From left, the Rev. Michael J.C. Fuller, Archbishop Timothy Broglio and Baltimore Archbishop William Laurie lead a plenary meeting of the U.S. Conference of Catholic Bishops in Baltimore on Tuesday.
Stephanie Scarbrough/AP
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U.S. Catholic bishops voted Wednesday to formally ban gender-affirming care for transgender patients in Catholic hospitals. The move formalizes the U.S. church's years-long process to address transgender health care.
In a Baltimore hotel ballroom, the bishops overwhelmingly approved changes to their ethical and religious guidelines that guide the nation's thousands of Catholic health care facilities and providers.
More than one in seven patients in the U.S. are treated in Catholic hospitals every day, according to the Catholic Health Association. Catholic hospitals are the only medical centers in some communities.
Major medical groups and health care organizations support gender-affirming care for transgender patients.
Most Catholic health care providers take a conservative approach and do not offer gender-affirming care, which may include hormonal, psychological and surgical treatments. The new directives will formalize this mandate. Bishops will have autonomy to make directives into law for their dioceses.
“As far as gender ideology is concerned, I think it is very important that the church makes a strong statement here,” Bishop Robert Barron of the Minnesota Diocese of Winona-Rochester said during a public discussion of the revised guidelines.
The Catholic Health Association thanked the bishops for incorporating much of the organization's feedback into the guidelines. The statement reads: “Catholic health care providers will continue to welcome those who come to us for health care and identify as transgender. We will continue to treat these people with dignity and respect, which is consistent with Catholic social teaching and our moral obligation to serve all, especially those who are marginalized.”
The new guidelines incorporate earlier documents on gender identity adopted by the Vatican in 2024 and by the U.S. bishops in 2023.
In a 2023 doctrinal note entitled “The Moral Limits of Technological Manipulation of the Human Body,” the bishops clarified: “Catholic health services should not perform interventions, whether surgical or chemical, aimed at transforming the sexual characteristics of the human body into those of the opposite sex, or participate in the development of such procedures.”
Progressive religious voices respond
The Catholic Church is not monolithic when it comes to transgender rights. Some parishes and priests welcome trans Catholics, while others do not accept them in the same way.
“Catholic teaching upholds the precious dignity of every human life, and for many transgender people, gender-affirming care is what makes life livable,” said Michael Sennett, a trans man who is an active member of his parish in Massachusetts.
Sennett serves on the board of directors of New Ways Ministry, which advocates for LGBTQ+ inclusion in the Catholic Church. In 2024, the group organized a meeting with Pope Francis to discuss the need for gender-affirming care.
New Ways Ministry Executive Director Francis DeBernardo said that for many transgender Catholics he knows, “the process of transition was not just a biological necessity, but a spiritual imperative. If they were going to live as real people, the way they believed God created them, then transition becomes a necessary thing.”
On the same day that U.S. Catholic bishops debated gender identity, the heads of several major progressive religious denominations issued statements supporting transgender, intersex and nonbinary people as many state legislatures and the Trump administration roll back their rights.
The 10 signatories included the heads of the Unitarian Universalist Association, the Episcopal Church, the Union of Reform Judaism and the Presbyterian Church (USA).
“At a time when our country is increasingly putting their lives at risk, it is a shameful misconception that all people of faith do not embrace the full spectrum of gender – many of us do. Instead, let it be known that our beloved are created in the image of God—holy and whole,” the religious leaders said in a statement.
US bishops united in concern for immigrants
Catholic bishops wrapping up their conference in Baltimore overwhelmingly approved a “special message” on immigration Wednesday. Such pastoral statements are rare; the last time was in 2013 in response to the Obama administration's mandate for insurers to provide contraceptive coverage.
Catholic leaders have individually criticized the Trump administration's immigration policies. Fear of immigration controls prevented mass attendance in some parishes. Local clergy are fighting to bring communion to detained immigrants.
“We are concerned when we see a climate of fear and anxiety among our people regarding issues of profiling and immigration control,” the bishops said in a statement. “We are saddened by the state of the current debate and the denigration of immigrants. We are concerned about the conditions in detention centers and the lack of access to pastoral care.”
In a show of unity, several bishops spoke in support of the statement during the day's final discussion, including Oklahoma City Archbishop Paul Coakley, the conference's newly elected president.
“I strongly support this for the benefit of our immigrant brothers and sisters and to find a good balance,” Coakley said, noting that they are calling on “our legislators and our administration to offer us a meaningful path to reform our immigration system.”
Chicago Cardinal Blaise Cupich took to the microphone to recommend stronger language on mass deportations. “This seems to be the central problem we face at the moment with our people,” he said.
His brother bishops agreed. The updated text now states that U.S. Catholic bishops “oppose the indiscriminate mass deportation of human beings.”
