language, and he found a similarly broad understanding in dictionaries contemporary with the adoption of Title VII in the 1960s. Thus, even in the absence of direct evidence about what the drafters of the “sex” amendment thought in 1964, there is indirect evidence that a broader understanding of the word and concept then existed.
The judge also quoted a favorite hypothetical case put by proponents of coverage for gender identity discrimination: just as an employer who had no bias against Christians or Jews could be held to have discriminated because of religion if she discharged an employee for converting from one religion to the other, an employer who has no particular bias against men or women could be held to discriminate because of sex if he discharged an employee for transitioning from male to female. He insisted that no court would make the mistake of finding no discrimination because of religion in the case of the religious convert. “Because Christianity and Judaism are understand as examples of religions rather than the definition of religion itself,” he wrote, “discrimination against converts, or against those who practice either religion the ‘wrong’ way, is obviously discrimination ‘because of religion.’ Similarly, discrimination on the basis of gender stereotypes, or on the basis of being transgender, or intersex, or sexually indeterminate, constitutes discrimination on the basis of the properties or characteristics typically manifested in sum as male and female – and that discrimination is literally discrimination ‘because of sex.’”
Thus he concluded, “on the basis of the plain language of the statute, and especially in light of the interpretation of that language evident in Price Waterhouse’s acknowledgment that gender-stereotyping discrimination is discrimination ‘because of sex, . . . discrimination on the basis of transgender identity is cognizable under Title VII.” In a footnote, he observed that he would reach the same conclusion under the pre-amended Connecticut statute. The legislature’s subsequent addition of the term “gender identity” to the statute did not require a different conclusion “because legislatures may add such language to clarify or settle a dispute about the statute’s scope rather than solely to expand it.”
With the denial of the hospital’s summary judgment motion, the case can proceed to trial unless a settlement is reached. The court noted that Delphi did not join in the motion for summary judgment.
Dr. Fabian is represented by Theodore W. Heiser of Sullivan Heiser LLC, of Clinton, Connecticut.
Judge Underhill was appointed to the District Court by President Bill Clinton.Tags: Connecticut Fair Employment Practices Act, Dr. Deborah Fabian, employment discrimination, Fabian v. Hospital of Central Connecticut, gender identity, gender identity discrimination, gender stereotyping, independent contractor, sex discrimination, sex stereotyping, Theodore W. Heiser, Title VII, transgender, U.S. District Judge Stefan R. Underhill