Sanctuary or Shutdown? US Bishops Block Gender-Affirming Care at Catholic Hospitals

U.S. Catholic bishops made a shocking ruling on gender-affirming medical care, taking it off the table at Catholic hospitals nationwide. Meeting in Baltimore on Nov. 12, the U.S. Conference of Catholic Bishops (USCCB) voted to revise their Ethical and Religious Directives for Catholic Health Care Services, according to AP News. They added language that bars Catholic facilities from providing gender-affirming treatments, including transition-related hormones and surgeries.

Catholic health systems treat more than one in seven patients in the U.S. and often serve as the only hospital in some communities. The decision hits hard for trans people who already struggle to access safe, affirming care. Here’s what the new directive means for LGBTQIA+ Catholics.

What Led to the Bishops’ Decision?

The vote marks the endpoint of a long campaign by U.S. bishops to determine a hard line against what they call “gender ideology.” In March 2023, the bishops’ doctrine committee released a document titled “Moral Limits to the Technological Manipulation of the Human Body.” It argued that gender-affirming medical treatments — including hormones and surgeries — are morally unacceptable and instructed Catholic health institutions not to perform procedures meant to change a person’s sex characteristics.

In Baltimore, the bishops took the next step and folded that teaching directly into the binding health-care rulebook that governs Catholic hospitals, clinics, and long-term care centers. According to the National Catholic Reporter (NCR), the revised directives tell facilities not to perform medical interventions that aim to transform a person’s sexual characteristics into those of another sex. It also bars Catholic providers from referring patients elsewhere to obtain those procedures.

Bishop Robert Barron of Winona-Rochester, Minnesota backed the move from the floor. “With regard to the gender ideology, I think it’s very important the church makes a strong statement here,” he said, per AP News. According to the NCR, the bishops ultimately approved the new language by a wide margin, 206–8, with seven abstentions. 

LGBTQIA+ Catholic and Human-Rights Groups Are Pushing Back

Queer Catholics and human-rights advocates responded immediately. New Ways Ministry, an advocacy group for LGBTQIA+ Catholics, condemned the new directives as a betrayal of Catholic social teaching.

“The directives adopted by the USCCB will harm, not benefit transgender persons,” executive director Francis DeBernardo warned. “In a church called to synodal listening and dialogue, it is embarrassing, even shameful, that the bishops failed to consult transgender people, who have found that gender-affirming medical care has enhanced their lives and their relationship with God.”

DeBernardo also criticized the process, stating that the bishops never consulted trans people or mainstream medical groups. He argued that the policy will be interpreted as encouragement by those who already seek to “deny, hurt and too often, even murder transgender people.” New Ways Ministry is now urging Catholics to contact their bishops and the Vatican and to push for policies rooted in trans people’s lived experiences and scientific evidence.

Patients may still be able to get basic care, emergency treatment, and some mental-health services at Catholic facilities. However, if their treatment plan includes surgery or hormones tied to transition, they could face canceled procedures or gaps in care.

What role should faith-based institutions play in LGBTQIA+ health care? Comment below!

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