Two weeks ago, Transgender Day of Visibility fell in the middle of Holy Week, so I am making like Jesus and climbing up a hill to die on: Catholic health care needs to stop excluding and neglecting gender-affirming care for trans people. As a trans person who attended Catholic school from kindergarten through high school, the Church’s thinly veiled hostility towards the trans community is nothing new to me. While socially transitioning in high school, I was singled out by the administration for things like using my chosen name in contexts where my cisgender peers used preferred names or nicknames with no issue or concern. I powered through until graduation, but I continue to be haunted by the Church’s anti-trans health care policies.
In my case, I am a dependent of an employee of my local Catholic Archdiocese, meaning what is and is not covered by my health insurance is determined by the Archdiocese. Since Catholic doctrine is categorically against gender-affirming medical care, be that hormone therapy, surgery, or otherwise, any costs associated with my medical transition (medication, bloodwork, appointments, and so on) come out of my own pocket—and those numbers add up fast. What really offends me about this policy, though, as someone who is educated on Catholic doctrine, is the hypocrisy underlying the Church’s exclusion of gender-affirming care. This exclusion is also not only applied to individuals insured by the Church, but extends to the prohibition of gender-affirming care in any Catholic health care facilities, such as hospitals. The Catholic Health Association of the United States lists its status as “the largest nonprofit provider of health care services in the nation” as a point of pride, and claims it “serves the full continuum of health care across our nation.”
Despite this, according to the United States Conference of Catholic Bishops (USCCB), “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,” and doing so would “contradict the organization’s core mission and identity as a ministry of faith.” The basis of these ideas is the Catholic doctrine regarding the unity of body and soul, and an argument that changing the body would disrupt this unity and cause harm rather than help. Catholic health policies regarding gender-affirming care are “developed in consultation with… medical ethicists, physicians, psychologists, and moral theologians,” and the USCCB Committee on Doctrine is made up of exclusively Catholic bishops, who are all cisgender men. Notably, no emphasis is given to the inclusion of transgender people in creating policies that affect us, despite the USCCB itself acknowledging in its descriptions of Catholic Social Teaching principles that “dialogue must not only favor the preferential option on behalf of the poor, the marginalized and the excluded, but also respect them as having a leading role to play.”
These policies that prohibit gender-affirming care are not based on scientific or medical evidence, they are based on the Catechism of the Catholic Church, Catholic Tradition, papal doctrine, and the Bible. Catholic health care policies claim to “provide the best medical care… to all patients, no matter who they may be or from what condition they may be suffering.” However, the USCCB also claims that gender-affirming care has “irreparable consequences,” “has not been substantially associated with improved long-term health outcomes,” and can be “detrimental to patients’ health” because it does not find these treatments medically necessary, or beneficial to “the authentic good of the human person.” As cited by the Human Rights Campaign, multiple systematic reviews of studies on the mental health impacts of gender-affirming care for transgender youth and adults found increases in happiness and quality of life, and decreases in depression, anxiety, and suicidality. While the Church presents its position on medical transition as being in the best interest of transgender people and our wellbeing, this position is in direct contradiction with secular medical science and ignores the input and experiences of the people these policies affect.
While my expectations for the Church to do better are slim, it is important to call out the hypocritical and harmful policies that affect the lives of transgender people who need gender-affirming care through Catholic-affiliated insurance or facilities. The Church should not portray itself as benevolent, charitable, and in favor of justice for the oppressed while creating and upholding a medical system that neglects a marginalized minority group in need of care.
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