Catholic bishops meet to discuss issues related to health care for transgender people

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More than 100 bishops from across North America met in Dallas to discuss a number of emerging bioethical issues, including physician-assisted suicide and new biotechnologies. But one of the primary topics on the agenda focused on learning how recently won rights for transgender individuals could affect Catholic entities, including hospitals, schools and parishes, on both ethical and legal grounds.

The National Catholic Bioethics Center, based in Philadelphia, hosted a conference called “Healing Persons in a Wounded Culture” from Feb. 6 to 8, which included a talk from a high-ranking Vatican official and sessions on how federal rules meant to protect the rights of transgender individuals affect Catholic institutions.

The center’s president, John M. Haas, told America in a phone interview on Feb. 9 that the N.C.B.C. surveys bishops to determine which issues are of most interest to them. “We were a little surprised this came to the top of the list.”

He said the number of questions from Catholic organizations to N.C.B.C.’s ethicists about transgender issues “has increased radically and surprisingly” in recent years. “We were having bishops and superintendents of schools and chancellors and university presidents and others calling us with questions about how to deal with some of the issues that have arisen.”

The number of questions from Catholic organizations to N.C.B.C.’s ethicists about transgender issues “has increased radically and surprisingly” in recent years.

An invitation to the conference obtained by America says that federal regulations within the Affordable Care Act compel hospitals to “provide transsexual surgery” and that “Catholic hospitals would not be able to appeal to conscience protections in refusing to allow it to take place.”

The letter also suggests that transgender issues are having an impact at Catholic schools, “with girls demanding that they be treated as boys, or vice versa,” and speculates that the issue “may also have an impact on our sacramental life, as a transgendered couple presents for baptism a baby who has been engendered by in vitro fertilization using other people’s gametes.”

“The traditional understanding of marriage and family founders,” the letter continues.

The first full day of the conference was called “Fractured Sexual Identity and the Transgender Question” and included sessions on psychology, pharmacology, legal issues and pastoral responses to transgender issues.

The letter states that “God created us in His own image as male and female” and says original sin “defaced that image and deviated from that plan. Humanity has suffered the consequences ever since.”

“But the Church through her sacraments and moral teachings, through her health care professionals and institutions, seeks to heal and bind those wounds,” it continues. “We have consequently devoted the first day of our Workshop to grappling with the issue of transgenderism.”

Federal mandates and recent legal actions on behalf of transgender patients suggest that more clashes over treatment of transgender people at Catholic institutions may be inevitable.

Mr. Haas said that no transgender individuals were invited to present at the event, but he said that the bishops present were seeking ways “to accompany these people, help them, be with them, be close to them.”

Federal mandates and recent legal actions on behalf of transgender patients suggest that more clashes over treatment of transgender people at Catholic institutions may be inevitable.

“There wasn’t a hint of treating them as outcasts,” he said. “We tried to garner as much scientific evidence for what was going on to be of help to the bishops in their pastoral approach to these people.”

But the head of a group that promotes L.G.B.T. rights in the church called the meeting “very disappointing” and said the agenda suggested that it ignored “the most up to date scientific research on transgender issues.”

“Most importantly, why do bishops close their eyes and ears to the life journeys of the Catholic transgender individuals?” asked Francis DeBernardo, head of New Ways Ministry. “They should instead follow the example of Pope Francis who has revealed that he has had discussions with transgender Catholics.”

The pope has been critical of efforts aimed at children that teach gender is merely a social construct and in 2015 the Vatican ruled that a transgender man could not be a godfather. Still, he has met at least twice with transgender Catholics and he has urged that L.G.B.T. people be provided pastoral care if they seek it.

“It is one thing for a person to have this tendency, this option and even to have a sex change, but it is another thing to teach this in schools in order to change mentalities. This I call ideological colonization," he said in a 2016 press conference.

Archbishop Vincenzo Paglia, head of the Vatican’s pro-life office, offered the conference’s keynote address on Feb. 6, and Heritage Foundation fellow Ryan T. Anderson spoke on legal issues and mandates related to transgender issues on Feb. 7. A copy of Archbishop Paglia’s talk distributed to the media showed that he spoke broadly about the impact of technology on life but did not address transgender issues specifically.

“Man’s desire to rule over nature soon becomes a desire in every heart to control, shape and empower the biological self, and the only reality worth relying on seems today to be the life that man believes he can build with his own hands,” the archbishop said.

The National Catholic Bioethics Center provides consultation to its members about a range of ethical questions. On its board sit several American cardinals and archbishops, including the head of the U.S. Conference of Catholic Bishops, Cardinal Daniel DiNardo, as well as the archbishops of Washington, Philadelphia, New York, Boston and Los Angeles. According to the conference brochure, support was provided by the Knights of Columbus.

Rights for transgender people in the United States have advanced rapidly in recent years, especially under President Barack Obama, whose administration directed changes in health care and schools cheered by L.G.B.T. activists but denounced by social conservatives. One such move was anti-bias language in the Affordable Care Act that said insurance companies and hospitals are required to provide procedures related to gender reassignment issues without discrimination.

The Catholic Health Association, which represents more than 600 U.S. Catholic hospitals, spoke out against the rule change, according to a 2016 story in Modern Healthcare.

“Health services related to gender transition present a potential conflict with the equally important principle of the free exercise of religion,” said the organization, which also called for “explicit language protecting its ministries both as health care providers and employers from having to perform, provide health insurance coverage of, pay for, or facilitate in any way procedures that would be contrary to Catholic doctrine.”

Ultimately, H.H.S. did not include new religious exemptions and in December a federal judge in Texas ruled in favor of the State of Texas and some Christian-affiliated health care providers that sued, arguing their religious liberty was at stake.

“Health services related to gender transition present a potential conflict with the equally important principle of the free exercise of religion.”

But a transgender man in New Jersey last month nonetheless filed suit against a Catholic hospital that, he said, refused to perform a hysterectomy in 2015, which his attorney says violates state and federal nondiscrimination laws.

“No hospital should be allowed to decide who their patients are, particularly when they receive government funds. Denying care to someone at their time of need because of their sex or gender identity is not only dangerous and humiliating, it’s against the law,” Omar Gonzalez-Pagan, the plaintiff’s attorney, said in a statement.

Though there does not appear to be information about the Dallas conference on the website of the National Catholic Bioethics Center, its homepage links to a statement from the group calling laws supporting trans-rights “coercive and based on a destructive understanding of human identity.”

“Gender transitioning insists on affirming a false identity and, in many cases, mutilation of the body in support of that falsehood,” the statement reads. “Consequently, no Catholic healthcare organization should establish policies that positively affirm the choice of any behavioral, hormonal, or surgical gender transitioning of patients, personnel, or other persons served by the organization,” it continues.

It goes on to say that Catholic health entities should not require staff to use “pronouns or sex-specific identifiers that are explicitly contrary to a person’s biological sex.”

That view does not appear to be settled.

Staff at some Catholic hospitals will use preferred pronouns and allow patients and guests to use facilities of their own choosing.

When it comes to treatment, at least one Catholic ethicist thinks there are still unanswered questions.

“For most medical providers the issue is settled in terms of seeing gender dysphoria as something that can be treated legitimately. However, Catholic ethicists still have many questions about its moral permissibility,” Charles E. Bouchard, O.P., the senior director of ethics and theology for the Catholic Health Association, told America.

“There is so much about transgender persons that we still don’t know,” Father Bouchard continued, pointing to a conference he recently attended where several transgender individuals called for more scientific inquiry into trans issues. “We just don’t understand this well enough, and we’re trying to be cautious before we make definitive ethical statements about it.”

Carol Bayley, vice president for ethics at the Catholic-affiliated Dignity Health, one of the nation’s largest hospital chains, wrote an article in Health Care Ethics USA in 2016 that argued Catholic hospitals may be morally permitted to carry out some gender reassignment procedures. She urged Catholic hospitals to have an open mind and to educate staff about trans issues.

“Because this condition is relatively rare, and also because it affects socially freighted aspects of our humanity—sex and gender—many in Catholic health care are unfamiliar with it. That should not prevent us from rendering compassionate care,” Ms. Bayley wrote.

“Furthermore, Catholic health care institutions should be cautious about developing practices that could violate their own policies of non-discrimination, particularly in light of the federal government’s recognition of transgender individuals as members of a protected class.”

Derrick Weiller
1 month 1 week ago

No hospital should be allowed to decide who their patients are, particularly when they receive government fund.
Case closed !

Tim O'Leary
1 month 1 week ago

To translate what Derrick means - If you get government funds, you must abandon any ethical judgment. If someone comes to have their child killed, you have to do it. If they come to have their aged parent killed, you have to do it. If they demand surgical mutilation, you must do it. That is the Brave New World being advocated. This is all wrong. That is why any ethical Catholic should oppose any government involvement in schools or healthcare or any service that has significant ethical ramifications. On Judgment Day, it will not be sufficient defense to say, I knew it was wrong, but the government/law/devil made me do it.

Derrick Weiller
1 month 1 week ago

1) Tim shamefully misrepresents my point.
The point is not: "If you get government funds, you must abandon any ethical judgement."
Rather, it is that "If you get government funds,
your services may not be made contingent upon approval of taxpayers' life paths.

2) Tim's "kill the child/parents kill/mutilation" examples are disingenuous and fatuous.
Tim must learn to distinguish:
a) between WHO requests services, and the services being requested; and
b) between services that are legal, and those which are not.

Tim O'Leary
1 month 1 week ago

Derrick - your phrase "approval of taxpayer's life paths" is a good example of fatuousness. We're not talking about a taxpayer's journey here, but the government's ability to compel a doctor to mutilate or kill, against their ethical judgment. You seem to think that as long as an action, once universally recognized as evil, is now made legal, it not only becomes allowed, but it becomes compulsory. Your choice of words is Orwellian. Abortion is not a service. Neither is euthanasia. Neither is castration.

Derrick Weiller
1 month 1 week ago

May a Catholic Hospital provide circumcision services if, among its providers, there are physicians who are not ethically adverse to the procedure?

Tim O'Leary
1 month 1 week ago

You still miss the point. You have moved from tolerance to compulsion. While circumcision is a trivial surgery (unlike abortion or castration), of course no doctor or hospital should be compelled to perform a circumcision, if it is against their ethical principles. If a doctor is interested in doing, say, sex selection abortions, the hospital can still refuse to allow it to be done on their property. etc. etc.

Derrick Weiller
1 month 1 week ago

Once again, Tim, you misrepresent me.
Please strive to read carefully.
It will help.

Oh.
One more thing.
Circum ision is mutilation.
There goes your argument.
Deal with it.
Your friend,
Derrick

Tim O'Leary
1 month 1 week ago

Is your point that if one form of mutilation is found to be ethical, all forms of mutilation must be ethical? Moreover, they must be compulsory. Very strange.

Derrick Weiller
1 month 1 week ago

OK

Tim O'Leary
1 month 1 week ago

Every bishop at the meeting should have read the most scientifically rigorous publication on gender identity from Johns Hopkins http://www.thenewatlantis.com/docLib/20160819_TNA50SexualityandGender.p…. Som of their conclusions:

"The hypothesis that gender identity is an innate, fixed property of human beings that is independent of biological sex — that a person might be “a man trapped in a woman’s body” or “a woman trapped in a man’s body” — is not supported by scientific evidence."

"According to a recent estimate, about 0.6% of U.S. adults identify as a gender that does not correspond to their biological sex. Studies comparing the brain structures of transgender and non-transgender individuals have demonstrated weak correlations between brain structure and cross-gender identification. These correlations do not provide any evidence for a neurobiological basis for cross-gender identification."

"Compared to the general population, adults who have undergone sex-reassignment surgery continue to have a higher risk of experiencing poor mental health outcomes. One study found that, compared to controls, sex-reassigned individuals were about 5 times more likely to attempt suicide and about 19 times more likely to die by suicide. "

Derrick Weiller
1 month 1 week ago

What Tim represents as "the most scientifically rigorous publication on gender identity...".is neither scientific nor rigorous.
a) It merely reviews "carefully selected" studies.
b) It underwent no peer review.
c) It was not published in a scientific journal, but rather, in a quarterly public advocacy journal.

With this in mind, then,
one might safely dismiss paper's conclusions as mere polemics.

Tim O'Leary
1 month 1 week ago

Derrick - I am not surprised to see you want to discredit the authors and this manuscript. The LGBTQIA stormtroopers have already threatened Johns Hopkins with a shaming campaign if they do not disown their professors. Your "carefully selected" quote is made up by you and is not in the document (see below re the thoroughness of the review).

Dr. Mayer writes: “I strongly support equality and oppose discrimination for the LGBT community, and I have testified on their behalf as a statistical expert.” Here is some more background of the two authors:

Paul R. McHugh, M.D. is the former chief of psychiatry at Johns Hopkins Hospital and one of the leading psychiatrists in the world (“arguably the most important American psychiatrist of the last half-century”). He and his colleagues at Hopkins drafted the manuscript, and then asked Dr. Lawrence S. Mayer, a biostatistician and epidemiologist trained in medicine and psychiatry, to ensure the accuracy of the statistical inferences and to review additional sources. He has been a full-time tenured professor for over four decades (including Princeton, Penn, Stanford, AZ State and Hopkins). His work focuses on the design, analysis, and interpretation of experimental and observational data in public health and medicine.

In several months, Dr. Mayer “closely read over five hundred scientific articles on these topics and perused hundreds more,” including research in “epidemiology, genetics, endocrinology, psychiatry, neuroscience, embryology, and pediatrics.” He also reviewed “many of the academic empirical studies done in the social sciences including psychology, sociology, political science, economics, and gender studies.” A very serious undertaking, by any measure. After this effort, he agreed to take over as lead author. He states “I support every sentence in this report, without reservation and without prejudice regarding any political or philosophical debates. This report is about science and medicine, nothing more and nothing less.”

Tim O'Leary
1 month 1 week ago

Derrick - I have more post-grad education in the health sciences than you had grade school, and my professional life has been several decades in health sciences. So, it would be interesting to hear of your scientific credentials, if any. Irrespective of your scientific limitations, I am happy to recommend the bishops read both your Patheos link as well as the original publication.

Derrick Weiller
1 month 1 week ago

Tim.
My credentiAls outstrip yours by a mile.
But this is irrelevant.

With this aside,
I celebrate your suggestion that bishops read both your litany of polemics and the citation I provided.

And again, a course in the The Nature of Science might help you.
Good luck.
Your Friend
Derrick

Tim O'Leary
1 month 1 week ago

There is no scientific test that objectively distinguishes any lettered member of the LGBTQIA... It is all based on self-identification, at a particular period in one's life. You need to distinguish science from pseudoscience. Also, metrics are important in science. Credentials are not measured in miles.

Derrick Weiller
1 month 1 week ago

OK

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