The U.S. Department of Justice is backing a group of Catholic nuns who have spent more than a century caring for dying cancer patients, stepping into their federal lawsuit against a New York law that could strip their license, impose thousands in fines, or send them to jail for refusing to comply with the state's gender identity requirements.
The Dominican Sisters of Hawthorne operate Rosary Hill Home in Westchester County, a free palliative care facility for indigent, terminally ill cancer patients. They have done so for over 120 years, charging nothing. Now, under New York's LGBTQ Long-Term Care Facility Residents' Bill of Rights, passed in 2023, the sisters face a choice the DOJ says no religious order should have to make: abandon their Catholic beliefs or lose everything they built.
New York Public Health Law § 2803-c-2 requires every long-term care facility in the state to assign rooms based on a resident's self-identified gender identity rather than biological sex. It also mandates that staff use residents' preferred pronouns and names, permit bathroom access based on gender identity, and post public notices of compliance, as Just The News detailed.
For the Dominican Sisters, whose Catholic faith teaches that biological sex is given by God and immutable, every one of those requirements collides with core religious conviction. The sisters' facility houses vulnerable, dying women. Compliance would mean housing biological males alongside those patients and affirming a view of gender that contradicts Church teaching.
The penalties for refusal are not gentle suggestions. Newsmax reported that facilities face civil penalties of up to $2,000 for a first violation, escalating to as much as $5,000 per subsequent offense. Courts can order forced compliance. And for willful violations, the law allows criminal prosecution carrying up to one year in prison and fines of $10,000.
That is the legal vise New York placed around a group of nuns who spend their days holding the hands of people dying of cancer.
The sisters filed their federal lawsuit on April 6, challenging the mandate on religious freedom grounds. On June 22, the DOJ announced it would intervene, with the department's Civil Rights Division certifying the case as one of "general public importance." That certification allows the federal government to join the fight directly, a signal that the Trump administration views this as a flagship religious liberty case.
Assistant Attorney General Harmeet K. Dhillon, who leads the Civil Rights Division, did not hold back. In a department news release, Dhillon stated:
"New York's law would force these religious women to choose between their faith and their license if they wish to continue serving the dying."
Dhillon also issued a broader warning to state governments. As Fox News reported, she declared:
"States should take notice that they cannot require Americans to abandon their religious beliefs in the name of woke gender ideology."
The DOJ argues that New York's mandate violates the Fourteenth Amendment's Equal Protection Clause by singling out religious organizations for burdens the state does not impose equally. That legal theory carries particular weight given one glaring fact in the record.
New York granted a religious exemption to at least one facility: a Christian Science care home. No Catholic organization has received the same accommodation. National Review highlighted this disparity, which the DOJ's equal protection argument appears designed to exploit.
If the state can carve out space for one religious tradition while forcing another to comply or face prison, the question of discriminatory intent becomes hard to dodge. Courts evaluating free exercise and equal protection claims look closely at whether a law is "generally applicable" or whether it targets specific religious groups. A selective exemption is exactly the kind of evidence that can unravel a state's defense.
The pattern is not unique to New York. CLN previously reported on the Dominican Sisters' original lawsuit, which laid out the constitutional stakes when the case was first filed in April.
The Dominican Sisters of Hawthorne were founded in 1900 by Rose Hawthorne Lathrop, daughter of novelist Nathaniel Hawthorne. Their mission has never changed: provide free nursing care to terminally ill cancer patients who cannot afford treatment elsewhere. They accept no payment from patients or their families. The order sustains itself through donations.
Rosary Hill Home serves some of the most vulnerable people in the state. Residents arrive knowing they will die there. The sisters bathe them, feed them, manage their pain, and pray with them. Losing their operating license would not just shutter a building. It would end a ministry that has outlasted two world wars, the Great Depression, and every political trend Albany has cycled through.
Authorities have not publicly confirmed whether any enforcement action has been initiated against the sisters under the 2023 law. The lawsuit is preemptive, seeking to block the mandate before it forces the order to choose between compliance and closure.
The DOJ's intervention fits into a wider conflict between progressive state mandates and religious organizations. In Oregon, a Catholic counselor sued the state after it levied a $90,000 fine for declining to affirm a client's same-sex relationship, another case where a blue state used licensing power to punish religious conviction.
The mechanism is similar each time. States do not outlaw religious belief directly. Instead, they attach professional or institutional consequences to acting on that belief. Refuse to use preferred pronouns? Lose your license. Decline to house residents by gender identity? Face criminal charges. The faith itself is technically untouched. The ability to practice it in public life is not.
That dynamic has drawn federal attention beyond the DOJ. Across the country, states have moved to strengthen protections for religious institutions in the wake of protests and disruptions targeting churches, a sign that the political appetite for defending religious practice is growing in statehouses even as blue states push in the opposite direction.
The DOJ's certification of "general public importance" transforms this from a solo challenge by a small religious order into a case with the full weight of the federal government behind it. The Civil Rights Division will now participate as a party, filing briefs, presenting arguments, and potentially shaping the legal standard that emerges.
The case will likely turn on several questions a federal court must resolve. Does the mandate qualify as a neutral, generally applicable law, or does the Christian Science exemption prove selective enforcement? Does forcing a religious order to affirm gender identity as a condition of licensure impose a "substantial burden" on religious exercise under the First Amendment and the Religious Freedom Restoration Act? And can New York demonstrate a compelling state interest that justifies that burden, applied in the least restrictive way possible?
Investigators and litigators will also need to determine whether other religious facilities in New York face similar pressure or whether the sisters' case is an isolated flashpoint. The answers will shape not just this lawsuit but the boundaries of state power over religious institutions nationwide.
Overseas, similar tensions have surfaced. A Northern Ireland court convicted a 78-year-old retired pastor for preaching near a hospital, a case that underscored how broadly governments are willing to restrict religious expression when it collides with progressive policy priorities.
New York is not the only state with gender identity mandates for care facilities. If the DOJ prevails, the ruling could establish a precedent that religious organizations cannot be forced to choose between their faith and their right to operate. If New York prevails, the signal to other states is equally clear: licensing power can override religious conviction as long as the mandate is framed as a civil rights protection.
For the Dominican Sisters, the stakes are not abstract. They are measured in the number of dying patients who will or will not have someone to care for them.
When a state threatens nuns with prison for running a free hospice the way they have for 120 years, the question is no longer about ideology. It is about whether the government still recognizes any limit on its power over people of faith.
