Intermountain Health will not provide ‘bottom surgery’ for trans patients, despite hiring surgical director with that expertise

KUER reported that while Intermountain has never offered such surgeries, the hospital system apparently planned to and accepted patients for such care before reversing the decision.

After hiring a plastic surgeon with expertise in “bottom surgeries” as its new gender care surgical director, Intermountain Health will not provide that care for transgender adults diagnosed with gender dysphoria.

Suzanne Draper, Intermountain’s vice president for business ethics and compliance, confirmed in April that the company “has never offered phalloplasty, vaginoplasty and metoidioplasty as part of its gender-affirming care,” according to a letter obtained by The Salt Lake Tribune. And in a statement provided to The Tribune, the health care system said it “has made no changes to the extensive adult gender care services it provides to the community, including surgeries.”

However, it appears Intermountain was planning to start offering the surgeries to such patients with the hiring of Dr. Nicholas Kim. KUER reported Thursday that transgender patient Amber Chevrier was scheduled to receive a vaginoplasty from Kim at Intermountain Health, until she received a call in February canceling the procedure.

Sue Robbins, a member of Equality Utah’s Transgender Advisory Council, said Thursday she had heard from at least one patient with a similar experience.

Intermountain noted in its statement that the procedures, known as bottom surgeries, “are offered in the community by other providers.” The statement did not say Kim was hired to perform such surgeries, but that “Intermountain aims to hire the best, most skilled surgeons. Some surgeons or providers have skills that are not utilized in their current role.”

“Intermountain always has and continues to help patients navigate their gender care journey and is committed to helping these patients connect with the care they need,” the statement said, “whether internal to Intermountain Health or through our community partners and referral resources.”

The news of Intermountain’s reversal comes after Utah lawmakers passed a bill in January that bars transgender children from accessing most gender-affirming care, such as hormone therapy and surgeries. Utah is one of 19 states to pass such a law this year, according to the Human Rights Campaign.

Business decision or discrimination?

Draper confirmed Intermountain does not provide bottom surgeries to transgender patients in a letter responding to a transgender employee’s discrimination complaint, following the hospital system’s apparent reversal in expanding gender-affirming care to include bottom surgeries.

The employee, Sylvia Mouton, said in the complaint that Intermountain had not been forthcoming about its decisions regarding these surgeries, and alleged the policy was discriminatory because such surgeries are available to patients without gender dysphoria.

“[N]ot allowing bottom surgeries for those who have been diagnosed gender dysphoria but allowing these surgeries in other context (like reconstruction after a horrible accident or an illness) is clearly making a distinction against those who are suffering from gender dysphoria from people who are wanting these surgeries for other reasons,” Mouton wrote.

Draper told the employee that the company didn’t find “evidence of discrimination” in its decision.

“Intermountain is dedicated to serving our LGBTQ+ patients, specifically transgender and gender diverse patients,” she said. “The adult gender care program at Intermountain Health currently provides a wide variety of gender-affirming services (medical and surgical) and will continue to provide them.”

Mounton has since submitted a complaint to U.S. Department of Health and Human Services’ Office for Civil Rights.

Where can one get gender-affirming bottom surgery?

Intermountain said in its statement that it would connect patients with providers who would do these surgeries. It added that SelectHealth, the nonprofit health insurance company and subsidiary of Intermountain, “facilitates medically appropriate care at other facilities when not available at network facilities.”

Still, it is not clear what hospitals in the state will perform bottom surgeries.

University of Utah Health providers do offer such surgeries, according to spokesperson Kylene Metzger. She did not answer The Tribune’s questions about whether Intermountain’s policy has increased the number of patients seeking such care at U of U Health.

Robbins said U of U Health was the first hospital system in the state to offer such surgeries and are likely the only providers in the state.

The Catholic-affiliated Holy Cross hospitals, which were recently renamed and acquired from Steward Health Care by CommonSpirit Health, do not offer these or any other gender-affirming surgeries, because they follow the faith’s “ethical and religious directives.”

Those directives bar it from offering services such as surgical contraception, in vitro fertilization, gender-affirming surgery and physician-assisted suicide.

In March, the United States Conference of Catholic Bishops released a document that said, “Catholic health care services must not perform interventions, whether surgical or chemical, that aim to transform the sexual characteristics of a human body into those of the opposite sex or take part in the development of such procedures.”

The statement also said, “They must employ all appropriate resources to mitigate the suffering of those who struggle with gender incongruence, but the means used must respect the fundamental order of the human body.”

Another hospital system in Utah, MountainStar Healthcare, did not immediately respond to The Tribune’s request for comment Thursday.