In a pivotal vote on November 12, the bishops of the United States made a significant change to the Ethical and Religious Directives for Catholic Health Care Services (ERDs). The approved amendments now clearly prohibit Catholic hospitals from providing gender-affirming care, including both surgical and hormonal treatments for transgender patients. This directive hinges on Catholic teachings about ethics and the dignity of the human person.
The ERDs serve as guidelines issued by the bishops to set forth ethical standards for health care within the Catholic Church. These standards, which have evolved over time, are currently in place under the sixth edition, last updated seven years ago. The amendments passed by the bishops will be integrated into the seventh edition of the ERDs, expected to be released in late 2025 or early 2026.
To gain approval, these amendments required a two-thirds majority from the members of the U.S. bishops’ conference. The revisions specifically address transgender care within the context of professional-patient relationships, emphasizing that any medical interventions must not alter the fundamental order of the human body. The newly amended directive states that Catholic health care professionals and their patients share a responsibility to “preserve the integrity of the human body.”
These guidelines clarify that while removing or suppressing the function of one part of the body may be permissible under certain conditions, gender-affirming care does not meet the necessary criteria. In their ruling, the bishops indicate that such surgeries “do not repair a defect in the body”—a key distinction as they argue these procedures aim to transform the body into the opposite sex, which violates the Church’s understanding of the natural order and purpose of human existence.
Support for the amendments was expressed by the Catholic Health Association, which thanked the bishops for their decision. They affirmed that while they would not conduct the now-prohibited medical procedures, their facilities would continue to serve transgender individuals with dignity and respect. The organization emphasized, “Catholic providers will continue to welcome those who seek medical care from us and identify as transgender.” This statement aligns with Catholic social teaching, underscoring a commitment to care for all, particularly marginalized groups.
In addition to discussing transgender healthcare, the bishops expressed concern over the treatment of immigrants in the current sociopolitical climate. Post-meeting, they voiced their discontent with the climate of fear surrounding immigration enforcement and profiling. They noted, “We are disturbed when we see among our people a climate of fear and anxiety around questions of profiling and immigration enforcement.” The bishops highlighted their worries over the conditions in detention centers and called attention to the lack of access to pastoral care for those affected.
This vote marks a clear stance by the bishops on an issue that continues to evoke strong emotions and divergent opinions. As the Catholic Church navigates complex moral terrains like this one, their decisions reflect not only religious convictions but also a broader conversation within society regarding health care and human dignity.
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