The U.S. bishops voted Friday to move forward with a significant revision to their document offering guidance to Catholic health care institutions on the issue of transgender surgeries and hormone treatments, and their incompatibility with the Church’s teaching on sex and the dignity of the human person.

Ethical and Religious Directives

The bishops’ Committee on Doctrine will begin the process of updating a portion of its Ethical and Religious Directives (ERDs) for Catholic health care services to reflect its March doctrinal note that emphasized that “Catholic health care services 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.”

The ERDs aim to reaffirm ethical standards of behavior based on Church teaching and provide authoritative guidance on the moral issues involved. Bishop Daniel Flores of Brownsville, Texas, chair of the Committee on Doctrine, noted that the professional-patient relationship portion, which they plan to update, had not been revised since 1994.

“At that time, it was not envisioned that it might be necessary to include specific guidance concerning radical modifications to the human body, such as are widely advocated in practice today for the treatment of those suffering from gender dysphoria,” Flores said.

The doctrinal committee plans to incorporate the guidance into the March doctrinal note into the ERDs with extensive consultation with “bishops, moral theologians, medical ethicists, physicians, and other various stakeholders in the field of Catholic health care,” Flores said. Following that consultation, the draft will be “subject to review, discussion, and ultimately the vote of the whole body of bishops.”  

The motion to revise the ERDs passed by a unanimous voice vote after some discussion on the floor as several bishops encouraged clarity on the issue, a pastoral approach, and the need to consult with various experts on the matter.

Cardinal Robert McElroy of San Diego emphasized the issue of maintaining Catholic doctrine while wrestling with “the existential question of those who are suffering from dysphoria.” He asked that the ERDs “incorporate into all the considerations: How may we help people who are wrestling with dysphoria,” saying that the doctrinal note did not address that issue.

The March statement, titled “Doctrinal Note on the Moral Limits to Technological Manipulation of the Human Body,” did emphasize that “the search for solutions to problems of human suffering must continue, but it should be directed toward solutions that truly promote the flourishing of the human person in his or her bodily integrity. As new treatments are developed, they too should be evaluated according to sound moral principles grounded in the good of the human person as a subject with his or her own integrity.”

McElroy encouraged wide consultation on the matter “within the medical communities and with people who are suffering from dysphoria as well.” Cardinal Joseph Tobin of Newark, New Jersey, also called for “a broad consultation, including people who are from the trans community.”  

Bishop Michael Olson of Fort Worth, Texas, said there was “a lack of clarity between what is authentic gender dysphoria and then also the gender ideology” that is “preying upon people” and “increasing their suffering.” He expressed hope that the revision process would “bring greater clarity between these two phenomena of gender dysphoria and also gender ideology, so that hopefully we can write a broader pastoral document after the completion of the ERDs.”

Caring for persons with disabilities

Another motion advanced on the final day of the bishops’ spring gathering was their planned update to the bishops’ pastoral statement on persons with disabilities.  

Bishop Robert Barron of Winona-Rochester, Minnesota, chair of the Committee on Laity, Marriage, Family Life, and Youth, told those gathered that in the 45 years since the bishops first published their pastoral statement on persons with disabilities, its fruits have been evident with families seeing that “the Church cares for their loved ones with disabilities” and persons with disabilities being “inspired to seek out accommodations at their parishes.”

He said that while that statement remains “foundational, we do believe a new statement is needed to address disability concerns in the Church of the 21st century.”

(Story continues below)

Updates encouraged by Barron included an emphasis on the “vocations of persons with disabilities, spiritual themes of hope and joy versus brokenness and suffering to help remove stigmas,” and “current disability language instead of the use of dated and pejorative words.”  

He added that the document could be updated with “a broader understanding of disability beyond physical and intellectual disabilities, inclusive of mental illness as well.”  

Several bishops praised the body’s working alongside the National Catholic Partnership on Disability. Bishop John Folda of Fargo, North Dakota, noted the need to address the increasing and concerning prevalence of assisted suicide and euthanasia “playing to people with disabilities” with “more and more pressure for these practices.”

Concluding discussions and prayer

Cardinal Sean O’Malley of Boston said that alongside the community of those with disabilities it was “crucial to convince people in the secular culture of how evil” physician-assisted suicide is.

The bishops dealt with a variety of other business, including an update on planning for the upcoming World Youth Day in Lisbon, Portugal, in August.

The meeting concluded with the bishops joining together to pray the Litany of the Sacred Heart, something the bishops have encouraged the faithful to pray on June 16, the solemnity of the Sacred Heart, the same day the Los Angeles Dodgers have chosen to honor the “Sisters of Perpetual Indulgence,” an anti-Catholic group that describes its members as “queer and trans nuns.”