Plaintiff alleges that Defendants compelled her to violate her religious beliefs and independent medical judgment after a DEI training. Plaintiff asserts that Defendants attempted to get her to pledge to use patients' preferred pronouns and make referrals for gender transition drugs and procedures. After requesting a religious accommodation for the pledge, Plaintiff alleges that Defendants denigrated her religious beliefs and soon terminated her because of her beliefs.

Plaintiff claims that Defendants accommodated other staff members. For example, Defendants allowed a male doctor to abstain from performing pelvic exams on female patients and accommodated providers who objected to prescribing controlled substances.

On February 20, 2023, Defendants filed a motion to dismiss for failure to state a claim. They argued that they were clear with Plaintiff that she was not required to provide care to patients she was not comfortable providing for due to lack of professional knowledge and experience, or personal, religious, or other ethical beliefs. However, Defendants asserted that during the times when Plaintiff chose to treat patients she knew to be LGBTQ or experiencing gender dysphoria, the hospital required her to follow its policies and federal law. Defendants asserted that Plaintiff was intentional in discriminating against patients she voluntarily chose to work with and knew were LGBTQ or experiencing gender dysphoria because she was adamant that she would not use patients' preferred pronouns or refer them to alternate providers for medical services. Due to Plaintiff's conduct, Defendant argues that she can't state a claim for failure to accommodate. Additionally, Plaintiff did not exhaust her administrative remedies, failed to identify a facially-neutral policy that had a disparate impact on a protected group, and has constitutional claims that fail due to qualified immunity.

On September 20, 2023, the court granted in part and denied in part Defendants' motion to dismiss. The court stated that Plaintiff had sufficiently stated a free exercise of religion claim against each Defendant due to elements of hostility towards Plaintiff's beliefs. As to the free speech claims, the court dismissed them because Plaintiff was speaking pursuant to her official duties, and not as a citizen. For the Equal Protection claims, the court determined that Plaintiff could pursue them due to the hostile comments against Plaintiff's religious beliefs.

On April 5, 2024, the court granted Defendants motion to compel arbitration. Plaintiff then appealed to the Sixth Circuit.