U.S. bishops' new guidelines aim to limit trans health care

U.S. Catholic bishops have issued new guidelines to Catholic hospitals barring them from providing transgender people with gender transition care

United States Catholic bishops have issued guidelines that seek to stop Catholic hospitals from providing gender transition care, a move LGBTQ advocates say could harm the physical and emotional health of transgender people within the church.

The 14-page doctrinal note, titled “Moral Limits to the Technological Manipulation of the Human Body,” sets forth guidelines for changing a person’s sex, specifically with youth. The document, issued Monday, says Catholic hospitals “must not perform interventions, whether surgical or chemical, that aim to transform the sexual characteristics of a human body into those of the opposite sex, or take part in the development of such procedures.”

Transgender Catholics have received a mixed response across the U.S. church. Some have found acceptance in specific parishes and rejection in certain dioceses, including those that bar church personnel from using trans people’s preferred gender pronouns. The bishops’ latest guidance to Catholic medical centers could prevent trans people from getting the health care they need, said Francis DeBernardo, executive director of New Ways Ministry, which advocates for greater LGBTQ acceptance in the church.

Catholic hospitals make up a sizeable portion of the U.S. health care system and in some communities they are the only option. The Catholic Health Association, which comprises more than 600 hospitals and 1,400 long-term care and other health facilities in the United States, says more than one in seven U.S. hospital patients is cared for in a Catholic facility.

“These decisions are being made at a much higher level without knowing the individuals and individual cases involved,” DeBernardo said. “When transgender people are not permitted or restricted from transitioning in ways they feel are appropriate, it could end in depression, anxiety or even self harm, including suicide.”

The bishops’ guidelines “will not change much” when it comes to caring for transgender patients at Catholic hospitals, said the Rev. Charlie Bouchard, CHA’s senior director of theology and sponsorship. Transgender people will continue to always be accepted in Catholic hospitals and treated with dignity and respect, but might not receive all of the gender-affirming care they request because of the church's theological and moral teachings, he said.

“As we look at the document from the bishops, what we are mindful of is that we have a history of caring for the marginalized, and we see transgender people very much as a marginalized group,” he said.

Catholic hospitals see transgender patients with a variety of health care needs from broken bones to cancer treatment and heart attacks, Bouchard said, adding that the hospitals would not perform cosmetic procedures such as reconstructive surgeries, hysterectomies, or treatments such as sterilizations on request, unless there is a medical need for them.

He said Catholic hospitals are also training staff to be respectful of transgender patients: “When a patient checks in, we ask staff to be respectful in how they ask questions. We want to affirm transgender individuals as persons and provide them with spiritual care and psychological counseling.”

Bouchard said Catholic hospitals will “base health care on science and continue to follow the science when it comes to transgender people.”

“But we don’t treat ideology,” he said. “We treat patients who are really suffering. There are things out there about gender fluidity that we do not agree with. But as Catholic hospitals, we are held to the same standard of care as other hospitals.”

DeBernardo disagreed, saying the bishops’ doctrinal guidelines cause harm rather than heal people by not paying heed to science.

“The bishops’ unwillingness to counter any of the evidence from the scientific community or the experience of transgender people is neither good theology nor acceptable pastoral care,” he said.

DeBernardo said he sees hope with many more Catholics in the pews showing greater understanding of transgender people's lives. He noted cases where Catholic parents are supporting their transgender children against restrictive policies in Catholic schools, including barring puberty blockers and preferred pronouns on campuses and in parishes.

Christine Zuba, a transgender woman who lives in New Jersey, said she feels accepted at her local parish, 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 were not even mentioned in the 14-page document.

“In my parish, I feel accepted unconditionally for who 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 is happy to see more engagement and interaction in some dioceses. In Davenport, Iowa, Bishop Thomas Zinkula formed a Gender Committee calling Catholics to “listen to the people in the margins,” calling ministering to LGBTQ people – particularly trans people – as “a life issue.” In a column published in the Catholic Messenger, Zinkula said he has been haunted by the story of a transgender youth who attempted suicide after being denied Communion.

“This type of thing should never happen again,” he wrote.

Zuba said she would like to see that type of commitment to listen and learn in the upper echelons of the church.

“All we ask is listen to us as a group and as individuals,” she said. “Open your hearts and try to understand.”

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