First Liberty Institute, a non-profit legal organization, filed a federal lawsuit against University of Michigan Health-West on behalf of Valerie Kloosterman, a physician assistant fired after she requested a religious accommodation from referring patients for transgender surgical procedures and drugs, as well as using patients' preferred pronouns.
Ms. Kloosterman is a third generation health care worker and worked in her local clinic for 17 years. During this time, she regularly received appraising reviews from her patients and her supervisors are quoted calling her "professional," "very ethical," and a "pleasure to work with," according to a Fox News article. Then, in 2021, The University of Michigan Health - West (UMHW) took over the clinic. Upon the acquisition, employees at the hospital were instructed to take a Diversity, Equity and Inclusion (DEI) module that required her to affirm statements concerning sexual orientation and gender identity which she believes went against her Christian faith. The module itself would not let her choose "No" when asked to affirm these principles, as she was informed beforehand that failure to mark "Yes" would result in termination. She then sought a religious exemption from the module and an accommodation for gender affirming surgery referrals through the human resources department but was denied. According to Ms. Kloosterman, during follow-up meetings, the DEI Coordinator called her “evil,” blamed her for gender dysphoria-related suicides, and told her she could not take the Bible or her religious beliefs to work with her. Less than a month later, she was fired.
After her termination, she filed a charge of discrimination with the Equal Employment Opportunity Commission. Her attorney's contacted Michigan Health and asked for her reinstatement but they refused. So in October of 2022, First Liberty filed a lawsuit on behalf of Ms. Kloosterman. Then, in September 2023, Federal Judge Jane Beckering allowed her religious discrimination claims to proceed, ruling that there was valid evidence that Ms. Kloosterman's freedom of religion was being threatened by violation of the Free Exercise Clause.
During the latest completed trial, Kloosterman's legal team made a compelling case and the court ruled in agreement with them. They argued that the hospital ultimately made her choose between acting against her religious beliefs or losing her job. According to them, forcing this choice upon her significantly burdened her religious beliefs. Additionally, during the final meeting, a hospital administrator allegedly mocked her beliefs, telling her she "could not bring the Bible to work" and she was “evil” for her refusal to use pronouns. They argued that if decision-makers show hostility toward religious beliefs, their policies may violate the Free Exercise Clause as actions of hostility are not considered neutral. Finally, Kloosterman requested a religious accommodation, proposing to use patients' names instead of pronouns and refer gender affirming patients to other doctors. The hospital denied her request without offering an alternative solution. This violates the Free-Exercise Clause because a law or workplace policy that burdens religious practice must be neutral and generally applicable, meaning it applies equally to everyone without targeting religious beliefs. Kloosterman alleged that UMHW’s policy allowed secular exceptions and targeted religious objections by denying only religious-based accommodations.
In my opinion, I do believe that terminating Ms. Kloosterman is a violation of her First Amendment Right to the freedom of religion and the Free Exercise Clause. The DEI Coordinator's choice of words and the manner in which they terminated her clearly represents hostility toward religion. As cited in Kennedy v. Bremerton School District, with reference to the Free Exercise Clause, she did not deserve to be fired or suspended simply for staying true to her religious convictions, as actions of hostility are not considered neutral. Ms. Kloosterman herself never explicitly expressed hatred towards any of LGBTQ+ individuals in the past, she was simply trying to receive an accommodation and was willing to use their names instead of pronouns. And, in fact, accommodations for doctors treating patients have been made at this hospital for secular reasons. For example, a doctor can opt-out of a surgery or procedure for medical reasons such as an injury to their hand or sickness. In Fulton v. City of Philadelphia, the Supreme Court ruled that if an employer grants secular accommodations but refuses religious ones, it may violate the Free Exercise Clause. If opt-outs are already part of the medical system, I don't see why they can't make an exception for religion. This is different from majority rulings in cases like Braunfield v. Brown, in which the majority ruled against an accommodation. The court decided, at least in part, that allowing Orthodox Jewish businesses to open on Sundays would present them with an economic advantage over Christian businesses and problems policing the law would arise. I do not see this being the case here, being that an efficient accommodation system is already in place. Similarly, the dissenting opinion in Braunfield argued that 21 out of the 34 states that enforced Sunday laws had functioning accommodation systems for Orthodox Jews, further disproving the claim that it would disrupt the flow and structural of the system in place. Furthermore, Ms. Kloosterman has lost her source of economic income because of a choice that her employer placed upon her. Forcing a person to choose between their livelihood and religious beliefs, while indirect, places a burden on their ability to practice religion freely. This argument is also very similar to that of the dissenting opinion in Braunfield. They argued that enforcing this choice has virtually the same effect as a tax on religious text would, and this type of tax was struck down in Follet v. Town of McCormick.
Some may imply that by her refusing to refer gender affirming procedures, as well as refraining from using a patient's desired pronouns, that she is being discriminatory and this would violate discrimination laws. I don't believe this to be true. If she was fired on the basis of her performance or she herself was being hostile towards a LGBTQ+ individual, this would be a different story. Others may say that Ms. Kloosterman took an oath to provide medical attention to anyone in need, no matter how much she disagrees with them. And in theory, if she was accommodated, it could have a slippery slope effect and entice other doctors to refuse treatment for individuals who they disagree with in some way. I don't think this scenario will play out this way. Let's be clear that gender affirming surgery is not an emergency surgery. She is not saying she, nor should anyone, deny any type of emergency service for a member of the LGBTQ+ community, rather she is simply referring gender affirming patients to another doctor who does not have religious obligations.
Either way, this case definitely has implications for the types of accommodations that will be made in workplaces in the future. As of February 2025, the Sixth Circuit Court of Appeals heard oral argument in the case. Be on the lookout for more actions as Ms. Kloosterman's case progresses.
Sources:
https://www.yahoo.com/news/christian-physician-assistant-fired-opposition-100049802.html
https://firstliberty.org/cases/valerie-kloosterman/#simple1
https://firstliberty.org/wp-content/uploads/2025/02/Release_Kloosterman_MTD_9.21.23_FNL.pdf
https://firstliberty.org/wp-content/uploads/2022/10/Release_Kloosterman_Lawsuit_10.11.22_FNL.pdf
https://www.supremecourt.gov/opinions/21pdf/21-418_i425.pdf
https://www.supremecourt.gov/opinions/20pdf/19-123_g3bi.pdf
https://supreme.justia.com/cases/federal/us/321/573/
13 comments:
This is a very interesting case as it involves a medical worker. One could argue that medical professionals, no matter what, will be serving diverse groups of people and should follow ethical standards. However, I believe that she did not do anything that went against these standards. As you pointed out, she simply wanted to meet in the middle and refer to these patients as their names and not their preferred pronouns. It does not seem to me that she did anything offensive or harmful to these patients, therefore she should receive religious accommodation, and her termination does in fact violate the Free Exercise Clause. It will be interesting to see the decision the Court makes and how they come to it, as it will have major implications on future cases.
This seems to bring the debate between belief and action/ inaction back into play. Kloosterman was not asking to practice evangelizing her faith in the workplace, but rather to simply not perform actions that work against her own faith while in the workplace. Nor was she suggesting that the clinic change their policy on who they serve, but simply asking for a personal exemption against a very particular kind of work that is not involved in life-or-death situations. Her termination was directly related to her religious beliefs, which she was forced to reveal and then discriminated against when others found out, which is definitely a violation of her right to Free Exercise. For the law to condemn her would lead to the governments elevating one set of beliefs over hers in particular, which would also violate the Establishment Clause that works to prevent the government from enforcing any particular religion.
I agree with everyone above. Kloosterman had an inaction against promoting transgender procedures and using their pronouns. She did not want to offend anyone by not doing these things, but she felt religiously inclined not to promote these pronouns and transgender surgeries. She just wanted a personal exemption to these policies, not asking anyone to not do this around her. I agree that Kloosterman getting fired violated her free exercise clause. Her employer should not punish her for her religious convictions to not use pronouns because she is not violating peace and good order by doing so. She is not inherently trying to be discriminatory, and she is still willing to use proper names, just not pronouns that she finds morally wrong.
I also agree with everyone else. Kloosterman is a trained professional who is highly accredited in her profession. When she sought a religious exemption from the DEI efforts that required her to affirm beliefs about gender identity and sexual orientation since they went against her religious conviction, she was fired and very clearly discriminated against. In seeking the religious exemption she was not trying to practice her faith in the work environment nor discriminate against certain groups of people. She was merely asking not to perform certain surgeries and say gender-affirming words that go against her religious convictions. This would allow her to freely exercise her religious beliefs in a neutral way, as she would still perform all other surgeries and allow everyone else to perform said surgeries, just not ones that go against her religion. As exclaimed by Sam, once it was revealed that Kloosterman wouldn't practice the DEI efforts, the DEI coordinator "called her “evil,” blamed her for gender dysphoria-related suicides, and told her she could not take the Bible or her religious beliefs to work with her." This makes it clear that she was solely fired for religious purposes. By denying her a reliable accommodation the government would ultimately violate the Free Exercise Clause.
I agree with this viewpoint. It was discrimination when Kloosterman, a highly skilled medical professional, was fired for asking for a religious exemption from DEI rules that went against her beliefs. She was merely looking for a way to avoid engaging in activities that went against her religious beliefs. She wasn't rejecting care or forcing her ideas on others. Her rights under the Free Exercise Clause are immediately violated when she is denied this accommodation and faces hostility at work.
I think that case is very interesting, because while forcing her to call her patients by their preferred pronouns would seem like an obvious injustice, I would argue that, because she was employed at a public university owned hospital, she should be required to treat every patient to the best of her ability equally regardless of their gender identity. This is healthcare that is helpful at combatting gender dysphoria, which is a medical condition that many trans people are faced with. Additionally, by treating them differently in any way, an healthcare professional are exacerbating the vast number of inequities that transgender people already face in our society. By refusing to administer treatment to a patient in need of care, regardless of urgency, should be grounds to fire any doctor.
This case is interesting as it allows some insight into the constitutionality of allowing companies to pick and choose which patients they serve, under what circumstances. I would argue that because she is a medical professional, which is an occupation which requires the operational capacity to execute critical, life-saving care, the individuals employed should be willing to operate indiscriminately under any circumstance on any patient, and so I believe that they should not rule in favor of Kloosterman.
In general, Kloosterman's choice to not perform certain gender transitioning surgeries or say gender affirming things that do not align with her religious beliefs are within her constitutional rights. This does risk the potential for an extremely steep slippery slope in people denying public services to minority groups. This case attempts to clarify the boundary between discrimination and freedom of religion. It is important to recognize that Kloosterman is not denying urgent or necessary care on the basis of disliking an individual, instead she is denying acting in ways that go against her religious convictions. Any other issues balancing discrimination and religion can be judged on a case to case basis.
I agree with your reasoning. Ms. Kloosterman’s termination for requesting a religious accommodation clearly places her in an unfair bind—forcing her to choose between her professional role and her deeply held Christian beliefs. This situation, where secular accommodations are granted while religious ones are denied, not only challenges her First Amendment rights under the Free Exercise Clause but also risks setting a troubling precedent. When an employer decides what counts as acceptable religious practice, it undermines the neutrality required by the law and could have long-term implications for how religious freedoms are upheld in the workplace.
This case is very interesting. While I can see both sides of the argument, I think that Kloosterman was unjustly fired due to her religious beliefs. This violates her first amendment rights by forcing her to choose between her religious beliefs and her job. She was not denying necessary care to people, rather she was just following her religious beliefs.
This is a tough case as it challenges both the rights of the patients and the rights of Kloosterman. I do not believe Kloosterman should have been fired for requesting a religious accommodation, and she should have rather been prescribed patients with issues that were not in direct contrast with her religion. These patients deserve to get the best care, and Kloosterman should not be forced to serve anyone that may force her to go against her values. Complete termination for this fact is unconstitutional as her free exercise is being violated for not allowing her an exemption for these reasons.
I also agree that Kloosterman didn't deserve to be fired for asking for a religious accommodation. I think there was a better way to work around the issue, to provide the best care for these patients. The act of firing is unconstitutional because she has a right to hold these beliefs.
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