## Facts

- Guadalupe T. Benitez, a lesbian living with her partner, sought infertility treatment after unsuccessful self-insemination attempts using donor sperm.
- Benitez was referred to North Coast Women’s Care Medical Group, a for-profit medical practice offering infertility services.
- At an initial consultation, Benitez told Dr. Christine Brody she was a lesbian; Brody stated her religious beliefs would prevent her from performing intrauterine insemination (IUI) if it became necessary.
- After medication and testing did not result in pregnancy, Benitez elected to undergo IUI.
- Dr. Brody and Dr. Douglas Fenton refused to perform IUI for Benitez, citing religious objections to providing IUI to an unmarried woman.
- Benitez alleged the refusal was based on her sexual orientation and violated the Unruh Civil Rights Act (Cal. Civ. Code § 51), which requires full and equal services by business establishments without discrimination based on sexual orientation.
- Benitez sued the clinic and physicians; defendants asserted constitutional defenses grounded in free exercise of religion and free speech.

## Issues

1. Whether the Unruh Civil Rights Act applies to a private, for-profit medical practice providing infertility services.
2. Whether the federal and California constitutional rights to free exercise of religion exempt physicians from complying with the Unruh Act’s ban on sexual-orientation discrimination when providing medical services.
3. Whether enforcing the Unruh Act to require provision of IUI constitutes compelled speech in violation of state or federal free speech guarantees.

## Decision

- The California Supreme Court unanimously held that the defendant physicians could not claim a religious exemption from the Unruh Act to deny IUI services based on a patient’s sexual orientation.
- The Court held the Unruh Act is a valid, neutral law of general applicability and may be enforced against religiously motivated discriminatory conduct in a business establishment.
- The Court rejected the physicians’ free speech defense, concluding the statute regulates discriminatory conduct (service denial), not protected expression.
- The Court reversed the Court of Appeal and remanded; the constitutional defenses failed as a matter of law, though factual questions about the motivation for refusal could remain for further proceedings.

## Legal Principles

- The Unruh Civil Rights Act applies broadly to “business establishments,” including private medical practices offering services to the public for profit.
- A neutral, generally applicable law that incidentally burdens religious practice does not violate the Free Exercise Clause solely because it conflicts with religious beliefs.
- Providers who choose to offer medical services to the public may not selectively withhold otherwise available services from patients based on protected characteristics such as sexual orientation.
- Enforcement of a generally applicable antidiscrimination law against discriminatory service refusals does not, without more, create a free speech violation.

## Conclusion

A for-profit medical practice subject to the Unruh Civil Rights Act may not deny otherwise available infertility services to a patient because of the patient’s sexual orientation; religious and free speech objections do not create a constitutional exemption from the Act’s nondiscrimination requirements.


North Coast Women's Care Med. Grp., Inc. v. Superior Court, 44 Cal. 4th 1145, 189 P.3d 959 (Cal. 2008)