The Dominican Sisters run Rosary Hill Home in Hawthorne, New York, a 42-bed facility providing free skilled nursing care to indigent cancer patients in their final days. The facility receives no state funding but is now involved in a lawsuit because New York State requires them to use gender pronouns, which violates Catholic beliefs. Photo courtesy of Rosary Hill Home.
The Dominican Sisters of Hawthorne, a 125-year-old non-profit order, filed a lawsuit on April 6, 2026, challenging a New York state law requiring long-term care facilities to base pronouns, room assignments, and restroom use on gender identity. Liberals claim conservatives reject biology, but laws forcing the assertion that men can become women because they “identify” as such represent a direct attack on reality, science, and religion.
The Bible is unambiguous on the question. Genesis 1:27 states, “So God created man in his own image, in the image of God created he him; male and female created he them,” and Deuteronomy 22:5 states, “The woman shall not wear that which pertaineth unto a man, neither shall a man put on a woman’s garment: for all that do so are abomination unto the Lord thy God.”
Science is equally unambiguous. Men have XY chromosomes, male genitalia, and male reproductive organs, while women have XX chromosomes, female genitalia, and female reproductive organs. Chromosomal sex is established at fertilization and is present in every cell of the body, where it cannot be changed by surgery, hormones, or legal declaration. A biological male cannot become pregnant, and a biological female cannot father a child. This is why medical records based on biological sex are clinically necessary, as chromosomal reality affects every system in the body.
The Dominican Sisters run Rosary Hill Home in Hawthorne, New York, a 42-bed facility providing free skilled nursing care to indigent cancer patients in their final days. The sisters accept no insurance or government funds and charge patients nothing, relying entirely on private donors.
The lawsuit was filed in U.S. District Court for the Southern District of New York against Governor Kathy Hochul and the state Department of Health. The law, the LGBTQ Long-Term Care Facility Residents’ Bill of Rights, requires nursing homes to assign patient rooms based on gender identity even over a roommate’s objection, use preferred pronouns including when the patient is not present, allow restroom access based on gender identity, and post public notices of compliance.
The state sent the sisters three “Dear Administrator Letters” in March 2024, October 2024, and January 2025, notifying them of their obligation to comply. The sisters stated they have not complied, and do not intend to.
The law applies to all licensed nursing homes in New York State, with the trigger being the state license to operate rather than the receipt of state funding. Courts have generally allowed the government to attach conditions to public funding, but applying mandates to private religious organizations that take no public funds is a significantly harder legal argument for the state, and more likely to be seen as direct infringement on religious freedom and free speech. New York granted an exemption to facilities run by the Church of Christ, Scientist, but not to Catholic institutions.
During a four-year reporting period, Rosary Hill Home received zero complaints from residents, compared to more than 55,000 complaints against other New York nursing homes over the same period. The sisters’ lawyer, L. Martin Nussbaum, noted that in over 125 years the sisters have never once had a patient seeking to transition, making the mandate a case of the state requiring the sisters to be trained in an ideology entirely contrary to Catholic belief despite no practical basis for the requirement.
The lawsuit asks the court to declare the mandate a violation of the sisters’ First and Fourteenth Amendment rights and to block enforcement while the case proceeds.
The First Amendment protects not only the right to speak but the right not to be compelled to say things one disagrees with. In 303 Creative v. Elenis (2023), the Supreme Court ruled that Colorado could not force a Christian web designer to create websites celebrating same-sex marriages, holding that compelling someone to speak a message that violates their beliefs is unconstitutional even when the state frames it as an anti-discrimination measure.
In Burwell v. Hobby Lobby (2014), the Court established that religious exercise extends to how an organization operates, not just what it professes. In Fulton v. City of Philadelphia (2021), the Court ruled unanimously that the city could not exclude Catholic Social Services from its foster care program over its religious beliefs, with the Court specifically sensitive to selective exemptions, exactly the mechanism New York employed by exempting Christian Scientists while excluding Catholics.
The combination of compelled speech, selective exemption, and no public funding places the state in a weak legal position on all three fronts.
The case is also a medical integrity argument that requires no religious belief to sustain. Male and female bodies differ in hormone profiles and medication response, cardiovascular disease presentation, drug metabolism, cancer risk, bone density, immune response, and surgical anatomy.
If a hospital records a biological male as female, every downstream clinical decision, including dosing, screening, and risk assessment, is built on false data. Medical records are legal documents, and a biological male recorded as female will not be flagged for prostate screening, may receive incorrect drug dosing, and creates emergency care confusion for physicians who need accurate biological information immediately. The British Medical Journal and other peer-reviewed publications have documented cases where transgender patients received incorrect care precisely because recorded gender did not match biological sex.
Room assignment by gender identity rather than biological sex creates privacy violations for patients who did not consent to share a room with someone of the opposite biological sex, safety risks for elderly, cognitively impaired, or terminally ill patients who cannot advocate for themselves, and confusion around personal care duties that in nursing home settings involve intimate physical care.
If a care facility is legally required to treat a patient as the gender they declare, the logical endpoint has no principled stopping point. A patient declaring a different age, a different medical history, or a different diagnosis would be overruled by clinical fact. Biological sex is equally a clinical fact, and there is no coherent medical argument for treating it differently from other objective biological data.
The Dominican Sisters are right based on reality, science, and religion. However, in a liberal state like New York, the court may ignore all of that and rule against them.
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