U.S. Catholic bishops voted to make official a ban on gender-affirming care for transgender patients at Catholic hospitals, formalizing a yearslong effort by the church to address transgender health care. In a Baltimore hotel ballroom, they overwhelmingly approved revisions to the ethical and religious directives that guide the nation’s Catholic health care institutions and providers.
More than one in seven patients in the U.S. are treated each day at Catholic hospitals, according to the Catholic Health Association, and in some communities Catholic hospitals are the only medical centers available. Major medical groups and health organizations support gender-affirming care for transgender patients, while most Catholic health care institutions have historically taken a conservative approach and not offered such care. The new directives will formalize that mandate, and bishops will have autonomy in implementing the directives as law in their dioceses.
“With regard to the gender ideology, I think it’s very important the church makes a strong statement here,” said Bishop Robert Barron of Minnesota’s Winona-Rochester diocese during public discussion of the revisions.
The Catholic Health Association thanked the bishops for incorporating much of its feedback, saying Catholic providers will continue to welcome and treat transgender patients with dignity and respect, consistent with Catholic social teaching and the moral obligation to serve everyone, particularly those who are marginalized.
The updated guidelines incorporate earlier Vatican and U.S. bishops’ documents on gender identity from 2024 and 2023. In a 2023 doctrinal note titled “Moral Limits to the Technological Manipulation of the Human Body,” the bishops wrote 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 Catholic Church is not monolithic on transgender issues. Some parishes and priests welcome trans Catholics, while others do not. Michael Sennett, a trans man active in his Massachusetts parish and a board member of New Ways Ministry (an advocacy group for LGBTQ+ inclusion in the church), said gender-affirming care is life-changing for many trans people. New Ways Ministry arranged a 2024 meeting with Pope Francis to discuss the need for such care. Its executive director, Francis DeBernardo, said for many transgender Catholics, transition was not only a biological necessity but a spiritual imperative to live authentically.
On the same day the U.S. bishops discussed gender identity, leaders of several major progressive religious denominations issued a statement supporting transgender, intersex and nonbinary people, noting many faith groups affirm the full spectrum of gender at a time when state legislatures and the federal government have restricted rights. The 10 signers included heads of the Unitarian Universalist Association, the Episcopal Church, the Union for Reform Judaism and the Presbyterian Church (U.S.A.), who affirmed that their communities view transgender people as created in the image of God.
Separately, the bishops overwhelmingly approved a rare “special message” on immigration as they concluded their conference in Baltimore. The pastoral statement voiced concern about fear among immigrants, conditions in detention centers, lack of pastoral care, and the vilification of immigrants. Archbishop Paul Coakley, the conference president, urged a balanced approach and called on lawmakers to pursue meaningful immigration reform. Chicago Cardinal Blase Cupich pushed for stronger language opposing mass deportation; the updated text now states that U.S. Catholic bishops “oppose the indiscriminate mass deportation of people.”
