New York State seeks to order Dominican Sisters to violate Church teaching

New York State Governor Cathy Hochul, a Catholic, who has never met a statute or policy opposing Church teachings she was unwilling to support, signed 2023’s LGBT Long-Term Care Facility Residents’ Bill of Rights into law. Among its provisions, the law requires nursing home operators to use pronouns, assign rooms, and grant access to patients based solely on their self-proclaimed gender identities.

The Dominican Sisters of Hawthorne, who operate a skilled nursing facility for indigents “from all walks of life, ideologies, and faiths” dying of cancer, filed suit challenging the law on April 7 in a federal trial court in New York.

Dominican Sisters of Hawthorne, and Servants of Relief for Incurable Cancer DBA as Rosary Hill Home v. Hochul seeks to enjoin the law’s enforcement for violating their constitutional rights based on their belief in Catholic Church teachings that people cannot change their biological sexes; they also request attorney fees to cover the cost of the litigation.

Given the potentially far-reaching impact of Dominican Sisters, this column reviews its background before offering analysis and commentary on its significance for religious freedom.

Background

Mother Mary Alphonsa, formerly Rose Hawthorne Lathrop (daughter of Nathaniel Hawthorne, author of the classic novel The Scarlet Letter), founded the Dominican Sisters of Hawthorne, Congregation of Saint Rose of Lima, in 1900. A convert to Catholicism wishing to serve God and the poor, she opened the 42-bed facility at the congregation’s motherhouse that separates men and women by floors while providing compassionate, dignified, palliative care, and comfort to indigent, incurable cancer patients in their final days.

The New York law requires officials at long-term care facilities to assign those receiving care to rooms based on their gender identities rather than biological sexes, regardless of other patients’ wishes, use their preferred pronouns even when not present, and post notices affirming compliance with its dictates. It also requires staff to undergo “cultural competency” training at least once every two years in attempting to force them to comply with the state’s preferred gender ideology.

Failure to comply subjects the Sisters to the risk of fines, the loss of Hawthorne Hills’ license, and even imprisonment for violating the law.

Despite the lack of complaints about the care they provided through January 31, 2026, on receiving the third of three letters from the New York Department of Health on January 25, 2026, reminding the Sisters of their purported statutory duties, they requested an exemption from its demands. After not receiving the courtesy of a response, the Sisters filed suit challenging the law on seven overlapping constitutional grounds, declaring that it is neither justified by a compelling state interest nor is it implemented by the least restrictive means.

The Sisters’ initial claim is that the law violates the First Amendment’s Free Exercise Clause in directing them to act in a manner inconsistent with their beliefs by associating with persons who reject Church teachings. Second, the Sisters charged that the law infringes on the related Church autonomy doctrine banning governmental interference in internal religious matters.

Third, the Sisters asserted that because the some fourteen religious sisters at Hawthorne Hill who care for the cancer patients with the help of lay certified nursing assistants are ministers dedicated to following Church teachings, the statute breaches the related ministerial exception, which forbids states from interfering in how ministers carry out their duties.

Fourth and fifth, the Sisters maintained that the law contravenes the First Amendment Establishment and Fourteenth Amendment Equal Protection Clauses by favoring one religion over another in granting an exemption to the Church of Christ, Scientist, but not Catholics or other faiths. Charges six and seven concern the related claims that the law transgresses their First Amendment rights of free speech and expressive association by seeking to compel staff members to address people by their preferred pronouns rather than their birth sexes, to undergo biennial training on gender ideology, and to associate with individuals whose beliefs are fundamentally at odds with Church teachings.

Analysis and commentary

As an initial matter, the New York law represents little more than the latest front in the ongoing culture war targeting religious freedom. While individuals experiencing gender dysphoria should be treated with respect, it is unclear why New York officials are seeking to limit religious freedom by imposing ideological demands on the Hawthorne Sisters and other faith-based groups caring for those with cancer approaching death by directing them to violate their sincerely held religious beliefs. The law also requires caregivers to allow biological men identifying as women to share rooms and facilities with females who may be uncomfortable with such arrangements.

In targeting the Sisters who have done so much good for so many for so long without any complaints, this situation calls to mind a worry Justice Alito raised in his dissent in 2015’s Obergefell v. Hodges, wherein the Supreme Court discovered a heretofore unidentified Fourteenth Amendment Equal Protection Clause right to same-sex unions. Justice Alito expressed his dismay that “people of faith can take no comfort in the treatment they receive from the majority today,” cautioning that it remains to be seen whether those who “cling” to their Christian beliefs will be limited to being able “to whisper their thoughts in the recesses of their homes, but if they repeat those views in public, they will risk being labeled as bigots and treated as such by governments….” As New York continues to harass the Sisters, it appears that Alito’s fears are coming to fruition.

Turning to the legal heart of the matter, when governmental actions such as the disputed statute seek to limit fundamental rights such as freedom of religion, speech, and/or association as identified in the First Amendment, they are subject to what the Supreme Court describes as strict scrutiny analysis. When courts apply strict scrutiny, the most stringent level of constitutional review, governmental limits on these rights can only be justified if they are based on compelling state interests implemented by the least restrictive means possible. Consequently, courts typically invalidate such ideologically based restrictions as New York seeks to impose on the Hawthorne Sisters.

The Sisters should be further heartened in light of the Supreme Court’s 2021 decision in Fulton v. City of Philadelphia wherein it found that public officials violated the Free Exercise Clause by refusing to contract with the Catholic Social Services agency unless it certified same-sex couples as foster parents. The Court determined that if public agencies grant exemptions for other reasons, they must also allow them on religious grounds.

Following Fulton, because, as indicated, the New York statute ignored the Court’s holding in granting an exemption to the Church of Christ, Scientist, but not Catholics or other religions, it is looking up for the Sisters. Still, it remains to be seen how the court rules.

Hawthorne Sisters is particularly troubling in light of the official antipathy New York displays toward the Sisters, and by extension, other people of faith when addressing gender dysphoria. Officials seeking to limit religious freedom would be wise to reflect on Justice Jackson’s words in 1943’s West Virginia State Board of Education v. Barnette. In upholding the rights of Jehovah’s Witnesses children to refrain from reciting the Pledge of Allegiance because it violated their religious beliefs, Jackson reasoned:

…freedom to differ is not limited to things that do not matter much. That would be a mere shadow of freedom. The test of its substance is the right to differ as to things that touch the heart of the existing order. If there is any fixed star in our constitutional constellation, it is that no official, high or petty, can prescribe what shall be orthodox in politics, nationalism, religion, or other matters of opinion, or force citizens to confess by word or act their faith therein.

As this dispute plays out, we must hope that officials in New York, and elsewhere, will treat the Hawthorne Sisters, as well as others of faith, with the same respect and dignity they wish for others by protecting their rights to religious freedom even when they disagree with their beliefs.