NEW YORK STATE
DIVISION OF HUMAN RIGHTS
TO:

Files

REGION: Rochester

FROM: Julia B. Day
Regional Director

DATE: December 12,2017

SDHR CASE NO: 10188477-17-E-DSI-E
Federal Charge No. 16GB7031 07
SUBJECT:

Annamaria Kontor v. Rochester Institute of Technology

FINAL INVESTIGATION REPORT AND BASIS OF DETERMINATION

I.

CASE SUMMARY

This is a verified complaint, filed by complainant, Annamaria Kontor, on Fri 6/23/2017.
The complainant who is female and alleges discrimination due to her association with
transgender patients, charges the respondent with unlawful discriminatory practices in relation to
employment because of sexual orientation, sex, disability.
II.

SUMMARY OF INVESTIGATION

Complainant's Position:
Complainant alleges that her employment as a physician for Respondent was terminated because
she treated transgender patients. Complainant maintains that she was told that she was dismissed
from employment because of a policy prohibiting such treatment, but that no such policy exists.
Complainant also asserts that a male colleague treated transgender patients and was not
disciplined or fired.
Respondent's Position:
Respondent denies discriminating against Complainant. Respondent states that Complainant
began full-time employment as a Staff Physician in the Student Health Center on September 21,
2015. Respondent says that Complainant's employment termination was the result of her actions
of continuing to prescribe hormone therapy for gender transition after she was repeatedly
directed to stop. Respondent maintains that managing and prescribing hormone therapy for the
purpose of gender transition is beyond the scope of the Student Health Center's practice and thus
prohibited. Respondent notes that it will prescribe a one-time hormone dose to transitioning
students in limited instances, such as a missed dose, where the student's hormone therapy is

 managed by an outside physician who has experience in the field. Respondent contends that
Complainant's employment was terminated after she refused to comply with a reasonable request
from a supervisor to cease a particular type of treatment. Respondent says that the male
colleague that Complainant refers to ceased prescribing hormone therapy for the purpose of
gender transition after the fall 2016 meeting in which Complainant was also directed to stop
prescribing hormone therapy for transitioning students.
Investigator's Observations:
Investigation showed that Complainant was employed in Respondent's Student Health Center as
a physician from September of2015 until her.emp1oyment was terminated on May 24, 2017.
Complainant had various supervisors throughout her employment; the Interim Medical Director
directly supervised Complainant for one day before she terminated Complainant's employment.
According to Complainant, she first prescribed hormone therapy for a patient at the Student
Health Center in the fall of 2016. Complainant asserts that prescribing hormone therapy is part
of her primary duties as a physician and that she is also ethically obligated to treat her patients
with hormone therapy when she deems this treatment is medically necessary. Respondent
disputes this and maintains that prescribing hormone therapy for students who are not under the
care of a physician experienced in this area is beyond the scope of services it can provide.
There is no dispute that Respondent does not have a written policy regarding prescribing
hormone therapy to patients. The parties dispute whether or not Complainant was ever told not
to prescribe hormone therapy for Student Health Center patients. Investigation showed that
Respondent terminated Complainant's employment for insubordination because she failed to
follow the directive of her previous supervisor on two separate occasions to stop prescribing
hormones for gender transition. However, Complainant denies that her former supervisor ever
gave her that directive and there was insufficient documentation to show that this instruction was
ever relayed to Complainant.
Complainant maintains that there was a conversation around the end of March of 2017 when her
former supervisor asked if she was still doing the prescriptions, and when she said that she was,
the supervisor told her that they would have to talk about this. Complainant says that nothing
further was said and that she reminded her supervisor that in November, her supervisor had told
her that it was "okay for now" to do that.
Respondent submitted a statement from Dr. Sanford Mayer and Dr. Taura Blyth, who both
supervised Complainant at some point during her employment. Dr. Mayer recalls that he and
Dr. Blyth told Complainant that without policies in place and without adequate training, they
would not want the Student Health Center to prescribe hormonal treatment for transitioning
students. He also indicated that this conversation was not documented. (See, Respondent's
Response, Exhibit E). Respondent also submitted an email from Dr. Blyth in its postconference submission. In that email, Dr. Blyth maintains that she told Complainant to stop
prescribing hormones immediately but that Complainant did not do so. (See, Respondent's PostConference Submission, Exhibit G).

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 A review of Complainant's April 25, 2017 performance review did not support Respondent's
assertion that Complainant's prior supervisor had voiced concerns with Complainant prescribing
hormone therapy. Complainant's overall rating was successful/meets expectations, which is
described as "Performance during appraisal period effectively fulfilled all expectations for the
position." There are spaces for the supervisor to provide comments in various categories, which
was done; the comments were favorable for the most part. Interestingly, the one comment that
could be construed as negative is that Complainant "sometimes does things on her own, such as
keeping over-the-counter medications in her office to give to students. When asked to stop, she
does comply." (See, Complainant's rebuttal, Exhibit 1, p. 4). This statement appears to be in
contrast to Respondent's assertion that Complainant was insubordinate and refused to comply
with her supervisor's directive to stop prescribing hormone therapy. There is no mention
anywhere in this evaluation that Complainant was engaging in behavior that was so serious that
Respondent felt it endangered the students' welfare; yet, Complainant's behavior was deemed to
be so egregious just one month later so as to warrant employment termination. Moreover,
Complainant's work with transgender students is referenced several times in the performance
appraisal, but nowhere does it address the alleged issue of prescribing hormone therapy in
violation of her supervisor's instructions. There is also no warning or documented counseling
issued to Complainant regarding this alleged behavior. According to Complainant, she was
prescribing hormone therapy for transgender students and had conversations with her supervisor
about this during at least part of the period covered by the performance evaluation. While
Respondent's Interim Medical Director maintains that she was unaware that Complainant was
prescribing hormone therapy until May of 2017, Complainant contends that she told the Interim
Medical Director that the Student Health Center was providing basic healthcare for transgender
students as far back as December of 2016.
Investigation showed that Complainant provided hormone therapy for non-transgender students,
such as birth control and issues with low testosterone, without repercussions.
Neither party identified any other physician terminated from employment for the same reason as
·Complainant. Complainant alleges that one of her former supervisors, Dr. Mayer, gave bridge
prescriptions to patients without facing discipline; she asserts that she was treated differently
from this male doctor because she is female. Respondent's Interim Medical Director denies this
allegation and says that when she looked through the medical records, she found no evidence that
Dr. Mayer had done that. Investigation revealed that with respect to its position on hormone
therapy, Respondent differentiates between a one-time bridge prescription and providing primary
care in the form of hormone therapy for transgender students.
It should be noted that Complainant filed a staff grievance regarding her employment
termination, and the majority of the Staff Grievance Committee members found that the Staff
Performance Improvement policy was not fairly administered and interpreted by the supervisor.
The Committee found that there was a lack of clear communication and written documentation
of concerns about Complainant prescribing hormone therapy for trans gender students from her
supervisor and that there was no proof that Complainant was aware that she was acting in
opposition to the wishes or instructions of her supervisor. (See, Complainant's Post-Conference
submission, Exhibit A).

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 It should also be noted that the New York State Division of Human Rights does not interfere
with medical decisions, nor attempt to substitute its judgement for that of medical professionals
and/or their supervisors. However, in the instant case, the complainant maintains that her
discharge constitutes discrimination by association, in that she was allegedly penalized for
providing services to persons who are transgender, which is considered to be a disability under
the New York State Human Rights Law. The issue before the New York State Division of
Human Rights relates to whether or not the complainant was terminated for non-discriminatory
reasons, or if her separation from employment occurred in whole or in part due to her providing
treatment and assistance to persons who ha(\ aprot'::'ted cat~ un~uman Rights Law.

Submittedby~~~ ~
\ fami Kaplan .
\J-Iuman Rights Specialist II

III.

BASIS FOR DETERMINATION

Investigation showed that Complainant, a physician in Respondent's Student Health Center,
prescribed hormone therapy for transgender students. Although there is no dispute that
Complainant prescribed hormone therapy, the parties dispute whether Complainant's former
supervisor gave a directive to Complainant to stop prescribing hormone therapy for transgender
students. Complainant asserts that she was never told to stop this, while Respondent maintains
Complainant was told on two occasions and refused to comply with her supervisor's request. As
a result, Respondent's Medical Director terminated Complainant's employment in May of 2017
for insubordination. However, investigation revealed that Respondent has no policy regarding
hormone therapy for transgender students and there is no documentation to establish that
Complainant was ever told to stop prescribing hormone therapy by a supervisor. A review of
Complainant's performance evaluation that was issued one month prior to her dismissal shows
that Complainant was rated as meets expectations in all areas and there was nothing on the
evaluation to indicate that she was not in compliance with Respondent's directives. There are
issues of material fact remaining, including but not limited to, whether Complainant's
employment was terminated for a legitimate, non-discriminatory business reason or whether
Complainant's association with transgender patients factored into Respondent's termination
decision. These issues of material fact are best resolved in the context of a full public hearing,
where there is sworn testimony and the opportunity for cross-examination. Therefore, there is
probable cause to support the allegations of the complaint.

Reviewed & Approved:

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 IV.

DETERMINATION
Based on the foregoing, I find Probable Cause to support the allegations of the complaint.

Regional Director

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