In a decision that reverberated across the nation, U.S. Catholic bishops voted on November 12, 2025, to formalize a ban on gender-affirming care for transgender patients at Catholic hospitals. The move, which took place in a Baltimore hotel ballroom, marks the culmination of years of debate within the American Catholic Church over how to approach transgender health care—a topic that has grown increasingly prominent both within religious circles and in the broader cultural landscape.
The bishops’ vote overwhelmingly approved revisions to the ethical and religious directives that guide thousands of Catholic health care institutions and providers throughout the United States. According to the Catholic Health Association, more than one in seven patients in the U.S. are treated each day at Catholic hospitals—facilities that, in some communities, are the only available medical centers. This means the decision will affect a significant portion of the American population, especially in areas where alternatives are scarce.
The new directives formalize a longstanding practice: most Catholic health care institutions have not offered gender-affirming care, which may include hormonal, psychological, and surgical treatments. Now, this approach is not just tradition but official policy. The bishops themselves will have autonomy to enact these directives as law within their respective dioceses, allowing for some local discretion but reinforcing a clear national stance. As reported by the Associated Press, the new guidelines draw upon earlier Vatican documents from 2024 and a 2023 U.S. bishops’ doctrinal note, "Moral Limits to the Technological Manipulation of the Human Body." That document states: "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."
During the public discussion of the revised directives, Bishop Robert Barron of Minnesota’s Winona-Rochester diocese emphasized the importance of the decision. "With regard to the gender ideology, I think it’s very important the church makes a strong statement here," Barron stated, as quoted in Fox News and other outlets. His remarks underscored the bishops’ desire to assert a clear doctrinal position at a time when gender identity issues are at the forefront of national debate.
Yet, even as the bishops drew a line in the sand, the Catholic Health Association—representing many of the hospitals affected—expressed gratitude that much of its feedback had been incorporated into the directives. In a statement, the Association said, "Catholic providers will continue to welcome those who seek medical care from us and identify as transgender. We will continue to treat these individuals with dignity and respect, which is consistent with Catholic social teaching and our moral obligation to serve everyone, particularly those who are marginalized." This sentiment reflects a tension within the Church: upholding doctrinal boundaries while striving to maintain compassionate care for all patients.
The Catholic Church’s stance is far from monolithic. Some parishes and priests have made efforts to welcome transgender Catholics. Michael Sennett, a transgender man active in his Massachusetts parish and a board member of New Ways Ministry (an organization advocating for LGBTQ+ inclusion in the Catholic Church), told the Associated Press, "Catholic teaching upholds the invaluable dignity of every human life, and for many trans people, gender-affirming care is what makes life livable." Sennett’s group even arranged a meeting with Pope Francis in 2024 to discuss the necessity of gender-affirming care. Francis DeBernardo, executive director of New Ways Ministry, added, "For many transgender Catholics I know, the transition process was not just a biological necessity, but a spiritual imperative. That if they were going to be living as authentic people in the way that they believe God made them, then transition becomes a necessary thing."
The same day the bishops were voting in Baltimore, the heads of several major progressive religious denominations—including leaders from the Unitarian Universalist Association, the Episcopal Church, the Union for Reform Judaism, and the Presbyterian Church (U.S.A.)—issued a joint statement supporting transgender, intersex, and nonbinary people. Their message, as reported by AP and Fox News, read: "During a time when our country is placing their lives under increasingly serious threat, there is a disgraceful misconception that all people of faith do not affirm the full spectrum of gender—a great many of us do. Let it be known instead that our beloveds are created in the image of God—Holy and whole." This statement sought to counter the notion that all religious people oppose gender diversity, highlighting a growing divide among faith communities on the issue.
Major medical groups and health organizations, for their part, support gender-affirming care for transgender patients, emphasizing its importance for mental and physical well-being. The bishops’ decision, therefore, places Catholic health care in direct opposition to prevailing medical consensus, a point not lost on advocates for transgender rights.
But the bishops’ conference in Baltimore wasn’t solely focused on gender identity. In a rare move, the assembled leaders also approved a "special message" on immigration, expressing deep concern over the state of the national debate and the treatment of immigrants. The message, which was unanimously supported, reads: "We are disturbed when we see among our people a climate of fear and anxiety around questions of profiling and immigration enforcement. We are saddened by the state of contemporary debate and the vilification of immigrants. We are concerned about the conditions in detention centers and the lack of access to pastoral care."
Several bishops stood up to voice support for the statement, with Chicago Cardinal Blase Cupich recommending stronger language around mass deportation. "That seems to be the central issue we are facing with our people at this time," Cupich said, according to AP reports. The final text now affirms that U.S. Catholic bishops "oppose the indiscriminate mass deportation of people." Oklahoma City Archbishop Paul Coakley, the newly elected president of the conference, described the message as a necessary step for "the good of our immigrant brothers and sisters, but also to find a nice balance," and called on lawmakers and the administration to pursue meaningful immigration reform.
The bishops’ dual focus—drawing a doctrinal line on gender-affirming care and issuing a pastoral plea for immigrants—reflects the complexities of leading a vast and diverse faith community in a polarized era. On one hand, the Church is doubling down on traditional teachings regarding gender and sexuality; on the other, it is seeking to uphold its longstanding commitment to the vulnerable and marginalized, particularly immigrants facing fear and uncertainty.
As the dust settles from the Baltimore conference, the impact of these decisions will be felt far beyond the walls of Catholic hospitals or the pews of parish churches. For transgender patients and immigrants alike, the bishops’ statements will shape not only policy but the tone of national conversations for months and years to come.
