A transgender woman in Arizona said this week that a CVS Health pharmacist refused to fill a prescription for hormone therapy, prompting the drugstore company to apologize, say the conduct violated its policy and note that the pharmacist was no longer employed there.
Hilde Hall, who lives in Fountain Hills, Ariz., a suburb of Phoenix, said in a statement posted Thursday on the American Civil Liberties Union’s website that she went to the pharmacy in April after receiving her first prescriptions for hormone therapy. Ms. Hall, 25, said a CVS pharmacist refused to fill one of the prescriptions, did not provide a reason and then declined to return her doctor’s prescription note.
A CVS spokesman, Michael J. DeAngelis, said in a statement on Friday that the pharmacist’s conduct “does not reflect our values or our commitment to inclusion, nondiscrimination and the delivery of outstanding patient care.”
Mr. DeAngelis said the pharmacist was no longer employed at CVS, but he would not clarify whether the pharmacist was fired after the company learned about Ms. Hall’s encounter.
Ms. Hall wrote that her experience at a CVS in Fountain Hills was embarrassing and distressing.
“I was finally going to start seeing my body reflect my gender identity and the woman I’ve always known myself to be,” said Ms. Hall, who declined through an A.C.L.U. spokesman to be interviewed for this article.
“After years of working to affirm my identity in a world where transgender people are questioned constantly about how well they know themselves, the pharmacist refused to fill one of the prescriptions needed to affirm my identity,” she said.
Ms. Hall wrote that the pharmacist repeatedly and loudly asked her why she needed the prescriptions, which nearly brought her to tears. After filling the prescription at Walgreens without trouble, Ms. Hall said that she called CVS’s corporate phone line multiple times to complain, but that no one addressed her concerns.
Mr. DeAngelis said the company did not appropriately respond to Ms. Hall’s complaint because of an “unintentional oversight.” He said the company learned of Ms. Hall’s post on Thursday and spoke with her on Friday to apologize directly.
Based on federal and some state laws, CVS does allow a pharmacist to refuse to fill specific medications if doing so would violate the person’s religious convictions, Mr. DeAngelis said. But the pharmacist would be required to notify the company in advance so it could ensure that the patient would promptly receive the medicine.
Ms. Hall made her story public about a month after a Walgreens pharmacist refused to fill an Arizona woman’s prescription for misoprostol, a medication that can be used to end a failed pregnancy. The woman’s doctor had told her the pregnancy was unviable, and another Walgreens filled her prescription.
Arizona has a law allowing pharmacists to object to providing abortion medication or emergency contraception if it interferes with their religious beliefs. The state law does not mention hormone therapy prescriptions.
The state also has no law prohibiting discrimination based on gender identity in public accommodations.
Steve Kilar, a spokesman for the civil liberties union in Arizona, said Ms. Hall had filed a complaint with the organization in May after she was having trouble getting a response from CVS. She also filed a complaint with the Arizona State Board of Pharmacy, which investigates concerns about pharmacists’ conduct.
Mr. Kilar said the A.C.L.U.’s objective in helping publicize Ms. Hall’s experience was ensuring that CVS makes clear to customers that it will not tolerate discrimination from employees on the basis of gender identity. Mr. DeAngelis said CVS was discussing ways to reinforce its guide for helping L.G.B.T.Q. patients.
In April, the Trump administration said it planned to roll back a rule issued under President Barack Obama that prevents doctors and hospitals from discriminating against transgender people. The 2016 rule says that sex discrimination, which is forbidden by the Affordable Care Act, includes discrimination based on “gender identity” and “stereotypical notions” about how men or women should present themselves.
An example of sex discrimination, according to an Obama administration training guide issued in 2016, would be a pharmacist not providing a flu vaccine to a woman and questioning her on her non-gender-conforming appearance.
Scott Skinner-Thompson, an associate professor of law at the University of Colorado, Boulder, who specializes in L.G.B.T.Q. issues, said that even if the Trump administration curtails the rule, federal case law generally interprets sex discrimination as including gender identity.
Professor Skinner-Thompson said that holding companies like CVS accountable to anti-discrimination policies in high-profile instances helps further the L.G.B.T.Q. rights movement. But ensuring that federal and state law protects people from this sort of discrimination is also critical, he said.
“Public pressure has been and can be a powerful ally for L.G.B.T.Q. rights,” he said. “But, certainly, we can’t be relying on corporate responsibility alone.”
