Welcome Big Pulpit readers – more of my writings on this issue here.
So the US bishops are going to revisit their ethical and religious directives for health care:
The proposal to review Part Three of the Ethical and Religious Directives for Catholic Health Care Services passed unanimously on a voice vote on the final day of the USCCB’s plenary assembly in Orlando.
The Ethical and Religious Directives for Catholic Health Care Services (ERDs) is a guide released by the bishops to offer ethical standards in health care, based on Catholic teaching about human dignity.
The guide is periodically updated. It is currently in its sixth edition, which was approved by the bishops five years ago.
Bishop Daniel Flores, head of the bishops’ doctrine committee, explained that part three of the document, dealing with professional-patient relationships, has not been updated since 1994. It does not include guidance on “radical modifications of the human body,” such as surgeries and hormones given for gender dysphoria, he said.
Several bishops reminded their brothers of the importance of a wide consultation:
Cardinal Robert McElroy of San Diego made a distinction between “the doctrinal tradition of the Church, particularly on male and female” and the need “to wrestle with the existential question of those who are suffering from dysphoria.”
“I think there’s a fundamental difference between a declaration on doctrine, which was issued, and the formulation of the ERDs,” he said.
He stressed that the ERDs are not just a statement of doctrine but an application of doctrine to “the existential situation of people who are suffering.”
“The ERDs are meant to be a pastoral, medical document to inform and guide the health care ministries,” he said.
Sure. But let’s not get lost here.
First thing to remember is that as presently constructed, “gender dysphoria” is a fluid – to say the least – diagnosis that is actually not a diagnosis of anything consistently specific.
To be very blunt about it, a young woman requesting to have her healthy breasts amputated and a middle-aged man asking to have implants inserted in his chest are not suffering from the same problem with the same root causes.
So there’s your first challenge – to account for that.
Secondly, not only remember, but keep in the forefront the specifics of these “gender-affirming” procedures.
This article was published in the Claremont Institute’s American Mind. It’s written by a woman who goes by the handle TT Exulansic. She has a wide web presence and is controversial, no doubt. Her primary contributions to the internet-fueled conversation about this are videos in which she analyzes and critiques videos made by people who’ve undergone these procedures, with a special focus on Jazz Jennings.
That said, this article is forthright and not wrong, because all she does is describe these “gender affirming” procedures in detail, which you can discern from the title: “Genital Mutilation for the Masses.”
So, if you want a frank explanation of these procedures – go here. I’m not going to excerpt the details in this space.
And then ask yourselves – and perhaps your bishop if you’ve a mind to:
Should Catholic hospitals be party to any of this?
And what about the kids and their puberty blockers?
The Food and Drug Administration has approved those medications to treat prostate cancer, endometriosis, certain types of infertility and a rare childhood disease caused by a genetic mutation. But it has never approved them for gender dysphoria, the clinical term for the belief that one’s body is the wrong sex.
Thus the drugs, led by AbbVie’s Lupron, are prescribed to minors “off label.” (They are also used off-label for chemical castration of repeat sex offenders.) Off-label dispensing is legal; some half of all prescriptions in the U.S. are for off-label uses. But off-label use circumvents the FDA’s authority to examine drug safety and efficacy, especially when the patients are children. Some U.S. states have eliminated the need for parental consent for teens as young as 15 to start puberty blockers.
Proponents of puberty blockers contend there is little downside. The Department of Health and Human Services claims puberty blockers are “reversible.” It omits the evidence that “by impeding the usual process of sexual orientation and gender identity development,” these drugs “effectively ‘lock in’ children and young people to a treatment pathway,” according to a report by Britain’s National Health Service, which cites studies finding that 96% to 98% of minors prescribed puberty blockers proceed to cross-sex hormones.
Gender advocates also falsely contend that puberty blockers for children and teens have been “used safely since the late 1980s,” as a recent Scientific American article put it. That ignores substantial evidence of harmful long-term side effects.
The Center for Investigative Reporting revealed in 2017 that the FDA had received more than 10,000 adverse event reports from women who were given Lupron off-label as children to help them grow taller. They reported thinning and brittle bones, teeth that shed enamel or cracked, degenerative spinal disks, painful joints, radical mood swings, seizures, migraines and suicidal thoughts. Some developed fibromyalgia. There were reports of fertility problems and cognitive issues.
The FDA in 2016 ordered AbbVie to add a warning that children on Lupron might develop new or intensified psychiatric problems. Transgender children are at least three times as likely as the general population to have anxiety, depression and neurodevelopmental disorders. Last year, the FDA added another warning for children about the risk of brain swelling and vision loss.
The lack of research demonstrating that benefits outweigh the risks has resulted in some noteworthy pushback in the U.S. and abroad. Republican legislatures in a dozen states have curtailed or banned gender-affirming care for minors. Finland, citing concerns about side effects, in 2020 cut back puberty blockers and cross-sex hormones to minors. Sweden followed suit in 2022 and Norway this year. Britain’s National Health Service shuttered the country’s largest youth gender clinic after 35 clinicians resigned over three years, complaining they were pressured to overdiagnose gay, mentally ill, and autistic teens and prescribe medications that made their conditions worse.
So in sum, perhaps in revisiting this matter, the bishops should take into consideration:
- Is it possible to change sex? If not, is it ethical to perform procedures on people that “affirm” their desire to do so?
- The question of the “sickness” or “condition” these procedures are said to treat. Is this a single, actual condition or a label for a number of very different issues that call for recognition and discrete treatment?
- Should Catholic hospitals be amputating healthy breasts, sewing up healthy vaginas, running urethras through clitorises, attaching tubes fashioned from forearm or thigh skin and tissue to women’s abdomens and amputating healthy male genitalia?
- Should Catholic health care providers be providing off-label medications to physically healthy children and adolescents in an attempt to halt puberty – a multifaceted stage that involves all systems of the body as well as brain development? Should Catholic health care providers be giving children and teens opposite sex-hormones?
I’m hoping it doesn’t take much to say….no.
I am glad the Church recognizes the need to address these questions and am trying to remain optimistic that the Bishops will not add to the growing cultural confusion, under the guise of “accompaniment.” Again, I would ask them, or anyone else giving even a moment’s consideration to permitting these horrific procedures be performed on dysphoric people, “would you permit an anorexic to have a gastric bypass procedure?” Further, would we permit the amputation of perfectly healthy limbs of those self-identifying as “disabled?” Would we intentionally blind a person who wants to participate in the life and culture of the visually impaired or sever the cochlear nerve to cause deafness? There can be no room for ambiguity in their guidance so I pray the Bishops be granted prudence and fortitude, wise counsel and above all awe of the G-d who made us and loves/d us first and best.
Alas, I fear that we’ll soon be seeing doctors forced mutilate bodies of the “transabled” because their do-it-yourself efforts would just be too dangerous and they crave “affirmation.” That train is already primed to leave the station.
Would that all the US bishops be required to sit through a fully detailed clinical description of what’s involved in gender “transitions.” As if….
Sorry to double-comment, but I just finished reading the article laying out the details of gender “reassignment” surgery and must admit, I really did not appreciate the degree to which the human body is modified and mutilated in these procedures (and I’m a nurse who tries to keep up). Dear LORD above. Yes, Sandra, the Bishops should have to sit through an in-service discussing these procedures in fine detail.