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Catholic bishops in the United States have issued guidelines aimed at blocking Catholic hospitals from offering care for gender transition, a move that LGBTQ advocates say is damaging to the physical and emotional health of transgender people within the church could.
The 14-page teaching note, titled “Moral Limits to Technological Manipulation of the Human Body,” provides guidelines for changing a person’s gender, particularly in adolescents. The document, released Monday, says Catholic hospitals “may not perform any surgical or chemical procedures aimed at converting the sexual characteristics of a human body into those of the opposite sex, or engage in the development of such procedures.”
Related: Catholic health organizations may refuse care for trans people, court rulings
Transgender Catholics have received mixed reactions across the US church. Some have found acceptance in certain communities and rejection in certain dioceses, including those that prevent church personnel from using trans people’s preferred gender pronouns. Bishops’ recent guidance on Catholic medical centers could prevent trans people from getting the medical care they need, said Francis DeBernardo, executive director of the New Ways Ministry, which works to promote greater LGBTQ acceptance in the church.
Catholic hospitals make up a sizable portion of the US healthcare system, and in some communities they are are the only option. The Catholic Health Association, which includes more than 600 hospitals and 1,400 long-term care and other healthcare facilities across the United States, says more than one in seven US hospital patients receive care in a Catholic facility.
“These decisions are made at a much higher level without knowing the individuals involved and the individual cases,” DeBernardo said. “When transgender people are not allowed or restricted from transitioning in ways they see fit, it can lead to depression, anxiety, or even self-harm, including suicide.”
The bishops’ guidelines “are not going to change much” when it comes to the care of transgender patients in Catholic hospitals, said Rev. Charlie Bouchard, CHA’s senior director of theology and sponsorship. Transgender people continue to be always admitted to Catholic hospitals and treated with dignity and respect, but may not receive all the gender-affirming care they demand because of the church’s theological and moral teachings, he said.
“As we look at the bishops’ document, we remember that we have a history of caring for the marginalized and we view transgender people very strongly as a marginalized group,” he said.
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Catholic hospitals see transgender patients with a variety of health needs, from broken bones to cancer treatments and heart attacks, Bouchard said, adding that the hospitals would not perform cosmetic procedures like reconstructive surgeries, hysterectomies, or treatments like sterilizations on request unless there is a medical need for them.
He said Catholic hospitals also train staff to be respectful of transgender patients: “When a patient checks in, we ask staff to be respectful of questions. We want to validate transgender people as individuals and provide them with spiritual care and psychological counseling.”
Bouchard said Catholic hospitals “base healthcare on science and continue to follow science when it comes to transgender people.”
“But we don’t deal with ideology,” he said. “We treat patients who are really suffering. There are things out there regarding gender fluidity that we don’t agree with. But as Catholic hospitals we are subject to the same standard of care as other hospitals.”
DeBernardo disagreed, saying that the bishops’ doctrinal guidelines hurt rather than heal people by ignoring science.
“The bishops’ unwillingness to confront any evidence from the scientific community or the experiences of transgender people is neither good theology nor acceptable pastoral care,” he said.
Related: Minnesota governor signs executive order protecting gender-affirming care
DeBernardo said he sees hope with many more Catholics in the pews showing a greater understanding of the lives of transgender people. He pointed to instances of Catholic parents supporting their transgender children against restrictive policies in Catholic schools, including bans on puberty blockers and preferred pronouns on campus and in parishes.
Christine Zuba, a transgender woman living in New Jersey, said she feels accepted in her local community but is upset that the national church “continues to deny our existence and our need for health care.” Zuba said she was disappointed to see that transgender people weren’t even mentioned in the 14-page document.
“I feel unconditionally accepted in my community just the way I am,” she said. “But that is missing in our hierarchy. There is no willingness to engage with us and understand our lives.”
Zuba said she looks forward to more engagement and interaction in some dioceses. In Davenport, Iowa, Bishop Thomas Zinkula formed a gender committee that called on Catholics to “listen to those on the fringes” and called serving LGBTQ people — particularly trans people — “a life’s work.” In a column published in Catholic Messenger, Zinkula said he was haunted by the story of a transgender youth who attempted suicide after being refused communion.
“This should never happen again,” he wrote.
Zuba said she would like to see that kind of commitment to listening and learning in the upper echelons of the church.
“All we ask is that you listen to us as a group and as individuals,” she said. “Open your hearts and try to understand.”
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