X

USCCB 20 March 2023 Doctrinal Note: source analysis

Source analysis: comparison of references to NCBC “Transgender Issues in Catholic Health Care” references

  • Comparison text: “Transgender Issues in Catholic Health Care” (Furton, 2021) by National Catholic Bioethics Center (NCBC)

USCCB Doctrinal Note references

1 Second Vatican Council, Pastoral Constitution Gaudium et Spes, no. 36; in Decrees of the Ecumenical Councils, ed. Norman P. Tanner, S.J. (Washington, D.C.: Georgetown University Press, 1990).

2 Pope Benedict XVI, Encyclical Letter Caritas in Veritate (2009), no. 48 (https://www.vatican.va/ content/benedict-xvi/en/encyclicals/documents/hf_ben-xvi_enc_20090629_caritas-in-veritate.html).

3 Pope Francis, Encyclical Letter Laudato Si’ (2015), no. 106 (https://www.vatican.va/content/francesco/en/ encyclicals/documents/papa-francesco_20150524_enciclica-laudato-si.html).

4 Pope Francis, Laudato Si’, no. 106.

5 While in ancient and medieval thought dualism was typically expressed in terms of soul and body, in modern thought it is often expressed in terms of mind and body.

6 Catechism of the Catholic Church, no. 365 (https://www.vatican.va/archive/ENG0015/__P1B.HTM): “The unity of soul and body is so profound that one has to consider the soul to be the ‘form’ of the body: i.e., it is because of its spiritual soul that the body made of matter becomes a living, human body; spirit and matter, in man, are not two natures united, but rather their union forms a single nature.”

  • USCCB 2023, text:
    • In opposition to dualisms both ancient and modern, the Church has always maintained that, while there is a distinction between the soul and the body, both are constitutive of what it means to be human, since spirit and matter, in human beings, “are not two natures united, but rather their union forms a single nature.”[6]
  • Cross-reference: Paul W. Hruz in Furton 2021, ref 1.7, p. 3, text:
    • Hypotheses based on asserting that experimental interventions 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.[7]
  • Cross-reference: Josef D. Zalot in Furton, 2021, p. 77, text:
    • The human person is a body-soul union, and the body is a constitutive aspect of the person (Catechism, nn. 364, 365). As such, Catholicism rejects any dualistic conception of the human person that proposes a self separate from the body, which gender ideology necessarily entails.

7 International Theological Commission, Communion and Stewardship: Human Persons Created in the Image of God (2002), no. 26 (https://www.vatican.va/roman_curia/congregations/cfaith/cti_documents/rc_con_ cfaith_doc_20040723_communion-stewardship_en.html).

8 Persons affected by Disorders of Sexual Development do not fall outside the two categories of male and female, but they do exhibit ambiguous or abnormal indicators of sexual difference, so that the sex of their bodies is difficult to determine, though not impossible for modern medical and genetic techniques.

9 Saint Pope John Paul II, Letter to Families (1994), no. 6 (https://www.vatican.va/content/john-paul-ii/en/ letters/1994/documents/hf_jp-ii_let_02021994_families.html). Cf. Catechism of the Catholic Church, no. 2333.

  • USCCB 2023, text:
    • Saint John Paul II reminded us that, in the Book of Genesis, we learn that “Man is created ‘from the very beginning’ as male and female: the life of all humanity—whether of small communities or of society as a whole—is marked by this primordial duality.”[9]
  • Cross-reference: Jozef D. Zalot in Furton, 2021, pp. 77-78, text:
    • Sexual difference is willed by God as part of the divine plan. The complementarity that results from sexual differentiation is ordered to human good and flourishing, and in particular to marriage and family life (Catechism, nn. 369, 2333).[5]

10 Catechism of the Catholic Church, no. 369.

  • USCCB 2023, text:
    • The Catechism of the Catholic Church affirms: “Man and woman have been created, which is to say, willed by God: on the one hand, in perfect equality as human persons; on the other, in their respective beings as man and woman. ‘Being man’ or ‘being woman’ is a reality which is good and willed by God.”[10]
  • Cross-reference: Jozef D. Zalot in Furton, 2021, ref 4.2, p. 77, text:
    • Essential points of Catholic anthropology, and how it contrasts with gender ideology, include the following: 1. Human beings are created male and female from conception (Gen. 1:27). Our dignity is grounded in part in this special creation as male and female.[2]
  • Cross-reference: Zalot in Furton, 2021, pp. 77-78, text:
    • Sexual difference is willed by God as part of the divine plan. The complementarity that results from sexual differentiation is ordered to human good and flourishing, and in particular to marriage and family life (Catechism, nn. 369, 2333).[5]
  • Cross-reference: Zalot in Furton, 2021, ref 7.4, p. 135, text:
    • Human beings are created as male and female from conception (Gen. 1:27). Our dignity is grounded in part in this special creation as male and female.[4]
  • Cross-reference: Zalot in Furton, 2021, ref 7.5, p. 143.

11 Congregation for the Doctrine of the Faith, Letter on the Collaboration of Men and Woman in the Church and in the World (2004), no. 8 (https://www.vatican.va/roman_curia/congregations/cfaith/documents/rc_con_cfaith_ doc_20040731_collaboration_en.html); quotations from Congregation for Catholic Education, Educational Guidance in Human Love: Outlines for Sex Education (1983), no. 5 and no. 4, respectively.

12 Pope Francis, Post-Synodal Apostolic Exhortation Amoris Laetitia (2016), no. 56; quoting the Relatio Finalis of the Synod on the Family (2015), no. 8 (https://www.vatican.va/content/francesco/en/apost_exhortations/ documents/papa-francesco_esortazione-ap_20160319_amoris-laetitia.html).

  • USCCB 2023, text:
    • In our contemporary society there are those who do not share this conception of the human person. Pope Francis has spoken about an ideology that promotes “a personal identity and emotional intimacy radically separated from the biological difference between male and female,” in which “human identity becomes the choice of the individual, one which can also change over time.”[12] In response to this, Pope Francis affirmed:
      “It needs to be emphasized that “biological sex and the socio-cultural role of sex (gender) can be distinguished but not separated.” … It is one thing to be understanding of human weakness and the complexities of life, and another to accept ideologies that attempt to sunder what are inseparable aspects of reality. Let us not fall into the sin of trying to replace the Creator. We are creatures, and not omnipotent. Creation is prior to us and must be received as a gift. At the same time, we are called to protect our humanity, and this means, in the first place, accepting it and respecting it as it was created.”[13]
  • Cross-reference: Jozef D. Zalot in Furton, 2021, refs 4.11, 4.12, p. 79, text:
    • In Amoris Laetitia, Francis echoed Benedict XVI by warning that gender ideology “denies the difference and reciprocity in nature of a man and a woman,” which in turn leads to laws and educational curricula that “promote a personal identity and emotional intimacy radically separated from the biological difference between make and female.” This ideology then asserts itself as “absolute and unquestionable,” even usurping the proper role of parents in raising their children.[11] In response, Francis emphasized that while biological sex and gender (understood as the sociocultural role of sex) can be distinguished, they can never be separated. He concludes, “It is one thing to be understanding of human weakness and the complexities of life, and another to accept ideologies that attempt to sunder what are inseparable aspects of reality. Let us not fall into the sin of trying to replace the Creator.”[12]
  • Cross-reference: Zalot in Furton, 2021, ref 5.10, pp 109-110, text:
    • Gender ideology raises profound medical and moral concerns, and it has been strongly criticized by Pope Benedict XVI, Pope Francis, and other sources of ecclesiastical guidance.[10]
  • Cross-reference: Zalot in Furton, 2021, ref 7.11, p. 136.

13 Pope Francis, Amoris Laetitia, no. 56; quoting the Relatio Finalis, no. 58.

14 Pope Pius XII, “Discours aux participants au Congrès International d’Histopathologie du Système Nerveux,” 14 September 1952 (https://www.vatican.va/content/pius-xii/fr/speeches/1952/documents/hf_p-xii_spe_ 19520914_istopatologia.html). See also his “Discours à la VIIIe Assemblée de l’Association Médicale Mondiale,” 30 September 1954 (https://www.vatican.va/content/pius-xii/fr/speeches/1954/documents/hf_p-xii_spe_19540930_viiiassemblea-medica.html).

  • USCCB 2023, text:
    • Because of this order and finality, neither patients nor physicians nor researchers nor any other persons have unlimited rights over the body; they must respect the order and finality inscribed in the embodied person. Pope Pius XII taught that the patient “is not the absolute master of himself, of his body, of his mind. He cannot dispose of himself just as he pleases.”[14] The Pope went on to affirm that, with regard to the faculties and powers of one’s human nature, a patient “is the user and not the owner” and thus “does not have an unlimited power to effect acts of destruction or of mutilation of a kind that is anatomical or functional.”[15]
  • Cross-reference: Harrison in Furton, 2021, ref 3.5, p. 57, text:
    • Gremmels takes a different approach than Bayley, examining SRS from Pope Pius XII’s principle of totality in the removal of body parts. Gremmels acknowledges the difficulty of justifying SRS according to this principle but finds a potential rationale in the Pope’s 1952 address to the Congress of Histopathology when he said that a patient “may use individual parts, destroy them or mutilate them, when and to the extent necessary for the good of his being as a whole.”[5] On the basis of this quote, Gremmels suggests that the meaning of whole in the principle of totality comprises a human being’s physical, psychological, social, and spiritual dimensions.

15 Pope Pius XII, “Discours,” 14 September 1952.

16 Pope Francis, Laudato Si’, no. 155. In the same paragraph, Pope Francis quotes Pope Benedict XVI, who asserted: “Man too has a nature that he must respect and that he cannot manipulate at will” (Address to the Bundestag, 22 September 2011 (https://www.vatican.va/content/benedict-xvi/en/speeches/2011/september/documents/hf_benxvi_spe_20110922_reichstag-berlin.html).

  • USCCB 2023, text:
    • The body is not an object, a mere tool at the disposal of the soul, one that each person may dispose of according to his or her own will, but it is a constitutive part of the human subject, a gift to be received, respected, and cared for as something intrinsic to the person. As Pope Francis affirmed: “The acceptance of our bodies as God’s gift is vital for welcoming and accepting the entire world as a gift from the Father and our common home, whereas thinking that we enjoy absolute power over our own bodies turns, often subtly, into thinking that we enjoy absolute power over creation.”[16]
  • Cross-reference: Edward J. Furton in Furton, 2021, refs 2.4, 2.5, p. 46, text:
    • Pope Francis has warned against what he calls the dangers of gender ideology. In his encyclical letter Laudato si’, he says that “the acceptance of our bodies as God’s gift is vital for welcoming and accepting the entire world as a gift from the Father and our common home, whereas thinking that we enjoy absolute power over our own bodies turns, often subtly, into thinking that we enjoy absolute power over creation. Learning to accept our body, to care for it and to respect its fullest meaning, is an essential element of any genuine human ecology.”[4] Pope Benedict XVI emphasized the same point: “There is also an ecology of man. Man too has a nature that he must respect and that he cannot manipulate at will. Man is not merely self-creating freedom. Man does not create himself. He is intellect and will, but he is also nature, and his will is rightly ordered if he respects his nature, listens to it and accepts himself for who he is, as one who did not create himself. In this way, and in no other, is true human freedom fulfilled.”[5]
  • Cross-reference: Jozef D. Zalot in Furton, 2021, ref 4.5, pp. 77-78, text:
    • Sexual difference is willed by God as part of the divine plan. The complementarity that results from sexual differentiation is ordered to human good and flourishing, and in particular to marriage and family life (Catechism, nn. 369, 2333).[5]
  • Cross-reference: Zalot in Furton, 2021, ref 4.10, p. 79, text:
    • Pope Francis spoke to gender ideology in two well-known documents of his early pontificate. In Laudato si’, he linked human sexual identity with care for the created order by stating, “Acceptance of our bodies as God’s gift is vital for welcoming and accepting the entire world as a gift from the Father and our common home.” He then warned that thinking that we enjoy absolute power over our own bodies turns, often subtly, into thinking that we enjoy absolute power over creation. Accepting and respecting the “fullest meaning” of our body is “an essential element of any genuine human ecology.”[10]
  • Cross-reference: Zalot in Furton, 2021, ref 7.6, pp. 135-136, text:
    • Sexual difference is willed by God as part of the divine plan. The complementarity that results from sexual differentiation is ordered to human good and in particular to marriage and family life (Catechism, nn. 369, 2333).[6]
  • Cross-reference: Zalot, 2022, in Furton, ref 7.11, p. 136.
  • Cross-reference: Zalot, 2022, in Furton, ref 7.7, p. 143.

17 Sometimes the technology is used not to return the body to a previous state but to compensate for some lack of normal development in the body.

18 Use of extraordinary means is never morally obligatory. Cf. Pope Pius XII, “Discours du Pape Pie XII en réponse à trois questions de morale médicale sur la réanimation,” 24 November 1957 (https://www.vatican.va/ content/pius-xii/fr/speeches/1957/documents/hf_p-xii_spe_19571124_rianimazione.html); Congregation for the Doctrine of the Faith, “Commentary on the Responses to Certain Questions of the United States Conference of Catholic Bishops Concerning Artificial Nutrition and Hydration,” 1 August 2007 (https://www.vatican.va/roman_ curia/congregations/cfaith/documents/rc_con_cfaith_doc_20070801_nota-commento_en.html).

19 United States Conference of Catholic Bishops, Ethical and Religious Directives for Catholic Health Care Services, Sixth Edition (2018), no. 32 (https://www.usccb.org/about/doctrine/ethical-and-religious-directives/upload/ ethical-religious-directives-catholic-health-service-sixth-edition-2016-06.pdf); cf. no. 56. See also Congregation for the Doctrine of the Faith, Declaration on Euthanasia (1980), Pt. IV (https://www.vatican.va/roman_curia/ congregations/cfaith/documents/rc_con_cfaith_doc_19800505_euthanasia_en.html).

20 USCCB, Ethical and Religious Directives, no. 32: “…no person should be obliged to submit to a health care procedure that the person has judged, with a free and informed conscience, not to provide a reasonable hope of benefit without imposing excessive risks and burdens on the patient or excessive expense to family or community”.

21 Pope Pius XII, “Discorso ai partecipanti al X Congresso Nazionale della Società Italiana di chirurgia plastica,” 4 Oct. 1958, III (https://www.vatican.va/content/pius-xii/it/speeches/1958/documents/hf_p-xii_spe_1958 1004_chirurgia-plastica.html).

22 Pope Pius XII, “Discorso,” 4 October 1958, III.

23 Pope Pius XII, “Discorso,” 4 October 1958, III.

24 Pope Pius XII provides some examples of incorrect intentions, such as increasing one’s power of seduction or protecting a guilty party from justice. He also gives as an example of an illicit cosmetic intervention one “that causes damage to the regular functions of the physical organs” (“Discorso,” 4 October 1958, III).

25 Pope Pius XI, Encyclical Letter Casti Connubii (1930), no. 71 (https://www.vatican.va/content/pius-xi/en/ encyclicals/documents/hf_p-xi_enc_19301231_casti-connubii.html). Emphasis added.

  • USCCB 2023, text:
    • Pope Pius XII’s predecessor, Pope Pius XI, also stressed the need to respect the fundamental order of the body, affirming that, as a rule, one is not allowed “to destroy or mutilate” members of one’s body. At the same time, however, he affirmed that there can be exceptions when the welfare of the body as a whole is at stake.
      “Christian doctrine establishes, and the light of human reason makes it most clear, that private individuals have no other power over the members of their bodies than that which pertains to their natural ends; and they are not free to destroy or mutilate their members, or in any other way render themselves unfit for their natural functions, except when no other provision can be made for the good of the whole body.”[25]
  • Cross-reference: Edward N. Peters in Furton, 2021, ref 9.3, pp. 176-177, text:
    • Notwithstanding that modern scientific advances have made more feasible surgeries that hitherto were avoided in part for fear of medical complications, Church teaching steadfastly rejects elective mutilation: “Christian doctrine establishes, and the light of human reason makes it most clear, that private individuals have no other power over the members of their bodies than that which pertains to their natural ends; and they are not free to destroy or mutilate their members, or in any other way render themselves unfit for their natural functions, except when no other provision can be made for the good of the whole body.”[3]

26 Pope Pius XII, “Discours aux Participants au XXVIe Congrès Organisé par la Société Italienne d’Urologie,” 8 October 1953, I (https://www.vatican.va/content/pius-xii/fr/speeches/1953/documents/hf_p-xii_spe_ 19531008_congresso-urologia.html). Cf. St. Thomas Aquinas, Summa theologiae II-II, q. 65, a. 1; I-II, q. 90, a. 2.

27 Pope Pius XII, “Discours,” 8 October 1953, I.

28 Congregation for the Doctrine of the Faith, Instruction on Certain Bioethical Questions (Dignitas Personae) (2008), no. 26 (https://www.vatican.va/roman_curia/congregations/cfaith/documents/rc_con_cfaith_doc_ 20081208_dignitas-personae_en.html). The Congregation adds the qualifications that the patient must not be “exposed to risks to his health or physical integrity which are excessive or disproportionate to the gravity of the pathology for which a cure is sought” and that the patient or his legitimate representative must give informed consent.

29 Congregation for the Doctrine of the Faith, Instruction on Certain Bioethical Questions (Dignitas Personae), no. 27.

30 Congregation for the Doctrine of the Faith, Instruction on Certain Bioethical Questions (Dignitas Personae), no. 27

31 Some even envision transferring what they imagine to be the essence of the human person from the brain into a computer, thereby leaving bodily existence behind altogether.

32 The term “gender dysphoria” was introduced in 2013 in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (Arlington, VA: American Psychiatric Association, 2013), 452-53. The term “gender incongruence” was introduced in 2022 in the eleventh revision of the International Classification of Diseases published by the World Health Organization (https://icd.who.int/browse11/l-m/en#/http%3a%2f%2fid.who.int% 2ficd%2fentity%2f411470068).

33 With some procedures of this category, the removal of the organ is directly intended in order to allow for its replacement with a simulation of the corresponding organ of the opposite sex; in other procedures, the removal of the organ is directly intended because the absence of the organ is a characteristic of the opposite sex; in still others, the reconfiguring of the organ is directly intended in order to make the organ resemble as much as possible the corresponding organ of the opposite sex.

34 With regard to those who identify as transgender or non-binary, there is a range of pastoral issues that need to be addressed, but that cannot be addressed in this document.

35 Pope Francis, Encyclical Letter Amoris Laetitia, no. 285; quotation from his Encyclical Letter Laudato Si’, no. 155.

36 See USCCB, Ethical and Religious Directives for Catholic Health Care Services, General Introduction

  • USCCB 2023, text:
    • To fulfill this duty, all who collaborate in Catholic health care ministry must make every effort, using all appropriate means at their disposal, to provide the best medical care, as well as Christ’s compassionate accompaniment, to all patients, no matter who they may be or from what condition they may be suffering. The mission of Catholic health care services is nothing less than to carry on the healing ministry of Jesus, to provide healing at every level, physical, mental, and spiritual.[36]
  • Cross-reference: Jozef D. Zalot in Furton, 2021, ref 4.64, pp. 95-96, text:
    • For Catholic health care, these mandates are particularly harmful because they condition financial assistance on reimbursement (Medicare and so on) on the performance of acts that conflict with religious convictions about anthropology and sexual differentiation.[63] As a result, these mandates undermine the ability of Catholic health care to “witness to the faith” and to provide care in accord with the Gospel of Jesus Christ and the teachings of the Church.[64] They may even threaten the very existence of Catholic health care, not to mention Catholic education and social services. Accommodation of these mandates, particularly absent any effort to resist or overturn them, is not legitimate.[65]

See also

Page status: Incomplete, in progress

Last updated 21 Mar 2023 by Zinnia Jones