U.S. Hospital Pays $410,000 After Firing Healthcare Worker with a Conscientious Objection to Gender-Affirming Care

A hospital in the U.S. state of Michigan has paid $410,000 to settle a protracted lawsuit brought by a healthcare worker who was fired in 2021 after refusing, on the basis of her Christian beliefs, to participate in gender-affirming care. The case brought by physician assistant Valerie Kloosterman against University of Michigan Health-West raises a question that extends beyond a single hospital: should healthcare workers be allowed to refuse to participate in treatment that violates their conscience without losing their jobs?

The Dismissal and Legal Proceedings

Kloosterman had worked at the hospital for seventeen years with positive performance reviews before she was fired in 2021. The reason was her objection to mandatory training on gender identity and to participating in referrals for gender transition and the use of pronouns that did not correspond to a person’s sex at birth. According to Kloosterman, the hospital had always accommodated her religious objections in the past, until its policies on gender-affirming care were tightened. In October 2022, the First Liberty Institute filed a federal lawsuit on her behalf, arguing that her dismissal violated religious freedom and statutory protections against religious discrimination. A three-judge panel of the U.S. Court of Appeals for the Sixth Circuit unanimously ruled in her favor, after which both parties reached a settlement in July 2026.

The Settlement: Money and a New Policy

In addition to the $410,000 in compensation for Kloosterman and her attorneys, the settlement requires the hospital to do more than simply pay money. University of Michigan Health-West must implement a formal religious accommodation policy, inform and train its staff about it, and from now on provide employees with a reasonable opportunity to refuse to participate in actions that conflict with their religious beliefs — without fear of retaliation. Specifically, this includes performing gender transition procedures or being required to use pronouns that do not correspond to a person’s sex at birth. The hospital has since implemented the new policy, and Kloosterman was represented not only by the First Liberty Institute but also by the law firms Clement & Murphy, LightStone Law, and Bossenbrook Williams.

What This Case Reveals More Broadly

The Kloosterman case is not an isolated one. In the United States, multiple lawsuits are pending involving healthcare workers who say they were pressured to participate in gender-affirming care against their conscience or were fired for refusing to do so. Pressure also comes from within the profession itself, as became clear when an ACOG section chair had to step down after criticizing the WPATH guidelines. The outcome of this case — a unanimous ruling by a federal court followed by a settlement involving structural policy changes — gives those cases a precedent to cite. In British Columbia, Canada, the outcome was different: a doctor was fined after refusing to prescribe a puberty blocker, as trans-nederland.nl reports. It touches on a tension that institutions are increasingly recognizing: how does the professional duty to provide patients with access to care relate to the right of individual healthcare workers, within limits, to refuse to participate in that care personally? For hospitals and healthcare institutions elsewhere, the settlement is a signal that dismissal on these grounds may be legally vulnerable, and that a detailed conscientious objection policy — with a clear procedure for reporting and honoring religious objections — is one way to reduce that risk. A separate article discusses how gender in the workplace plays out in the Netherlands.