CMA, NCBC and CMDA religious position statements on transgender identities, healthcare and conscience
Last updated: 13 January 2023
1: Catholic Medical Association (CMA)
Declaration of CMA executive director Mario Dickerson in American College of Pediatricians, Catholic Medical Association and Jeanie Dassow MD v. Becerra et al. (4 November 2021):
27 . CMA and its members sincerely believe that sex is a biological, immutable characteristic.
28 . CMA and its members believe that the norm for human design is to be conceived either male or female.
29 . They respect the dignity of the human person as an embodied true male or female.
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33 . These beliefs reflect scientific reality, as well as thousands of years of Christian anthropology, with its roots in the narrative of human origins that appears in the Book of Genesis, when “God created man in his own image . . . male and female he created them.” Gen. 1:27.
34 . The Catholic Church teaches that men and women are created in two sexes with corresponding identities. (2) [2: See, e.g., Catechism § 2333, 2393; Pope Francis, Encyclical letter Laudato Si’ ¶ 155 (2015), https://www.vatican.va/content/francesco/en/encyclicals/ documents/papa-francesco_20150524_encicli ca-laudato-si.html.]
35 . The Catholic Church thus opposes invasive and drastic medical interventions promoted by modern gender ideology. “Except when performed for strictly therapeutic medical reasons, directly intended amputations, mutilations, and sterilizations performed on innocent persons are against the moral law.” Catechism § 2297.
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50 . In accord with these scientific and religious understandings, CMA and its members believe that healthcare that provides gender-transition procedures and interventions is neither healthful nor caring; it is experimental and dangerous.
51 . For CMA and its members, gender-transition procedures and interventions can be harmful, particularly to children, and medical science does not support the provision of such procedures or interventions.
52 . CMA and its members thus believe providing or referring patients for the provision of gender identity interventions violates their core beliefs and their oath to “do no harm.”
53 . CMA thus opposes pubertal suppression of minors, as well as hormone administration or other surgical interventions for purposes of “choosing” a gender or sex, and it objects to engaging in speech affirming these gender interventions.
54 . CMA has adopted an official resolution stating, “the Catholic Medical Association does not support the use of any hormones, hormone blocking agents or surgery in all human persons for the treatment of Gender Dysphoria.”
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69 . The gender identity mandate requires CMA members to engage in various practices to which our members objection on medical and ethical grounds, including the following:
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k . Referring patients for any and all such interventions, procedures, services, or drugs;
l . Ending or modifying their policies, procedures, and practices of not offering to perform or prescribe these procedures, drugs, and interventions;
m . Saying in their professional opinions that these gender intervention procedures are the standard of care, are safe, are beneficial, are not experimental, or should otherwise be recommended;
n . Treating patients according to gender identity and not sex;
o . Expressing views on gender interventions that they do not share;
p . Saying that sex or gender is nonbinary or on a spectrum;
q . Using language affirming any self-professed gender identity;
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130 . Our members’ sincerely held religious beliefs prohibit them providing, offering, facilitating, or referring for gender transition interventions and also from engaging in or facilitating the objectionable practices.
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138 . CMA’s members are healthcare providers who object on grounds of science and medical ethics, as well as on religious grounds, to providing, offering, participating in, referring for, or paying for the objectionable practices.
Fehring et al., “The Holy Alliance”, 2019:
The Holy Alliance Project/Program seeks to develop a strong alliance among priests and physician members of the Catholic Medical Association. The unity of faith and reason is under direct assault in our world today. As Catholics, we acknowledge with certainty that the truths of science and the truths of the Faith have one and the same Source. There can never be a conflict between faith and reason. The controversial moral issues of our day all have a medical or bioethical component. Our priests and faithful Catholic physicians must join forces to counter the false claims and seductive arguments that our secularized culture is using to advance the bifurcation of faith and reason.
2: National Catholic Bioethics Center (NCBC)
Ethicists of the National Catholic Bioethics Center, “Transgender Issues in Catholic Health Care” (February 2017)
Gender Transitioning Interventions: Behavioral, Hormonal, and Surgical
Gender transitioning of any kind is intrinsically disordered, because it cannot conform to the true good of the human person, who is a body–soul union unalterably created male or female. Gender transitioning should never be performed, encouraged, or positively affirmed as a good in Catholic health care. This includes surgeries, the administration of cross-sex hormones or pubertal blockers, and social or behavioral modifications.
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Cooperation with Evil: Maintenance, Referral, Coverage, Policies, and Mandates
Maintenance of cross-sex hormone regimens or other transitioning interventions by Catholic physicians or at Catholic health care facilities—even if a patient is being treated for unrelated reasons—amounts to formal cooperation with gender transitioning and is immoral.
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While it is true that “bottom surgeries” result in sterilization by destroying healthy genitalia, any transitioning intervention is intrinsically disordered because it entails a rejection of the person’s actual sexual identity in favor of a falsification. This can never serve the good of the whole person, so even less drastic surgical and hormonal transitioning procedures remain unacceptable for Catholic health care.
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Question 4. A male-to-female transgender patient who had sex reassignment surgery elsewhere was admitted to our emergency room following a car accident and needs to be kept several days for treatment. The patient has been on a regimen of female hormones to maintain the transition. The patient wants to continue the regimen to avoid interruptions. Can we allow this?
Reply: No. Maintenance entails approval by the physician writing orders, and makes those who administer the drugs principal agents in the transitioning. However, if cessation of the hormones would cause serious physical harm, providing a dosage necessary to avoid the harm could be legitimate.
NCBC staff ethicist Josef D. Zalot, “Catholic Health Care and Gender Identity”, in “Transgender Issues in Catholic Health Care” (Furton, 2021, p. 86):
The affirmative model of care fails the principle of double effect on at least two of the four criteria. The first is criterion 1. To determine the liceity of a particular action (or intervention), one needs to evaluate it in light of the moral object – that which gives the act its moral significance. When psychotherapy is used to affirm patients’ perceptions that they are in the wrong body, to encourage them to socially transition, and then to move them toward hormones and surgical procedures, the moral object is gender transition – understood as the deliberate alteration of a person’s thinking, behavior, or appearance to affirm that person’s erroneous perception of sexual identity. Similarly, when puberty-blocking hormones are prescribed (and provided) for the direct and intended purpose of offering a child more time to discern his or her so-called true sex, the moral object is gender transition. When cross-sex hormones are prescribed (and provided) for the direct and intended purpose of altering one’s secondary sex characteristics (breasts, facial hair, and so on) so that the body presents with the physical attributes of one’s preferred gender, the moral object is gender transition. Finally, when surgical procedures are performed on organs and tissues absent a diagnosed pathology – and in the context and for the direct purpose of so-called reassignment – the moral object again is gender transition. As previously explained, transitioning one’s gender (or attempting to do so) is contrary to Catholic anthropology and Church teaching, not to mention logic, basic biology, and medical evidence. As such, interventions directed toward this end are never morally good or neutral; they are always morally evil.
Second, Catholic health care should seek sound legal advice and consider membership in organizations committed to upholding the legal rights of Catholic institutions. One such organization is the Catholic Benefits Association (CBA). The CBA has gained permanent injunctive relief for all its members against (1) the Obama administration’s contraception and sterilization coverage mandate, and (2) the HHS regulation interpreting section 1557 of the Affordable Care Act (2010) to mandate insurance coverage for gender-transitioning hormones and surgeries. CBA membership is a viable option for Catholic health care institutions seeking legal protections and support against unjust government mandates.
NCBC fellow Paul W. Hruz, “Medical Approaches to Gender Identity”, in “Transgender Issues in Catholic Health Care” (Furton, 2021, p. 3)
Central to this work is the consistent application of fundamental principles of Catholic anthropology and bioethics. Pope St. John Paul II’s teaching on the Theology of the Body, with its understanding of human dignity and bodily integrity, can inform the ethical boundaries that must be established when working with people who experience gender dysphoria. Continued efforts to provide the best possible care must remain centered on the ultimate good of affected persons as dignified members of the entire human family. Hypotheses based on asserting that experimental intervention will realign an individual’s body with his or her so-called true self as male or female according to the individual’s mind distort the objective biological understanding of sex and are therefore untenable. If viewed in light of an intrinsic body-soul unity, the hypothesis essentially asserts that separating what cannot be separated is beneficial. Regardless of the investigator’s intent, he or she has reasonable grounds to question the proportionality – for both the affected individual and society as a whole – of violating this fundamental principle of the very nature and meaning of sex.
Given the high rate of desistence and the lifelong medical dependency of patients who experience persistent gender discordance, concluding that desistance is a desirable outcome seems reasonable.
One overlooked challenge to obtaining informed consent for any gender-affirming intervention is the assumed participation of the community. Since support of a patient’s desired gender is not restricted to the affected person but rather enlists the participation of multiple individuals within the surrounding community, it is appropriate to question whether current use of the gender-affirmation paradigm leads to unwilling participation in social experimentation. The consent of parents, neighbors, teachers, siblings, and peers in pronoun usage and bathroom access is not solicited.
Objective evaluation of the nature and scope of the problem yields a clear moral imperative to develop effective and long-lasting solutions to the complex needs of individuals with gender discordance. To be successful, this work must respect human dignity without violating bodily integrity. Better understandings of the various contributing factors, both biological and environmental, and of the effects of psychological and medical interventions will undoubtedly make effective therapeutic approaches more precise. Continued recognition of anthropological assumptions and non-negotiable moral principles can help the medical community distinguish hypotheses that are plausible and worthy of investigation from those that are untenable even without experimental testing.
With a contemporary cultural climate that rejects the long-held understanding of the nature of purpose of human sexuality, secular institutions are increasingly unlikely to make serious efforts to identify and directly address underlying psychological dysfunction. Catholic hospitals and academic medical centers are well positioned to fill this void. In the absence of definitive magisterial teaching, bioethicists and IRBs at Catholic institutions will need to apply existing general guidelines to this unique clinical problem. With greater understanding of the particular challenges that are likely to surface, researchers and practitioners can provide sound guidance for safe clinical trial design and apply clear ethical boundaries without imposing unnecessary barriers. Even if some affected patients are ultimately found to experience lifelong gender discordance, fruits of this labor are likely to assist ongoing efforts to alleviate human suffering and foster psychological and spiritual health.
NCBC staff ethicist Edward J. Furton, “A Critique of Gender Dysphoria in DSM-5”, in “Transgender Issues in Catholic Health Care” (Furton, 2021, p. 49):
These statements are centuries-old and have been affirmed as de fidei, or dogma, the highest class of revealed truth. They are not supernatural doctrines, but truths evident to reason. They form part of the general Western metaphysical understanding of the person and therefore are potentially knowable by all people of good will, Christians and non-Christians alike. They address (1) the metaphysical unity of the person and (2) the creation of the soul by God at the moment of its infusion into the body. Any argument in favor of sex-reassignment surgery must content with these teachings.
If it were true that a soul could be infused into the wrong body, whether at the moment of conception or at some later time, it would necessarily follow that God had erred, as there is no prior step between God’s creative act and the infusion of the soul. This, however, is a blasphemous conclusion. Any implication that God has made a mistake in creating a particular human being must be false because the divine Being is not subject to error; hence, He cannot infuse a soul into the wrong body.
Jacob Harrison, “Karol Wojtyla and the Body-Soul Union”, in “Transgender Issues in Catholic Health Care” (Furton, 2021, pp. 57–58):
In another article published in Health Care Ethics USA, Elliott Bedford and Jason Eberl examine Catholic anthropology to address the morality of SRS and offer opinions contrary to those of Bayley and Gremmels. Building on traditional and recent magisterial teaching and influenced by Thomistic philosophy, they assert that the Catholic belief in body-soul unity is sexed by virtue of its relationship to the body. While there is ambiguity in Bedford and Eberl’s concept of the soul as sexed, one can assume that they mean this only by the soul’s relation to the body. In other words, as Edward Furton argues, the soul is sexed in the sense that the soul, as it exists in its embodied state, forms part of our male or female psychological identity. A transgender person, in their view, has “a discrepancy between the perceiving mind and the existing body – a body-self dualism.” They point out that while some may argue that the ultimate end of bottom surgery is to unify the body-soul disconnect, the immediate end reinforces a body-soul dualism. Furthermore, Bedford and Eberl contend that arguments claiming that SRS “helps align or integrate a person as a composite being” deny at least one of the following tenets of Thomistic hylomorphism: “(1) that the soul is simple and not comprised of parts (e.g., the part informing the brain is female while that informing the genitals is male), and (2) an organ of a live human being that is typically developed (even those atypically developed) and functional is not properly informed by a human soul.” From this understanding, they conclude that the integrative goal of SRS presupposes an “ontological dis-integrity” that is contrary to the Catholic understanding of the human person. In their perspective, these anthropological conclusions call into question Bayley’s use of the double effect and Gremmels’s application of the principle of totality.
A full analysis of Aquinas’s influence on Wojtyla is beyond the scope of this chapter, but for our purposes, it suffices to recognize that Wojtyla built on the Boethian-Thomistic definition of personhood by providing “an interpretation that understands the basic concepts of substance, rationality, and nature as part of a deeper unity that also includes the aspects of subjectivity, consciousness and personal love.” Here we can already begin to see Wojtyla’s integration of the whole person and his affirmation of body-soul unity. Thomistic influences are evident throughout Wojtyla’s anthropology, especially in regard to the body-soul relationship. In addition, Wojtyla’s recognition of both sense experience and rational thought is particularly relevant to SRS.
SRS negates the biological meaning of the body by changing the sexual organs of the human person to match a self-perception. At the anthropological level, it appears that to morally permit SRS, one must subscribe to a type of dualism that views the body as mutable and inferior to the gender perception of the mind – an anthropology that John Paul II would reject.
It is important to bring John Paul II’s idea of freedom into dialogue with SRS. It appears that in an autonomy-focused health care system, a person should have the freedom to choose SRS if he or she believes it will improve health and well-being. As noted earlier, John Paul II believed that freedom means that a person must act in accord with truth. Therefore, if SRS is to be morally permissible, it must be in agreement with the truth of the human person. As mentioned previously, if freedom is separated from truth, decisions are based on a person’s subjective and changeable opinion; the self becomes a project to be molded in whatever way the individual believes is best. Consequently, the ability to choose SRS does not in fact make one authentically free, because SRS does not adhere to truths about human nature and the natural law.
This brings us to John Paul II’s conclusion that a morally licit action must accord with the natural law and be directed toward the teleological end of union with God. This means that a person’s action must do the following: uphold the human person as a body-soul unity, recognize the person as made in the imago Dei and therefore respect his or her inherit [sic] dignity, and accord with the call to be in relationship with God and others and therefore align with the command to love God and one’s neighbor. Applying John Paul II’s understanding of the human person, it is clear that SRS is not in accord with the natural law and consequently is not morally permissible in Catholic health care.
NCBC staff ethicist John A. Di Camillo, “Gender Transitioning and Catholic Health Care”, 2017 (presented at Twenty-Sixth NCBC Workshop for Bishops):
What sorts of interventions are proposed for people with transgender desires and beliefs? If we are talking about a person without either a disorder of sex development or a diagnosis of gender dysphoria, the first reasonable response would be to prevent such desires and beliefs from reaching the level of gender dysphoria. This could mean simply waiting for them to resolve during adolescent development or intervening through corrective counseling or psychotherapy to help the person accept his or her bodily sex. This, however, is not the standard approach right now. The typical response is so-called gender affirmation, perhaps more accurately called transgender affirmation, which means encouraging the adult or child to seriously question his or her sexual identity and supporting any gender-nonconforming thoughts or feelings. This might help distinguish a diagnosis of gender dysphoria, but it might also precipitate the condition when it could have been prevented.
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DSM-5 defines psychotic delusions as “fixed beliefs that are not amenable to change in light of conflicting evidence.” Persistent transgender beliefs would seem to fit this definition.
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What does all of this mean for Catholic health care practice? We cannot be hoodwinked by ideologically compromised science. The real transgender issue is not a technical medical one but a profound anthropological error with moral consequences. No amount of scientific data can help provide real healing if its interpreters deny God’s design of each human person as an individual body–soul unity, male or female.
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It should be clear from this that bodily acceptance efforts can be morally sound, whether we are talking about basic human support, expectant waiting, pastoral counseling, or some form of corrective psychotherapy. By their nature, these interventions have a good end and properly ordered means that respect the integrity of the human person: they seek to eliminate or mitigate transgender beliefs and desires by acknowledging the truth of one’s objective sexual identity, taking the body as given and the whole person as worthy of love.
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In the end, there is no authentic transition either anthropologically or biologically – just mutilation. If gender-transitioning efforts, from trans-affirmative counseling to invasive surgery, always amount to a rejection of the person’s body, we can say that inclinations toward transitioning, namely, transgender desires and beliefs, are disordered. As real as the experience of these feelings and convictions may be, they are ordered only to disfiguring the body and literally dis-integrating the person.
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We can summarize the ethical framework of transgender issues in health care by saying that gender-transitioning interventions are necessarily vitiated by the denial or rejection of a person’s healthy, God-given body with its objective sex characteristics. Because transgender beliefs are false and transgender desires are intrinsically disordered, deliberately acting on them is intrinsically immoral and cannot be justified in any circumstances. Of course, the psychological and developmental complexities and external pressures behind the beliefs, desires, and experiences are real, and they could notably attenuate or eliminate subjective culpability, particularly in children.
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Catholic health care cannot simply accept the standards of medical associations or legal regulations in this area, because those standards reflect a faulty anthropology. It should therefore promote the proper understanding of the human person, a body-soul unity whose sexual identity should be accepted for the gift that it is; promote sound science and medical information, including the limits of scientific data and what the facts do not tell us; provide training to health care providers and administrators; offer patients and families sound practical resources, such as well-formed Catholic mental health professionals and pediatricians; and actively support those who offer care consonant with Christian anthropology, such as corrective psychotherapy.
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Finally, Catholic health care providers, especially organizations, have a grave responsibility to uphold the freedom to offer authentic care consistent with the life of the Church. When it comes to gender ideology, which Francis has called a “world war to destroy marriage” spread through “ideological colonization,” there is no room for coercion. We must offer only authentic healing in accord with God’s Word, including his creative design.
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In sum, to truly heal wounds from the ground up as an exercise of the Church’s ministry and life, Catholic health care must swim against the current, proactively affirming the Christian understanding of the human person in medical practice while refusing to perform, allow, or deliberately facilitate any form of gender transitioning.
John A. Di Camillo, “Dysphoria and disorder: a tale of two disturbances”, in Legatus Magazine (1 July 2017):
Masking the problem of an identity disorder by focusing on the consequence of dysphoria gravely undermines the possibility of authentic healing for vulnerable persons experiencing gender confusion. It reflects a fundamental misunderstanding of what it means to be a human person, who is a unity of body and soul. Maleness or femaleness is found in the unified, embodied person. There is no “inner self” that can be a distinct source of personal identity over and against bodily sex; rather, the convictions or desires of the mind might be at odds with the person’s embodied sexual identity. In fact, the DSM-5 lists six criteria that can be invoked for a gender dysphoria diagnosis, five of which reference a “desire” or “conviction.”
Focusing on the dysphoria while attempting to deny the disorder demands reinforcing the disorder and mutilating the body to meet an imagined version of the “self” at odds with the person’s body-soul reality.
National Catholic Bioethics Center remarks on planning revisions to the USCCB’s Ethical and Religious Directives, including “gender affirmation and the ERDs”, following the Twenty-Eighth Workshop for Bishops (2022):
It was a real joy and privilege for the NCBC to work for several days with so many engaged bishops. They took significant time out of their busy schedules to focus on the theme of “Renewing Ecclesial Guidance: The ERDs in the Twenty-First Century.” The latest approved modifications to the ERDs were issued in 2018, but the last major update came in 1995. With the rapid development of health care technology and emerging cultural challenges, a living document like the ERDs benefits from frequent updating.
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We were very blessed to have Knights of Columbus Supreme Knight Patrick Kelly, Esq., address the always important topic of religious liberty and Catholic health care. It was particularly timely due to the indications from the Biden administration of their intent in the near future to make federal regulations that would violate conscience and religious liberty rights regarding abortion and many other issues, including transgender policies and interventions.
Other major topics addressed included the history of the various revisions of the ERDs, opportunities for renewed ecclesial guidance for medicine in our very secular world, gender affirmation and the ERDs, and ethical integrity vs. referral for unethical actions. Bishop Ricken of Green Bay spoke on the significance of clinics for witness in Catholic health care – a topic that has not received enough attention in the past.
Remarks of Archbishop Christophe Pierre, papal nuncio (Vatican diplomatic representative) to the United States, at the National Catholic Bioethics Center’s Twenty-Sixth Workshop for Bishops (7 February 2017):
As the Holy Father’s personal representative in the United States, I wish to express his spiritual closeness and prayers during this gathering addressing the theme of “Healing Persons in a Wounded Culture.” … What is happening today with the so-called gender ideology is no different from what Jesus lamented in the Gospel: the attempt to replace God and the Word of God with merely human constructs. It is this that your gathering will explore. It is no easy task to speak in this wounded culture about transgenderism or pornography addiction, yet it would not be pastoral to remain silent about the vision of man and woman proposed by Revelation.
3: Christian Medical & Dental Associations
Brief of the Franciscan Alliance and Christian Medical & Dental Society in Franciscan Alliance et al. v. Becerra et al. (10 June 2022):
CMDA has adopted an ethics statement reflecting its members’ beliefs on gender transitions. ROA.3384, 3392-97. Based on input from medical experts in numerous fields, the statement outlines the risks associated with transition procedures, including inhibition of growth and fertility, cancer, high blood pressure, blood clots, lost bone density, and increased incidence of depression, anxiety, suicidal ideation, and substance abuse. ROA.3384-85, 3393. Given these effects, CMDA determined that “attempts to alter gender surgically or hormonally … are medically inappropriate.” ROA.3386.
Thus, CMDA members routinely treat transgender individuals “for health issues ranging from common colds to cancer.” ROA.3389. But they view participating in transitions as inconsistent with “the obligation of Christian healthcare professionals to care for patients struggling with gender identity with sensitivity and compassion.” ROA.3392.
CMDA Ethics Statement: Transgender Identification (2021):
The naming of gender as a category set apart from sex is an idea foreign to the holistic view of the person as understood within Christianity. Christians affirm the biblical understanding of humankind as having been created male and female, with the two sexes having equal dignity and a complementary relationship to each other. At the heart of disagreement over transgenderism is a difference in worldviews.
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The Christian Medical & Dental Associations (CMDA) believes that healthcare professionals should not be forced to violate their conscientious commitment to their patients’ health and welfare by being required to accept and participate in harmful gender-transition interventions, especially on the young and vulnerable. CMDA affirms the obligation of Christian healthcare professionals caring for patients struggling with gender identity to do so with sensitivity and compassion, consistent with the humility and love that Jesus modeled and commanded us to show all people.
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CMDA considers “sex” (i.e., male or female) to be an objective biological fact (see section B.1. below). CMDA affirms the historic understanding of gender as referring to biological sex and the enduring biblical understanding of humankind as having been created male and female and that this is good. CMDA acknowledges the current cultural use of the word “gender” to refer to one’s sense of identity as male or female. CMDA cannot support the recent usage of the term “gender” to emphasize an identity other than one’s biological sex, that is, a subjective sense of self based on feelings or desires leading to identifying somewhere on a fluid continuum of gender identity. (See Glossary at the end of this document)
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CMDA affirms the obligation of Christian healthcare professionals caring for patients struggling with gender identity to do so with sensitivity and compassion. CMDA holds that attempts to radically reconstruct one’s body surgically or hormonally for psychological indications, however, are medically, ethically, and psychologically inappropriate. These measures alter healthy tissue and increasingly are not supported by scientific research evaluating behavioral, medical, and surgical outcomes.
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We live in a fallen world (Gen 3), and we all come into this world as fallen creatures with a sinful nature. (Rom 3:9-12). The fall is expressed in nature and in humanity in many ways, including sexuality. Confusion of gender identity is but one example of the fall, as are also marital breakdown and sexual immorality (Rom 1:24-32; Eph 5:3).
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In our current social context, there is a prevailing view that removing traditional definitions and boundaries is a requirement for self-actualization. Thus, Christian healthcare professionals find themselves in the position of being at variance with evolving views of gender identity in which patients or their subcultures seek validation by medical professionals of their transgender desires and choices through medical or surgical solutions to gender dysphoria. Although such desires may be approved by society at large, they are contrary to a biblical worldview and to biological reality and thus are disordered.
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There is a social contagion phenomenon luring young people into the transgender culture.
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CMDA opposes efforts to compel healthcare professionals to grant medical legitimacy to transgender ideologies. Cooperation with requests for medical or surgical gender reassignment threatens professional integrity by undermining our respect for biological reality, evidence-based medical science, and our commitment to nonmaleficence (see CMDA Statement on Healthcare Right of Conscience).
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CMDA believes that the appropriate medical response to patients with gender dysphoria is to help them understand that they are people God loves and who are made in his image, even when their choices cannot be validated. Christian healthcare professionals should validate their right as individuals in a free society to make decisions for themselves. This right, however, does not extend to obligating Christian and other healthcare professionals to prescribe medication or perform surgical procedures that are harmful (see CMDA Statement on Healthcare Right of Conscience).
CMDA believes that Christian healthcare professionals should not initiate hormonal and surgical interventions that alter natural sex phenotypes. Such interventions contradict one of the basic principles of medical ethics, which is that medical treatment is intended to restore and preserve health, and not to harm.
CMDA believes that prescribing hormonal treatments to children or adolescents to disrupt normal sexual development for the purpose of attempting gender reassignment is ethically impermissible, whether requested by the child, the adolescent, or the parent (See CMDA Statement on Limits to Parental Authority in Medical Decision-Making, and CMDA Statement on Abuse of Human Life).
Declaration of CMDA chief executive officer David Stevens in State of New York et al. v. Department of Health and Human Services et al. (25 June 2019):
CMDA has long advocated for legislative and regulatory action to protect conscience rights. CMDA has an official position statement on Healthcare Right of Conscience, which states: “Respect for conscientiously held beliefs of individuals and for individual differences is an essential part of our free society. The right of choice is foundational in our healthcare process, and it applies to both healthcare professionals and patients alike. Issues of conscience arise when some aspect of medical care is in conflict with the personal beliefs and values of the patient or the healthcare professional. CMDA believes that in such circumstances the Rights of Conscience have priority.”
4: CMA and CMDA support for sexual orientation and gender identity change efforts
“ACPeds, AAPS, CMDA and CMA Support Minors’ Right to Therapy” (July 2017):
Legislators must NOT ban therapy for minors with unwanted same-sex attractions and/or gender dysphoria. The State must not violate minors’ right to seek psychotherapy they believe may aid them, and must not restrict the right of licensed professional counselors to provide this ethical care.
So called “conversion therapy bans” bar ethical talk therapy. Specifically, when minors present with unwanted same-sex attractions and/or gender dysphoria, therapists are prevented from exploring potential factors underlying the attractions or beliefs, including but not limited to, sexual abuse, family and peer dynamics, social media use and social contagion. Instead, therapists are required to engage solely in speech that affirms the child as lesbian, gay, bisexual or transgender. Therapists are barred from providing heterosexual-affirming psychotherapy even when the minor him or herself asks for help to identify as heterosexual. As a result, a number of youth will be legislated into a false sexual identity, and many others will unnecessarily begin the high risk sex change process as young as age 11 that renders them permanently sterile. This fact alone makes it highly unethical, if not criminal, for the law to require therapists to affirm every child with gender dysphoria as transgender.
CMA, “The Holy Alliance” (2019):
The therapists below are Christian and/or espouse conservative values. They have expertise in helping youth with sexual identity & gender identity issues. Some also provide therapy by Skype if you are unable to locate a local gender critical therapist. You can find more information about these therapists here https://www.acpeds.org/find-a-therapist
David Pickup, M.A.
Alliance for Therapeutic Choice
Thomas Aquinas Psychological Clinic
Marc Dillworth, Ph.D
Christopher Doyle, M.A., L.C.P.C
Robert Vazzo, L.M.F.T
Petrit Ndrio, MD
Albert Lameroux, L.M.H.C.
Maryellen Ebert, L.M.H.C.
CMA, “Homosexuality and Hope: Statement of the Catholic Medical Association” (2003):
The Catholic Medical Association recognizes the responsibility that a Diocesan Bishop has to oversee the orthodoxy of teaching within his Diocese. This certainly includes clear instruction in the nature and purpose of intimate sexual relations between persons and the sinfulness of inappropriate relations. The CMA looks forward to working with Bishops and priests in assisting in the establishment of appropriate support groups and therapeutic models for those struggling with same-sex attractions. While we see the Courage and Encourage programs as very useful and valuable and actively promote them, we are certain that there are other modes of support and are willing to work with any psychologically, spiritually and morally appropriate program.
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Those who wish to be free from same-sex attractions frequently turn first to the Church. CMA wants to be sure that they find the help and hope they are seeking. There is every reason to hope that every person experiencing same-sex attraction who seeks help from the Church can find freedom from homosexual behavior and many will find much more, but they will come only if they see love in our words and deeds.
5: Individual members
Dr. Quentin L. Van Meter – Florida AHCA expert report contributor (Attachment E); appeared as state expert at 28 July 2022 AHCA hearing; state expert at 5 August 2022 Florida Board of Medicine hearing.
Van Meter is a member of CMA. Declaration of Quentin Van Meter in American College of Pediatricians et al. v. Becerra et al. (9 November 2021):
13 . I am a member of the Catholic Medical Association.
Transcript of presentation “The Growing Deception of Transgender Medicine” at God’s Voice conference
“2022 God’s Voice 7th Presentation ‘The Growing Deception of Transgender Medicine’ by Dr.Van Meter” (6 June 2022):
[53:23] QUENTIN L. VAN METER: So there are little chinks in the armor that are starting to form. There’s a group called the Society of Evidence-Based Gender Medicine, SEGM. You should look them up because they are a reference, a beautiful scientifically-based reference group, that has a broad clinical spectrum of politics in terms of the backgrounds of these individuals. But what we all agree on is that the affirmation, from social to medical to surgical, is an abomination for these children, it is the wrong thing to do. Not based on a faith base, however faith may work through you to recognize that this is what it is, but these are some very agnostic individuals, human- secularists that don’t have any particular faith at all. They still see the truth, and they are publishing it and they are making statements to legislative bodies. They are being used in declarations for state laws and whatnot to support the idea that this should not happen to children. So there are again these little chinks in the wall that are very, very helpful for us. [54:20]
[59:04] So we don’t play the game they play, we don’t do the name calling. Some people might but it’s not effective, it’s not the calling, it’s not what we should do as compassionate God-fearing human beings. We should treat the other folks as if we could change their minds and hearts if we explain to them where we come from, and that’s how we try to do it. We join with a broad-based group of diverse backgrounds, the SEGM I mentioned, and never be afraid to introduce your faith into the discussion. When I was deposed by the ACLU and Lambda Legal attorneys in the state of Ohio, Ohio is trying to fight against changing the gender, or the birth sex, to be the gender identity on birth certificates. And they said, you know, for the public health purposes, this takes, you know, health populations and mixes them up. You no longer can look at disease states that are germane to a biologic sex if you don’t know what the sex of the patient is because the birth certificate has been altered. Population studies of disease over decades can’t be followed because you don’t know what the sex is if it can be just randomly assigned. So I was grilled for four and a half hours by these attorneys from the ACLU and Lambda Legal.
And at one point in time they said, ‘Dr. Van Meter, do you practice a religious faith?’
And I said, ‘yes, I’m a Roman Catholic.’
And they said, ‘a-ha, okay – what does your church say about transgender?’
And I said, ‘well, the church teachings are that you love your neighbor as yourself, and so I love these children and care for them as if I were caring for myself, which is my calling to do so.’
And they just went, oh, crap, that’s not the answer we wanted – you know, we wanted you to say ‘this says so in our doctrines and this is terrible and sinful and awful and hateful’. And I just didn’t give them that answer, because I wanted them to know how my faith drives me. I’m not going to play a game where I can be quoted out of context. And yet my faith does drive what I do in my practice every single day. [1:01:20]
Dr. Patrick W. Lappert – AHCA expert report contributor (Attachment F).
Lappert is a member of CMA. Patrick Lappert, “Catholic Medical Association – Medical Student and Resident Boot Camp” (25 February 2017):
A graduate of Uniformed Services University, Patrick Lappert, MD, has served as the president and surgeon of Madison, Alabama’s Lappert Plastic Surgery since 2003. An experienced plastic surgeon and physician, Patrick Lappert, MD, is a member of several industry organizations, including the Catholic Medical Association (CMA).
Lappert is also a chaplain for the division of Catholic ex-gay apostolate Courage International within the Diocese of Birmingham.
G Kevin Donovan – AHCA expert report contributor (Attachment G); contributed declaration for AHCA in Rule 59G-1.050(7) Medicaid exclusion case Dekker v. Marstiller.
Donovan is a member of CMA. “CMA Members Federally Appointed to The Human Fetal Tissue Research Ethics Advisory Board of National Institutes of Health”, Catholic Medical Association (10 August 2020):
Doctors Greg Burke (Co-Chair of CMA’s Ethics Committee), Ashely Fernandes, Kevin Donovan and Father Tadeusz Pacholczyk, Ph.D. will work with other appointed members to advise the administration on the ethics of federally funded research which includes tissues from the bodies of babies who were aborted.
Dr. Andre Van Mol – State expert at 28 July 2022 hearing; contributed declaration in Dekker v. Marstiller.
Van Mol is a member of CMDA (12 January 2023):
André Van Mol, MD, is a board-certified family physician in full-time practice in California. He co-chairs both the American College of Pediatricians’ Committee on Adolescent Sexuality and the CMDA Sexual & Gender Identity Task Force. Dr. Van Mol writes and speaks on issues of bioethical and Christian concern. He works with Alliance Defending Freedom in a coalition of professionals advising on policy matters addressing sexual orientation and gender identity advocates, and he has served as amicus/friend of court in federal appellate and U.S. Supreme Court cases. Dr. Van Mol serves on the boards of Bethel Church of Redding and Moral Revolution.
Dr. Patrick K. Hunter – Appointed to the Florida Board of Medicine by Governor Ron DeSantis on 17 June 2022; voted to advance trans youth care ban Rule 64B8-9.019 at 5 August 2022 and 28 October 2022 hearings; moved to strip exemption for clinical trials at 4 November 2022 hearing.
Hunter is a member of CMA. Diocese of Orlando, “CMA students make a difference in NFP education and more” (25 July 2019):
The Catholic Medical Association’s student chapter at UCF began with three medical students just three years ago. Kaitlyn Hite, Jais Emmanuel and Michael Mankbadi would gather to support each other in the faith. After participating in Mass at Nemours Children Hospital, a mutual friend connected them to the Catholic Medical Association Orlando Guild. Enter Dr. Peter Morrow, who was president that year. The introduction was a God moment. Morrow and friend, Dr. Patrick Hunter, had both been praying for the opportunity to establish a student guild at the university. In fact, the entire CMA Orlando guild was praying.
Hunter also received his master’s degree in bioethics through the NCBC program in Catholic bioethics at University of Mary, and he states that his study was largely focused on “ethical dilemmas” in gender-affirming care (see Gender Analysis FLBOM complaint 1, section 5).
Dr. Paul W. Hruz – Publication against gender-affirming care in Catholic Medical Association journal (Hruz, 2019) cited by Florida Department of Health in 20 April 2022 press release; cited by AHCA in June 2 GAPMS report; cited by AHCA assistant deputy secretary Jason C. Weida at 28 July hearing.
Hruz is a member of CMA and CMDA. Outpost Ministries (1 July 2022):
Dr. Paul Hruz of the Catholic Medical Association and the Christian Medical and Dental Association (with Laura Perry Smalts) shared insight into “Practical Issues in Addressing Sex-Discordant Gender Identity.”
Hruz is also a fellow of NCBC and a recipient of the NCBC Certification in Healthcare Ethics.
6: Umbrella groups
Alliance for Hippocratic Medicine (AHM)
The Alliance for Hippocratic Medicine is an umbrella group for the Catholic Medical Association, Christian Medical & Dental Associations, American College of Pediatricians, American Association of Pro-Life Obstetricians and Gynecologists, and Coptic Medical Association of North America.
Catholic Health Care Leadership Alliance (CHCLA)
The Catholic Health Care Leadership Alliance is an umbrella group for the Catholic Medical Association, the National Catholic Bioethics Center, the Catholic Benefits Association, the Catholic Bar Association, and the Christ Medicus Foundation.
