USCCB Note on Gender Transitions “Could Have Been Written in the 1950s,” Writes Bioethicist

M. Therese Lysaught, a bioethicist and theologian, comprehensively dissected the U.S. Conference of Catholic Bishops’ Committee on Doctrine’s recent statement that seeks to stop Catholic healthcare institutions from providing gender-affirming care.

Writing for the National Catholic Reporter, Lysaught, who is also a member of the Pontifical Academy for Life, dismantles the USCCB document as it “suffers from three significant flaws: intellectual, theological (or, troublingly, doctrinal) and moral.” Lysaught does so especially in relation to Pope Francis’ standards for theological ethics in the modern world, as she observes that the pope has exhorted moral theologians to listen, to be respectful, and to work across disciplines for solutions.

Lysaught quotes Francis as saying that bioethics in particular “must be attentive to the real dramas lived by people who often find themselves confused in the face of the moral dilemmas of life.” The pope continually eschews the “cold morality, theoretical morality” of the pre-Vatican II era. In contrast, Lysaught observes that the USCCB document “reads as if Vatican II never happened. It exemplifies the cold, casuistic morality that Pope Francis decried.”

On an intellectual level, Lysaught illustrates that the document fails to follow basic steps in moral analysis, such as laying out the details of the issue at hand, before making an argument to establish shared knowledge and credibility. She describes this process as:

“[D]efining one’s terms (accurately and charitably), providing relevant statistics or other data (e.g. suicide, poverty and homelessness rates; cultural histories; and data regarding discrimination). Crucially important here would be information on the evolving legal landscape in the U.S., since as of March 2023, some 435 anti-LGBTQ+ bills have been introduced. The committee does none of this.”

This intellectual failure opposes Vatican II’s teaching for bishops that exhorts them to speak clearly. Of this, Lysaught writes, “this means episcopal communications must meet basic standards for a careful, professional, well-reasoned argument. The doctrinal note does not.” Indeed, she continues, the issues intellectually are not even theological, but “flaws in basic analysis and argumentation.”

Whereas Pope Francis urges “engaging in particular with the cry of the least, to understand their real difficulties, to look at existence from their perspective,” the Committee on Doctrine refuses to even acknowledge the language preferred by those most affected by their prescriptions. The bishops fail to acknowledge and include the perspective and voice of those most affected, in this case, transgender people themselves. Lysaught notes that the only use of the word “transgender” is a footnote on page 12 of 13. She comments, “Transgender persons do not appear in a document about transgender persons and their medical care.”

Yet, the bishops also fail to explain why some gender-related medical interventions are morally acceptable only when they are not performed on transgender patients, such as puberty suppressors for girls with mental disabilities, plastic surgery, or hormone therapy during menopause. Lysaught asserts that, “The committee could not have provided a better example of the desiccated moral theology Pope Francis critiqued” because they make unsubstantiated and debated theological claims to disallow gender-affirming medical care. Indeed, Lysaught states, “this document could have been written in the 1950s” with its primary argument hingeing on the teachings of Pope Pius XII.

There are theological issues, too. With the document’s focus on order and absolutes, its view of God is also problematic. Lysaught explains:

“God, as depicted here, is largely a deist god–a god who created an invariant universe with laws and order that must be invariantly followed. . .For the god we meet here is a mono-tarian god, (not a Trinitarian one). Jesus is, at best, an afterthought, mentioned only twice, in the final two sentences. The Holy Spirit is not mentioned at all. And Scripture is reduced to two prooftexts.”

Crucially, the doctrinal note is simply offensive in moral terms, she claims, to both those they purport to be instructing and to those most affected by these guidelines. Lysaught states later:

“Equally, it fails to demonstrate many of the basic cardinal virtues. Providing such a poor analysis in such a fraught sociopolitical context does not demonstrate prudence. Failing to exercise the patience needed to wait for the necessary knowledge on this issue to unfold, it fails to demonstrate temperance. As it provides no evidence of being formed or transformed by charity — exhibiting no self-emptying love for those who are suffering via encounter and accompaniment — it likewise fails to exercise that theological virtue.

“[The document] disrespects its audience–health care providers and ethicists and mission leaders, many of whom have greater expertise in this topic and who understand the standards of professional discourse. In refusing to use the language of transgender and acknowledge the reality of transgender persons, they effectively erase them as persons.”

Unlike Pope Francis’ example of dialogue with and compassion towards the LGBTQ+ community, this document fails to listen to the experiences of transgender people, much less use preferred language and consider consequences of supposed pastoral responses on those most affected.

But, Lysaught explains, these points are largely missed due to the failures of the committee in what seems to be a “willful misunderstanding.” The document’s only real success is that it “demonstrates conclusively that the manualist method–the cold morality that persists as a remnant of another era–is intellectually, theologically, and morally bankrupt.” She concludes:

“I hope going forward that the Committee on Doctrine will heed a final word from the Holy Father’s remarks to the Alphonsianum — to avoid ‘extremist, polarizing dynamics,’ and instead ‘apply instead the principle, always indicated by St. Alphonsus, of the “middle way,” which is not a diplomatic balance, no; the middle way is creative, it arises from creativity, and it creates.'”

—Angela Howard McParland (she/her), New Ways Ministry, June 8, 2023