The ACLU of Washington filed a federal discrimination lawsuit against PeaceHealth St. Joseph Medical Center for allegedly refusing to cover transgender medical services for a Bellingham family and their 17-year-old son.

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Cheryl Enstad spent 20 years as a medical social worker at PeaceHealth St. Joseph Medical Center in Bellingham. When PeaceHealth refused to cover transgender medical services for her son Pax, Enstad said she felt “betrayed.”

“They were telling me my son was undeserving of care,” she said at a Thursday news conference announcing a lawsuit against PeaceHealth by the ACLU of Washington on her family’s behalf.

The federal lawsuit, filed in U.S. District Court in Seattle, appears to be the first of its kind in Washington state, said ACLU staff attorney Lisa Nowlin.

The ACLU contends that PeaceHealth’s blanket policy of refusing to pay for transgender medical services discriminates on the basis of sex and gender identity, violating the Affordable Care Act (ACA), which prohibits such discrimination. The lawsuit also claims PeaceHealth violated the state law against discrimination.

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Nowlin said PeaceHealth hasn’t provided the Enstads or their lawyers with an “underlying rationale” for their policy.

Jeremy Rush, a spokesman for PeaceHealth said he couldn’t comment on pending litigation.

But Rush provided a statement via email:

“PeaceHealth is committed to creating an inclusive health care environment. Throughout our 126-year heritage, we have been dedicated to embracing and celebrating the diversity of our communities, our caregivers and the individuals we are privileged to serve. We remain committed to promoting personal and community health, and treating each person in a loving and caring way.”

PeaceHealth, a Catholic organization, operates 70 facilities in Washington, Oregon and Alaska with 16,000 employees, according to the lawsuit.

Cheryl Enstad and her husband, Mark, took a second mortgage on their Bellingham home and used some of Pax’s college savings fund to pay more than $10,000 for the chest-reconstruction surgery prescribed for Pax by his doctor.

“We feel privileged to even have the option of taking out a second mortgage,” Cheryl Enstad said, noting that some families in similar situations aren’t so fortunate.

The surgery “definitely was a weight lifted, physically and metaphorically,” said Pax Enstad, 17, a high-school senior. “My whole life changed. I went swimming for the first time in nine years. I wore a suit at homecoming and felt really proud.”

He called his parents “really cool” and praised their willingness to listen to his feelings and learn about his condition.

Pax Enstad was designated a female at birth, but came to feel he had a male identity. He was diagnosed with gender dysphoria, a condition in which the conflict between a person’s gender identity and sex assigned to them at birth causes distress.

Before he began receiving treatment, Pax said, he suffered depression and anxiety. He wore layers of clothing to hide his chest from view and he avoided going outside, the lawsuit said.

He also began wearing a binder to flatten his chest nearly 24 hour a day. His doctors prescribed hormone therapy and chest-reconstruction surgery. When they submitted a preauthorization request for surgery, PeaceHealth, which provides coverage for employees such as Cheryl Enstad, stated it does not cover any “transgender services” in its health-benefits plan.

That’s illegal discrimination, said Nowlin, the ACLU attorney. “Under state and federal law, no company is allowed to single out and exclude one group of individuals from medical care that is prescribed for them by their doctors and that the company routinely provides for others,” she said.

When Cheryl Enstad learned of PeaceHealth’s decision, she said, she channeled her “upset” into research. She contacted Danni Askini, executive director of the Gender Justice League, who connected her with the ACLU.

“For decades health-insurance companies have exploited transgender people by denying them medically necessary life-saving care that others receive, all while taking their money in premiums,” Askini said.

Mark Enstad said his son has “taught us so much” and his journey has brought the family closer.

A yacht technician, Enstad said he hopes his generation will open their minds to “people who don’t see gender as binary.”

He said his co-workers have been very supportive. “They ask about Pax a lot. I haven’t had any negativity” from them, he said.

He has had some “minor encounters,” he said with older yacht owners, “jabbering about” bathroom laws. “I had to stand up and put that out quickly,” he said.

Mark Enstad said he is “incredibly proud” of his son. “He is an amazing guy,” he said.