Welcome transgender people, show them compassion, experts advise ministry

August 1, 2023

During a CHA webinar on providing spiritual care to transgender people, a sister described one of the many harrowing phone calls she has received during her 24 years as a spiritual companion to people who are transitioning or have transitioned.


Sr. Luisa Derouen, a Dominican Sister of Peace of St. Catharine, Kentucky, recalled the desperate middle-of-the-night call from Shane, who was both transgender and Catholic and struggling with feeling disconnected from the church. Sr. Derouen said Shane, weeping, told her, "I miss going to Mass and I miss receiving Holy Communion. But I can't go back to church because I'm not safe there. The Catholic Church doesn't want me."

Transgender people are on a spiritual journey — a "holy journey," Sr. Derouen said, as they are "claiming the truth of who they are." She said it is important that the church and its ministries welcome them, show them dignity and compassion and provide them with the spiritual care services they need.

Sr. Derouen was one of three main speakers during the June 8 webinar, "Care for the Transgender Soul: An Introduction to Spiritual Care for Trans Persons and their Families." The others were Erica Cohen Moore, executive director of the National Association of Catholic Chaplains, and Jamez Terry, a chaplain with the Children's Hospital at Providence Alaska Medical Center in Anchorage. Webinar moderators were Jill Fisk, CHA director of mission services; and Fr. Charles Bouchard, OP, who retired in late June as CHA senior director of theology and sponsorship.


Discernment and action
During the webinar, Fisk and Fr. Bouchard explained that CHA in recent years has been in discernment on how to advise the ministry when it comes to care of transgender patients.

Four years ago, CHA and the United States Conference of Catholic Bishops formed a task force on the subject. CHA produced a document on transgender people and the church. The conference's Committee on Doctrine has been using that document as well as other input to guide its work in this area. In March, the conference's committee issued a statement providing moral criteria to ministry providers for "discerning which medical interventions promote the authentic good of the human person and which are in fact injurious," particularly when it comes to care of people with gender dysphoria or gender incongruence.


In the statement, the committee said Catholic health care facilities are 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" but that the means used "must respect the fundamental order of the human body" or else the human person will not be helped, but rather harmed.

CHA has formed a subcommittee that is working through the association's Spiritual Care Advisory Council to study how best to ensure that ministry facilities provide appropriate spiritual care services to transgender people. The three presenters of the June webinar are on that subcommittee.

The subcommittee has been surveying some ministry facilities and convening groups of selected ministry leaders for discussion. Fisk said the subcommittee's main takeaway is that it is essential that the ministry provides all people who need spiritual care with those services and the services should address the needs in a specific and holistic way. "We don't need to re-create our spiritual care services but to bring them forth" to all who need them, Fisk said.

Sr. Derouen said that based on her two-plus decades working closely with transgender people, it is her belief that being transgender is a medical condition, and not a personal choice, and since it is a medical condition, it would be incorrect to refer to it as a pathology or as sinning against God. She said in today's heated political climate, incorrect narratives are promoted about transgender people such as that they are suffering from a pathology and are at war with God. Sr. Derouen said some people pretend transgender people don't exist. She said denying the existence of transgender people contributes to their marginalization. That in turn causes stigma, shame, and secrecy.

She explained that people who are transgender generally move through several stages as they discover the gender they are meant to be. Those stages include false integration, disintegration and reintegration of a person's identity.

In describing the stages, she said the most fundamental spiritual question for everyone is "Who am I?" She said that question takes a lifetime to answer. Sr. Derouen described a common pattern for how many transgender people process that question. First, they try to be who everyone expects them to be — false integration. Then they reach the point where they can't pretend to be who they aren't — disintegration. Then finally they claim to live in harmony with who they know themselves to be — reintegration.

"It's a holy journey, as they become closer to who they are," Sr. Derouen said.

She added, "They deserve to be treated with dignity."

Terry, the children's hospital chaplain, became part of the transgender community two decades ago. Terry said it has been clear to him in the ensuing years that it is a common experience among people in this community to have had a religious background and to have spiritual longings and to be undertaking "deep soul work as they discern who they are and who they are meant to be." Becoming aware of this, Terry said, "I discerned my own call" to be a chaplain who helps people with their spiritual challenges.

Cohen Moore wrapped up the discussion by acknowledging that the church and its bishops are navigating numerous complex questions around the specifics of providing various types of care to transgender people. She said it is important for ministry providers to stay abreast of that work and its implications.

While there is ambiguity and uncertainty in these matters now, Cohen Moore said ministry providers should proceed with love. "It's a journey, and we're pioneering in this area," she said. "In light of Catholic social teaching we are to live into our set of competencies" — the competencies that have been established for chaplains.

She said, "Our competencies say we are to provide spiritual care that respects differences."

Catholic bishops to amend directives on health care; CHA will offer advice

During its spring plenary assembly in Orlando, Florida, in June the United States Conference of Catholic Bishops voted to give the Committee on Doctrine permission to prepare an amendment to the Ethical and Religious Directives for Catholic Health Care Services relating to the care of transgender people.

On June 16, CHA issued a press release expressing its intention to work with the bishops' conference to ensure that the revisions will allow Catholic health care to continue to provide high-quality patient care that respects church teaching, federal and state laws and the human dignity of all.

The press release, which quoted
Sr. Mary Haddad, RSM, CHA president and CEO, affirmed that the ministry "welcomes and cares for transgender patients, or those experiencing gender dysphoria, with the same care and respect as any patient in our facilities." Sr. Mary said in the release that there is still much to learn about the complexities of gender dysphoria and the use of different treatments to address the condition.

She said that as the bishops' conference navigates the revision of the Ethical and Religious Directives in reference to the treatment of transgender patients in ministry facilities, they should "engage in broad consultation with patients suffering from gender dysphoria and providers who care for them to ensure the health of the whole person."

CHA has convened standing advisory groups of experts that have been providing input on transgender care to CHA. Those multidisciplinary groups remain available to advise CHA and the bishops' conference, including during the revision of the Ethical and Religious Directives. The groups have expertise in ethics, moral theology, medicine, law and public relations.

Ways to improve encounters with transgender patients

During CHA's June webinar on spiritual care for people who are transgender, a ministry chaplain shared recommendations on how to better serve them.

Jamez Terry, a chaplain with the Children's Hospital at Providence Alaska Medical Center in Anchorage, shared on the call six practical steps spiritual care providers at ministry facilities can take when offering services to people who are transgender and their loved ones.

Those steps are:

  • Recognize the hurt that religion may have caused or may be causing for them. Terry said many transgender people have felt or currently feel alienated from the church and harmed by the church.
  • Understand that spiritual care is not being provided in a vacuum. Transgender people live in a society where many people prefer they not exist. This marginalization, Terry said, causes spiritual harm and many transgender people are spiritually weary of enduring that harm.
  • Acknowledge that there is a need for spiritual connection. Terry explained that many transgender people are well connected to their own spiritual life but often disconnected from a broader faith community. The spiritual care provider should seek to understand whether that connection is desired.
  • Advocate for transgender people. It is important to stand up for transgender people at a time when they need this advocacy, Terry said.
  • Understand it is a gift when transgender people reveal their identity. Terry explained that it is not always clear who is and who is not transgender. When a member of this community shares that information, it is a gift. The recipient of that gift should affirm the person and help them identify what spiritual strengths they have to share with the world.
  • Celebrate the joy of transgender people. While people often focus on the hardships of transgender people, there also is joy for people who are becoming their true self by transitioning, Terry said. Spiritual care providers should recognize that all people are children of God, deserving of affirmation as they strive to live with authenticity and integrity.

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