The actress, 31, reunited with TV mom Julie Bowen, host of Quitters Podcast, to share how she's been feeling as of late — now four years after her second kidney transplant — and reflect on how her health struggles impacted her tenure on their hit show, which ended its 11-year run in 2020.
"I'm well," Hyland said of her health today. "Everything's stable. I haven't left the house in a very long time right now, but everything is stable as of now."
Hyland was born with kidney dysplasia, a condition in which the kidneys don’t fully develop in the womb. She had two transplants: First when she was 21 with her father's kidney. After her body rejected it, she quietly had a second transplant, at age 26, with her younger brother's kidney. And those were just transplants — she had over 15 surgeries in all for her kidney condition.
Both transplants took place while Hyland was starring as Haley Dunphy on the ABC comedy. On the podcast, she talked about often being in excruciating pain on the set — and suffering from exhaustion.
"There are some episodes of Modern Family where I do not remember filming because I was asleep," she said. "Dead ass asleep. The episode where Haley asked [Luke for] money and he's like, 'Don't worry, I've got it on ice.' It's in the freezer or something. The entire episode I was asleep," referring to Oct. 2011's "Hit and Run."
"You have to be a certain level of sick in order to receive a transplant. I was reaching that certain level of sick," she said prior to her first transplant. "I was not able to be awake for eight hours at a time. I was so exhausted. So I'd be on the set, I'd be dead asleep, my head on the table, I would hear, 'and...'" before "action" — the cue taping was to begin — and her head would shoot up and she'd deliver her lines. When they cut, she'd fall back asleep.
Bowen recalled Hyland being "doubled over" in pain while shooting "The Old Wagon" episode in 2010.
"I will never forget 'What's the plan, Phil?' [on location at L.A.'s] Griffith Park," Bowen said. "It was cold. [Hyland's] wearing a Haley special — like a Vegas skirt. The sun had set... She's a small girl to begin with and she had kidney issues." When they were told they needed another take, Bowen privately asked Hyland, who was doubled over with hot packs on her kidneys, to see if she had one in her. She said Hyland got up "like a robot" to do the scene. "She [was] in a lot of pain, but you'd always turn it on when you needed to take care of business."
"I never really said no," Hyland replied.
Bowen added, "You never really said no until you were in the hospital."
Hyland said the first five years of being on Modern Family, the show was "a nice escape" from her medical woes. However, after her body rejected her first donor kidney and it was removed, her health greatly declined. With no kidney function, she was on dialysis three times a week for a year while still taping the show. It was then, when she was so sickly, that she had suicidal thoughts, ahead of her second transplant in 2017.
"'What if this happens again?'" Hyland recalled of her worry that her body would reject a second donor kidney. "Plus, [my donor brother] is so young. What do I do?' That's where I felt suicidal. I would avoid going into [organ] rejection and being on dialysis [again] at all costs."
She said her thoughts were a culmination of "years and years and years" of chronic illness.
"Twenty-seven years of almost always being in pain," she said. "Always being in and out of the hospital. I don't think I've gone more than one or two years without being hospitalized."
It was "exhaustion of fighting because it's draining," she said. "Just energetically I was like, 'This is just hard for me to do anymore. And it would just be easier for everyone else too,'" as she felt like a burden to her loved ones.
Video: Sarah Hyland describes her two kidney transplants
It was also years of masking her pain.
"When you have grown up your entire life having health issues and always being pain, you have to learn how to have thick skin, put on a show ... otherwise you're just going to be looked at as a really weak and pathetic and sad person," she said. "I don't like to victimize myself. I don't like other people to victimize me. I had almost 27 years of putting on a show, whether it was on Broadway or in my family living room."
Hyland said she was proud of herself after revealing her depression in 2019.
"I've had people write to me saying thank you for talking about this," she said.
In the interview, Hyland also spoke about media pressure to discuss her health publicly, especially at times when she wasn't ready to. Before she had her first transplant, she said a makeup artist leaked her private health condition to the press. A magazine said they would be doing a story around it, so Hyland agreed to discuss it.
She also recalled public speculation when she was privately on dialysis and her weight dropped to 75 pounds.
"People thought I was dealing with an eating disorder when I was just really sick," she recalled.
Ditto when she was taking steroids to stay alive resulting in her face getting puffy. She had to respond to public criticism that she looked "fat" and address rumors she was pregnant.
That's why she said she waited until months after her second transplant to publicly disclose it. She wanted to "be on the other side" and know that it worked, having learned from experience.
Coming soon for Hyland is a wedding. She's been engaged to Wells Adams since 2019 and they twice postponed their nuptials due to the pandemic.
If you or someone you know are experiencing suicidal thoughts, call 911, or call the National Suicide Prevention Hotline at 1-800-273-8255 or text HOME to the Crisis Text Line at 741741.