Advocates blast Vatican's new position on gender-affirming surgery as 'dangerously ignorant'

Transgender activists and allies on Monday decried the Vatican's new doctrine against gender-affirming surgery as "hurtful" and devoid of the voices and experiences of trans, non-binary and gender-diverse people, especially in its distinction between transgender and intersex people.

"The suggestion that gender-affirming health care — which has saved the lives of so many wonderful trans people and enabled them to live in harmony with their bodies, their communities and (God) — might risk or diminish trans people's dignity is not only hurtful but dangerously ignorant," said Mara Klein, a non-binary, transgender activist who has participated in Germany's church reform project.

"Seeing that, in contrast, surgical interventions on intersex people — which if performed without consent especially on minors often cause immense physical and psychological harm for many intersex people to date — are assessed positively just seems to expose the underlying hypocrisy further," Klein said.

The Vatican on Monday declared gender-affirming surgery as well as surrogacy as grave violations of "human dignity," putting them on par with abortion and euthanasia as practices that it says rejects God's plan for human life.

The Vatican's doctrine office issued "Infinite Dignity," a 20-page declaration that has been in the works for five years. After substantial revision in recent months, it was approved March 25 by Pope Francis, who ordered its publication.

In its most eagerly anticipated section, the Vatican repeated its rejection of what it calls "gender theory," or the idea that one's gender can be changed. Gender theory, often called gender ideology by its detractors, suggests that gender is more complex and fluid than the binary categories of male and female, and depends on more than visible sex characteristics.

The term "gender theory" is often used to suggest that trans and non-binary people have a political agenda.

"It follows that any sex-change intervention, as a rule, risks threatening the unique dignity the person has received from the moment of conception," the document said. 

It distinguished between gender-affirming surgeries, which it rejected, and what it called "genital abnormalities" that are present at birth or that develop later. Those abnormalities can be "resolved" with the help of health-care professionals, it said.

The Vatican's use of "sex-change" is also considered a loaded term by transgender advocates. The Trans Journalists Association notes that "sex-change" and "sex reassignment" are outdated terms and "are now generally considered offensive, though some medical literature still uses them. Some organizations with anti-trans political goals also use these phrases in lieu of gender-affirming care."

Advocates for 2SLGBTQ+ Catholics immediately criticized the document as outdated, harmful and contrary to the stated goal of recognizing the "infinite dignity" of all of God's children. They warned it could have real-world effects on trans people, fuelling anti-trans violence and discrimination.

"While it lays out a wonderful rationale for why each human being, regardless of condition in life, must be respected, honoured, and loved, it does not apply this principle to gender-diverse people," said Francis DeBernardo of New Ways Ministry, which advocates for 2SLGBTQ+ Catholics.

The document's existence, rumoured since 2019, was confirmed in recent weeks by the new prefect of the Dicastery for the Doctrine of the Faith, Argentine Cardinal Víctor Manuel Fernández, a close Francis confidant. 

The document comes at a time of some backlash against transgender people, including in the United States where Republican-led state legislatures are considering a new round of bills restricting medical care for transgender youths — and in some cases, adults.