Reacting to a recent report that shows that scores of Catholic hospitals have provided children with drugs or surgeries to change their gender identity, a U.S. bishop has called for a special meeting of the country’s bishops to address what he sees as a major breach of Catholic medical ethics.

“As bishops, I think we need to confront Catholic health care, because they are violating their mission,” Bishop Thomas Daly of the Diocese of Spokane, Washington, told the Register.

The medical watchdog group Do No Harm published a database of public hospital records on Oct. 8 that catalogs nearly 14,000 sex-change-related treatments — including 5,747 sex-change surgeries — patients age 17 and under received from health-care facilities from 2019 to 2023.

Nearly 150 Catholic hospitals were among the health-care facilities that appear in the database, an EWTN News analysis found.

Of the more than 520 minors treated at these Catholic hospitals, more than 150 had surgeries to alter their appearances to resemble the opposite sex, while more than 380 children were given puberty blockers or hormone therapies, EWTN News found.

The Register sent a request for comment about the report to every bishop who heads a diocese in the United States. Bishop Daly of Spokane was among those who responded.

“I’m appalled, but sadly I’m not surprised,” he told the Register.

The U.S. bishops will gather in Baltimore next month for their annual fall assembly, but Bishop Daly said he doesn’t expect that the hospitals’ involvement in transgender treatments will be a formal topic of discussion, as the meeting’s agenda is already set. But he said he hopes bishops set a date to discuss it.

None of the Catholic hospitals in the database are in the Diocese of Spokane, which covers eastern Washington.

But Bishop Daly described for the Register a conversation he and the vicar general of his diocese once had with the ethicist of a Catholic hospital.

“The vicar general asked, ‘Why don’t you do gender-transitioning surgeries?’ And his answer was: ‘Because we don’t have the doctors,’” Bishop Daly recalled.

“And my response was: ‘The answer should be: ‘Because we’re a Catholic hospital.’”

150 Catholic Hospitals

Do No Harm says it collected data from commercial health-insurance providers and federal agencies with health care in their portfolios.

EWTN News, which publishes the Register, compared the gender-transitioning database with a list of Catholic hospitals published by the Catholic Health Association of the United States and found that about 150 Catholic hospitals in 89 dioceses in 40 states offered gender-transitioning services during the five-year period.

For many of those hospitals, participation was minimal — filling as little as one prescription, for instance.

But some were more involved, including 33 Catholic hospitals that provided gender-transitioning surgeries.

Several bishops contacted by the Register expressed disgust with reports that Catholic hospitals have provided such services.

“The surgical mutilation and chemical castration of young kids under the rubric of ‘gender-affirming care’ is a moral outrage. That any of it takes place within the confines of a Catholic hospital is appalling,” said Bishop Robert Barron of the Diocese of Winona-Rochester, Minnesota, by email through a spokesman. (None of the Catholic hospitals in the database is in that diocese.)

Fourteen of the Catholic hospitals that the database says assisted gender transitioning are in Ohio.

The Catholic Conference of Ohio, which represents the bishops of the state’s six dioceses in public-policy matters, provided the Register a written statement saying that people “experiencing gender incongruence must receive compassionate treatment and personal accompaniment without resorting to medical interventions that harm the created body.”

The statement notes the bishops’ support for Ohio’s ban on gender transitioning for minors, which took effect April 24 after the state Legislature enacted a bill in January over the governor’s veto. The statute was upheld by a state trial court but is now before a state court of appeals, which heard oral arguments Sept. 11 but has yet to issue a decision.

“The dioceses in Ohio will continue to monitor Catholic hospitals’ compliance with the Ethical Religious Directives,” the Ohio bishops’ statement says.

‘Inconsistent’?

Catholic hospitals are expected to adhere to a document called “Ethical and Religious Directives for Catholic Health Care Services,” a publication of the U.S. Conference of Catholic Bishops (USCCB) that sets out do’s and don’ts for Catholic hospitals on the basis of the Church’s moral teachings.

The document, which a USCCB spokesman told the Register was last updated in 2018, doesn’t mention gender transitioning.

Even so, the Vatican and the U.S. Conference of Catholic Bishops have said publicly that gender transitioning is immoral.

The USCCB’s Committee on Doctrine in March 2023 said Catholic health-care entities “must not perform interventions, whether surgical or chemical, that aim to transform the sexual characteristics of a human body into those of the opposite sex or take part in the development of such procedures.”

Pope Francis wrote in his 2016 apostolic exhortation Amoris Laetitia: “Beyond the understandable difficulties which individuals may experience, the young need to be helped to accept their own body as it was created.”

The Vatican’s Dicastery for the Doctrine of the Faith in March 2024 published a document called Dignitas Infinita, which says “any sex-change intervention, as a rule, risks threatening the unique dignity the person has received from the moment of conception.”

Spokesmen for bishops of two dioceses told the Register the bishops may have relied on misleading information about Catholic hospitals operating in their jurisdictions.

A spokesman for the Diocese of Toledo, Ohio, told the Register that the Stop the Harm database’s findings “are inconsistent with the recent Ethical Religious Directives audit report” conducted by Bon Secours Mercy Health, a Catholic health system headquartered in Cincinnati that runs four Catholic hospitals in the Diocese of Toledo that appear in the Stop the Harm database. They are Mercy Health St. Anne Hospital in Toledo (eight patients, eight puberty blockers, 55 prescriptions); Mercy Health St. Vincent Medical Center in Toledo (one patient, one puberty blocker, four prescriptions); Mercy Health Tiffin Hospital in Tiffin (one patient, one puberty blocker, one prescription) and Mercy Health Lima Hospital in Lima (one patient, one puberty blocker, two prescriptions).

The diocesan spokesman directed further questions about the audit to a spokesman for Bon Secours Mercy Health, who provided the Register with a statement on Wednesday by email.

“The Ethical and Religious Directives (ERDs) are foundational to who we are as a Catholic ministry and we maintain full compliance with these standards. Bon Secours Mercy Health denounces this one-sided report which serves to negate the high-quality, compassionate care provided by Catholic health systems in full compliance with the ERDs. As caregivers, we will compassionately serve every patient who walks through our doors — maintaining their privacy and human dignity at every step,” the statement said.

The spokesman declined to share Bon Secours Mercy Health’s “Ethical and Religious Directives” audit, saying that it “contains protected health information,” and did not answer a question from the Register about whether Bon Secours Mercy Health hospitals have provided gender-transitioning assistance to minors.

In Montana, a spokesman for Bishop Austin Vetter of Helena said the diocese has not independently verified the Stop the Harm database’s findings that two Catholic hospitals in the diocese assisted minors in gender transitioning. But the spokesman said this bishop’s message about Catholic moral teachings is clear.

“The Catholic Church and Bishop Vetter have been clear in communicating that such treatments are contrary to the infinite dignity of each person as created in the image and likeness of God,” the spokesman told the Register by email.

“This allegation also contradicts what Catholic healthcare providers have communicated to Bishop Vetter,” the spokesman continued. “Bishop Vetter will address these concerning claims directly with Catholic providers in the diocese amidst his ongoing support of their 150-year legacy of healing and service to the people of Montana.”

The spokesman did not name the Catholic health-care facilities. But two Catholic hospitals in the Diocese of Helena appear in the Stop the Harm database.

One is St. James Hospital in Butte, which the database reports provided puberty blockers one time and filled a gender-transitioning prescription one time during the five-year period.

The other is Providence St. Patrick Hospital in Missoula, which the database says treated eight patients, providing two surgeries, puberty blockers six times, and gender-transitioning prescriptions 11 times.

That hospital is part of the Providence health system, headquartered in Renton, Washington, which operates hospitals in five Western states that the database says provided 76 of the 152 gender-transitioning surgeries on minors in Catholic hospitals during the five-year period.

Last week, a spokesman for Providence didn’t confirm or deny the details of the Do No Harm database, but told the Register that the health-care organization offers “the full range of care” for all patients, including transgender patients, who he said “come to us for many health care needs.”

“We are committed to providing them with quality, compassionate health care, and helping them to feel welcome, safe and included,” the Providence statement said last week. “Consistent with our Mission and values, Catholic teaching and state and federal laws, we treat LGBTQ+ people with respect and sensitivity and provide all patients with the full range of care available at our facilities.”

The Register contacted the Providence spokesman earlier this week about the Diocese of Helena’s comments. The Providence spokesman said Wednesday that Providence did not have anything to add to its original statement last week.

The Register also contacted St. James Healthcare, but did not receive a response by deadline.

In Arkansas, an official for the Diocese of Little Rock said the diocese is pursuing information from Mercy Health Northwest Arkansas in Rogers, which the Stop the Harm Database says provided gender-transitioning services for two patients ages 17 and younger, including puberty blockers and gender-transitioning prescriptions.

“Our diocese takes very seriously the concerns about Catholic entities that are engaged in so-called gender-transition care, particularly when a Catholic health care provider in our diocese might be involved,” said Deacon Matthew Glover, chancellor for canonical affairs for the diocese, by email through a spokesman. “Without knowing more from Mercy in Northwest Arkansas on what has been reported about them, it would be premature for our diocese to comment further at this time.”

The Register contacted a spokesman for Mercy Health Northwest Arkansas — which is run by Mercy, a Catholic health organization headquartered in Chesterfield, Missouri, that operates hospitals in Missouri, Arkansas, Oklahoma and Kansas — on Tuesday night, but did not hear back by deadline.

What Can Bishops Do?

The Catholic Health Association, which represents about 650 Catholic hospitals in the country, last week defended the hospitals named in the Stop the Harm database and criticized Do No Harm for publishing it, saying the organization is “irresponsibly presenting claims data without necessary clinical context.”

“This harmful report makes dangerous assumptions that seek to disparage health care providers and the patients they treat,” the Catholic Health Association said in a written statement.

But a board member of the Catholic Medical Association, which represents Catholic doctors, dentists and nurses, criticized Catholic hospitals that have offered gender-transitioning services.

"The work done by Do No Harm is both very revealing and disturbing. Their study has drawn back the curtain to reveal the depth and breadth of transgender interventions that lead to lifelong harms to a very vulnerable population in our society," Dr. Tim Millea, chairman of the Catholic Medical Association's Health Care Policy Committee, told the Register by email through a spokesman Wednesday.

"The fact that any Catholic-identifying hospital is involved in these interventions is very disappointing,” he said. “When profit from unethical interventions on children is prioritized over the mission of Christ-centered care, our society is also harmed. These hospitals must recommit to the values and principles of the Gospel message in their delivery of ethical health care to all they serve.”

Catholic health care in the United States is more complicated than it used to be, which makes upholding Catholic moral standards more complicated than it used to be.

A couple of generations ago, most Catholic hospitals were run either by religious orders or by dioceses.

Today, though, many Catholic health-care companies have holdings in several states, crossing the boundaries of various Catholic dioceses. Church jurisdiction can get messy. Spokane Bishop Daly said he has heard that some officials at some Catholic hospitals tell the local bishop that a hospital in his diocese is not under his authority, but instead under the authority of the bishop of the diocese where the health-care company is headquartered.

Moreover, he noted, while canon law gives a diocesan bishop the authority to declare on behalf of the Church whether a health-care institution is or is not Catholic (216), a bishop doesn’t have the ability to tell health-care organizations what they can and can’t do because he doesn’t have direct authority over them.

“So there is a bit of powerlessness about it. We’re not being cowards, but what can we do?” Bishop Daly said.

He said the gender-transitioning practices at Catholic hospitals could use some direction from Rome, which he said he believes will be forthcoming.

“We are anticipating a document from the Holy See that is going to address why this is wrong,” Bishop Daly said. “It has no place in Catholic health care.”