in the 1980s, hill started out as a lay minister in the saint paul-reformation lutheran church. by the 1990s, her congregation wanted her to be ordained despite rules against lesbian pastors in the evangelical lutheran church in america (elca) at the time. the church's head pastor, paul tidemann, created the goal for his church that it would have a non-celibate, openly gay minister by 1993. hill was an open lesbian in a committed relationship. she was ordained on april 28, 2001, within the extraordinary lutheran ministries but was later censured for her ordainment as an lgbt person. on september 18, 2010, she was formally inducted into the elca clergy roster. she left working at the church in 2012 and went on to fight a state constitutional amendment in her state which banned gay marriage.