Dear Brothers and Sisters in Christ,


The bishops of Iowa, Missouri, Nebraska, and Kansas traveled to Rome in January of 2020 to meet with the Holy Father, Pope Francis. While we were with him he affirmed that abortion is the pre-eminent moral issue of our time. But he added that another problem today is transgender theory/gender ideology, and he asked us to address it.

In response to his request I’d like to articulate some thoughts. I do not intend to give a comprehensive treatment of the issue here. But it is a growing concern, and I want to address some of its principal aspects.


Sincerely in Christ,


Most Rev. Robert J. Carlson, Archbishop of Saint Louis

June 1, 2020
Feast of the Blessed Virgin Mary,
Mother of the Church



Download and print a pdf copy of Compassion and Challenge here.


Compassion and Challenge


The first Sunday after Easter is Divine Mercy Sunday. It’s a liturgical pivot point, and it provides a lesson in discipleship. For a week after Easter we simply experience the power of the Risen Jesus. Every day is treated as Easter; the Gospels tell of one resurrection appearance after another. Then we pivot. After drinking deeply from the power of his risen love we’re called to bring that love to the hurts of the world.

One of those hurts today concerns gender ideology.

Rather than speak first about a cultural movement, however, I want to speak first about individuals who are questioning their identity, and individuals who consider themselves as having a gender identity at odds with their biological sex.

The first thing we’re called to do there is not to offer criticism but compassion. To wrestle with our identity, and to wonder about the meaning of our maleness and femaleness, is a common human experience. In addition, those who are questioning their identity, and those who consider themselves as having a gender identity at odds with their biological sex, are at risk for a whole series of poor health outcomes. They experience higher rates of anxiety, depression, and substance abuse, and have a much higher rate of suicide attempts than the general population. They are uniquely vulnerable.

Knowing these things, what should be our first reaction? The first thing we need to do is not to draw away in suspicion, fear, or condemnation, but to lean in with compassion. And we need to make it clear that violence against any of our brothers or sisters is unacceptable.

If you’re uncomfortable with your biological sex, or if you consider yourself as having a gender identity at odds with your biological sex, here’s the first thing I want you to know: God loves you. He loves you right where you are. He has a plan for you.

Think about Zacchaeus: he was a tax collector, and Jesus stayed at his house. Think about the Samaritan woman: she had previously had 5 husbands, and was now living with a man who was not her husband. Jesus initiated a conversation with her, and asked her to give him a drink. Think about Peter: he betrayed Jesus – three times! Jesus reached out to walk and talk with him. In each case Jesus didn’t draw away, he drew closer.

But, you might say: “Those were cases of sin, and sin freely chosen. What we’re talking about here is different.” And that’s right. What we’re talking about here is, first, before any action is even taken, a condition people experience, which is not the same as a sin, and a condition most people experience as not freely chosen.

So it’s important to say something more: Jesus also reached out to people who experienced conditions that were not sins, and that were not freely chosen. In just two chapters of the Gospel of Matthew (chapters 8-9) Jesus reaches out to a leper, a paralytic, a woman with a fever, a woman with a hemorrhage, two blind men, and many others with conditions they did not choose. The list can be multiplied by looking at the rest of the Gospels.

Whether we’re talking about sins we have freely chosen or conditions we have not the Gospels make it very clear: whatever our hurt is, Jesus came for the hurt. He doesn’t draw away there, he draws closer.


But if compassion is the first (and the last) thing to say, it’s not the only thing to say.

We are beloved sons and daughters of God in our best and worst moments. And when Jesus comes to us with a word of compassion, he always comes with a word of challenge too. Yes, he loves us where we are; that doesn’t mean he simply affirms or celebrates where we are. When the Rich Young Man came to ask about eternal life Jesus both welcomed him and challenged him (see Mark 10). He does so repeatedly with various people he encounters in the Gospels. We have to expect him to do the same with us. The welcome and the challenge are both expressions of his love.

The basic challenge on this topic is articulated by Jesus when he says “Have you not read that from the beginning the Creator made them male and female?” (Matt. 19:4). God made us male and female. God also made us as a union of body and soul. God has a purpose and a plan in giving us the male or female body we have.1

How we live our masculine and feminine identity is certainly diverse, and there needs to be room for that. There’s a wide variety of personalities, and they don’t always fit gender-stereotypes. But that doesn’t mean being male or female is negotiable, or that sex and gender can be separated. Being male or female is written into every cell of our body, and is part of the body-soul unity that we are.

And that’s the root issue. Gender ideology maintains that sex can be separated from gender. The Catholic understanding of the human person holds that sex and gender cannot be separated, and that there are limits to how we should manipulate our bodies. According to the Catholic understanding there is, and is meant to be, a profound unity in the human person: “In fact it is from [their] sex that the human person receives the characteristics which, on the biological, psychological and spiritual levels, make that person a man or a woman, and thereby largely condition his or her progress towards maturity and insertion into society.”2 

Based on the unity of the human person, the basic challenge on this matter is articulated by the Catechism of the Catholic Church when it says: “Everyone, man and woman, should acknowledge and accept his sexual identity.”3  Long before gender ideology was a cultural topic, the Catechism had already named the central issue: this is a question of reconciling ourselves to the physical facts of sexual identity, not trying to change the facts according to how we think and feel.
That, in fact, is one of the great tasks of human living: to integrate the powers of our sexual identity into how we live our lives.4  It’s no small task. It’s no easy task. But in his body Jesus reveals God’s plan for our bodies.

In the Eucharist Jesus reveals that we’re called to make a gift of ourselves to others. The complementarity of men’s and women’s bodies is made to serve that gift, and allows us to give life. When we integrate that truth into our lives we become living symbols of the Eucharist.

On the Cross Jesus reveals that self-gift also involves sacrifice. We all have our own ways of making our lives a sacrifice. But we’re called to make that sacrifice as a man or as a woman – not to change our bodies, but to follow Jesus in our bodies.

Following Jesus isn’t easy. As we take up the task each of us will have our own cross to carry. Sometimes that cross will involve our feelings about our body. If we take up our cross and follow Jesus we’ll find the peace that only he can give. If we turn away from Jesus our only recourse will be to the wisdom of the world. There’s no lasting peace there.

Faced with Jesus’ challenge, the Rich Young Man went away sad. Do you ever wonder if he came back? I think part of the reason we never hear is that the ultimate point of the story isn’t what happened to him. The point is: I am the Rich Young Man, Jesus asks something of me, and I have to decide how to respond. I can walk away sad, or I can embrace his challenge.

But, no matter what I decide, both the compassion and the challenge are expressions of his love.


“Yet another challenge is posed by the various forms of an ideology of gender that denies the difference and reciprocity in nature of a man and a woman and envisages a society without sexual differences, thereby eliminating the anthropological basis of the family. This ideology leads to educational programs and legislative enactments that promote a personal identity and emotional intimacy radically separated from the biological difference between male and female. Consequently, human identity becomes the choice of the individual, one which can also change over time. ... It needs to be emphasized that biological sex and the socio-cultural role of sex (gender) can be distinguished but not separated.”
Pope Francis, Amoris Laetitia, 56 




Gender Ideology

I’d like to say something about the broader cultural trend sometimes called the transgender movement and sometimes referred to as gender ideology.
My first concern here is the underlying philosophy of the movement. It’s not a philosophy that’s unique to this movement, but it finds particularly clear expression there. That philosophy seems to hold the following things:

1.    Feelings define our identity: “How you feel is who you are.”

2.    Human integrity means acting on our persistent desires. “I have to be true to myself.”

3.    Anyone who doesn’t affirm our feelings and actions hates us.

As Catholics we need to object to each of those ideas.

First: feelings are a part of us but they do not define us. Thanks be to God they don’t! As creatures who are both fallen and graced, we feel a lot of things every day. Following Jesus requires letting our identity guide our feelings, not the other way around.

We are, first and foremost, beloved sons and daughters of God. If we looked only to our feelings we wouldn’t know that. Feelings are shifting sand in adults. Those sands shift more readily and more dramatically in children. If we let our feelings define us we wouldn’t have a stable identity at all!
Saint Paul knew this struggle, and described it with great psychological clarity:

What I do, I do not understand. For I do not do what I want, but I do what I hate...The willing is ready at hand, but doing the good is not. For I do not do the good I want, but I do the evil I do not want…For I take delight in the law of God, in my inner self, but I see in my members another principle at war with the law of my mind, taking me captive to the law of sin that dwells in my members. Miserable one that I am! Who will deliver me from this mortal body? Thanks be to God through Jesus Christ our Lord. (Romans 7:15-25)

We all have our own version of that struggle. But Saint Paul let his identity in Christ guide his feelings, not vice-versa. We can and must do the same, and teach our children to do the same.

Second: human integrity requires us to sift our desires, not simply follow them. I may want a dozen things before breakfast! We all do. But acting on every desire will lead to personal and social disintegration, not integrity.

The reason is simple: our desires have many sources. Some of them are rooted in our identity as God’s sons and daughters. Some are the result of original sin – our inherited fallen condition. Some come from our personal history of sin. Human experience tells us that following our desires sometimes helps us live well and sometimes leads to trouble. Catholic theology simply places that experience against an eternal horizon: acting on our desires sometimes keeps us moving toward Heaven and sometimes does not. Desires are not self-authenticating. Whether or not they move us toward Heaven is the criterion for making decisions.

This is where, frankly, sin has to factor more deeply into our assessment of human experience. For gender ideology a feeling or desire is authentic and good if it is persistent, insistent, and consistent. But any number of examples can tell us that sinful and unhelpful desires – desires and feelings that are contrary to our identity as God’s children, and lead us away from Heaven – can be persistent, insistent, and consistent. The persistent existence of a desire is no proof that “God made us this way.” Sin and its effects are just as real as God’s designs and grace when it comes to analyzing our human experience. Gender ideology gives insufficient attention to the effects of the Fall on human desire. We must give a more searching account.

Third and last: disagreement is not hatred. Sometimes people object to our actions precisely because they love us. To love is to will the good of another. If I love someone then sometimes I need to speak out. Parents, coaches, teachers, brothers and sisters, and friends can respect our freedom even while saying: “I don’t think that’s good for you. I don’t see that bringing out the best in you.”

A wide range of human experience tells us that love and disagreement can co-exist. We need to pay closer attention to their legitimate co-existence, and learn how to hold them in proper tension. Labeling someone as a “hater” is simply an easy way to dismiss their unwelcome questions.5 

A few other elements of gender ideology concern me.

Double Standards: Media treatments of transgender issues are full of double standards. Two consecutive cover stories in Time Magazine are a good illustration, and can stand for many other examples.

The cover story from March 27 of 2017 (“Beyond He or She”) celebrated the fact that, for today’s generation of young people, gender is not determined by the physical facts but by how they feel about the facts. The very next cover story, from April 3 of 2017 (“Is Truth Dead?”), chided the president and claimed that, for him, the truth is not determined by the facts but by how he feels about the facts.

Either the truth is determined by the facts or it is not. You can’t have it both ways. To say that the truth is determined by the facts in one case and how we feel about the facts in another case is a double standard.

The desire for consistency on this issue is not particular to the Catholic faith, it’s just common sense. We can do this gently, but we need to do it repeatedly: we need to object to double standards.

The Body Matters: Gender ideology would have us believe that the body can and should be re-shaped according to our desires, and that we can ignore or override the biological differences between women and men.

By contrast, the Catholic faith teaches that those biological differences are profoundly meaningful. Sexual identity is written into every level of our physical being, from chromosomes to hormones to anatomy. We are called to integrate those realities into the psychological and spiritual aspect of our lives, not override them.
Thinking that we can ignore and override the facts about the body is linked with a broader inability to respect the structures written into nature. The link was highlighted by Pope Francis when he wrote:

The acceptance of our bodies as God’s gift is vital for welcoming and accepting the entire world as a gift from the Father and our common home, whereas thinking that we enjoy absolute power over our own bodies turns, often subtly, into thinking that we enjoy absolute power over creation. Learning to accept our body, to care for it and to respect its fullest meaning, is an essential element of any genuine human ecology. (Laudato Si, 155)

There’s a link between the ecological crisis of the body and the ecological crisis of the world. Once again, we can’t have it both ways: respect for the one entails respect for the other, and disrespect for one will result in disrespect for the other.

Additionally, if we can ignore differences as fundamental as those between man and woman, only dealing with them after we have re-arranged them according to our desires, it bodes ill for our ability to deal with any differences we can’t re-arrange. Again, Pope Francis wrote pointedly about this:

[V]aluing one’s own body in its femininity or masculinity is necessary if I am going to be able to recognize myself in an encounter with someone who is different. In this way we can joyfully accept the specific gifts of another man or woman, the work of God the Creator, and find mutual enrichment. (Laudato Si, 155)
A world that can’t reconcile itself to the differences between women and men will never be able to “celebrate diversity.”

Freedom: Gender ideology maintains that freedom is a matter of choosing, period. As Catholics we understand freedom to be at once more noble and more nuanced than that.

Human intellect is perfected by two things together: thinking, and knowing the truth. Human intellect is most fully itself when it has both of these together. Catholic education has always, at its best, striven to perfect the intellect by building up both aspects.

Something similar is true of human freedom. It’s not perfected simply in choosing freely. We can all name examples of people freely choosing something that’s bad for them and bad for others. Freedom is perfected in the combination of choosing freely and choosing the good.

A simple analogy comes from playing a musical instrument. You don’t have more freedom simply because you’ve never had lessons. You’re most free to make beautiful music when you’ve been trained and learned discipline. The same is true for excellence in human living.

As Catholic education has done for both aspects of the intellectual life, Catholic moral formation has to strive to build up both aspects of human freedom.

Compassion and Compromise: Gender ideology asks us to conflate compassion and compromise. It says, in effect: “If you were compassionate you would let me have my way.”

Pope Francis, by contrast, has written very clearly about the distinction between the two. For example, he says: “It is one thing to be understanding of human weakness and the complexities of life and another to accept ideologies that attempt to sunder what are inseparable aspects of reality.”6  Again, he says: “To show understanding in the face of exceptional situations never implies dimming the light of the fuller ideal, or proposing less than what Jesus offers to the human being.”7 

Must we show understanding and compassion? Yes, always! Does that mean compromising what Jesus offers – the union of body and soul, and a profound integration of the physical, psychological and spiritual aspects of our lives? Or accepting false dichotomies, like a division between the sex a person has and the sex a person wants to have, or wants others to perceive the person as having? No, never.

In laying out a better path, Pope Francis turns toward Jesus. So should we. He says:  

[The Synod Fathers] began with the gaze of Jesus and they spoke of how he looked upon the women and men whom he met with love and tenderness, accompanying their steps in truth, patience and mercy as he proclaimed the demands of the Kingdom of God.”8  

There are three key words there: met, accompanied, proclaimed. Gender ideology wants us to meet people where they are, capitulate to their demands, and celebrate them as they are. Jesus calls us to meet people where they are, proclaim the truth of God’s plan, and accompany them along the way of that plan.


“The acceptance of our bodies as God’s gift is vital for welcoming and accepting the entire world as a gift from the Father and our common home, whereas thinking that we enjoy absolute power over our own bodies turns, often subtly, into thinking that we enjoy absolute power over creation. Learning to accept our body, to care for it and to respect its fullest meaning, is an essential element of any genuine human ecology. Also, valuing one’s own body in its femininity or masculinity is necessary if I am going to be able to recognize myself in an encounter with someone who is different. In this way we can joyfully accept the specific gifts of another man or woman, the work of God the Creator, and find mutual enrichment. It is not a healthy attitude which would seek to cancel out sexual difference because it no longer knows how to confront it.”
Pope Francis, Laudato Si, 155


Some Basic Guidelines

The Church’s duty is to remain faithful to the Word of God, both to what it contains explicitly and to what it contains implicitly. As we try to do so, it’s important that we be faithful to the Word both in what we say and in how we say it.

Clarity: adhering to the truth about our bodies

How do we remain faithful to the Word of God in the practical details of what we say and do with respect to this topic? The fundamental norm is that the biological sex of a person should provide the basis for all our interactions with them.9 

That means people should be addressed and referred to with pronouns that are consistent with their biological sex in all Catholic programming and events. They should use bathrooms and locker rooms that correspond with their biological sex while on Archdiocesan or Parish properties, or at Archdiocesan or Parish events – thereby affording our bodies the healthy modesty and dignity deserved under such circumstances.

Those who experience discordance with their biological sex should not be denied admission to Catholic schools or participation in Archdiocesan or Parish events as long as they agree to abide by these guidelines. It’s important that we be willing to help people in their struggles and questions. Our solution can’t be to abandon them, and only welcome them after they’ve resolved their questions on their own. We want to be with people, and we need to be there for them and with them in the midst of their questions and struggles.

Respectful, critical questioning of Catholic teaching should be welcomed – as long as its intent is to help people come to greater awareness and understanding of the truth. Anyone, however, who insists on open hostility toward or defiance of Church teaching need not be welcomed in Catholic programs.

Clarity is not opposed to compassion. Clarity also comes from God’s tender heart. Clarity needs to characterize our witness to the truth about the body.

Charity: how the truth is articulated

What we say matters. But how we say it matters, too. It’s possible to violate our fidelity to God in what we say or fail to say. It’s also possible to violate that fidelity in how we say things.

Therefore let me say, with equal conviction: our faithful adherence to the truth about the body must be articulated not only with clarity, but also with a charity – a charity marked by compassion and patience.

Pope Paul VI spoke beautifully about this combination of charity and clarity in Humanae Vitae. While he was speaking to priests, I think his words are equally applicable to all of us. And while he was speaking about the difficulties of married couples, I think his words are equally applicable to the topic of gender. He said:

Refusal to compromise anything concerning the saving doctrine of Christ is an outstanding act of charity to souls; yet at the same time it is necessary always to combine this with tolerance and charity. When he spoke and associated with Men, the Redeemer Himself exemplified this truth. Coming not to judge the world but to save it, He was severe against sin, but patient and merciful to sinners.

Therefore, let spouses in their times of trouble find in the speech and hearts of their priests the image of the voice and love of our Redeemer.

So, Beloved Sons, preach with full confidence and be certain that the Holy Spirit of God, who guides the Magisterium in its teaching, will illuminate the hearts of the faithful and invite them to give their assent. Teach spouses the indispensability of prayer; instruct them properly so that they may come regularly and with great faith to the sacraments of the Eucharist and of penance and that they may never become discouraged because of their weakness.10

These words provide a beautiful template for all of us to approach the topic of gender.

Finally, I cannot conclude this section without insisting on one further point. What the Catechism says about our treatment of those who experience same-sex attraction applies with equal force to our treatment of those who are uncomfortable with their biological sex, and those who identify as transgendered. The Church rejects unjust discrimination, and every sign of unjust discrimination against them.11

Very simply: these are our brothers and sisters. They have been subjected to violence and harassment, which is a violation of their human dignity. We, for our part, must protect them, welcome them into our hearts, and reach out to them in love just as Jesus did. Whether or not we totally understand their experience, and whether or not we agree with the decisions they make, they need to find us offering a safe place in which they can experience the love of God.

Some Specific Applications

I make this special appeal to parents and friends: when someone you love is unhappy with their biological sex, listen! Keep the channels of communication open. We can sympathize with their feelings without capitulating to their desires. It’s important not to leave them feeling alone.

Keep in mind, however, that there are sometimes other factors involved with gender dysphoria. For example, anxiety and low self-esteem can be factors. Deceptive sources of “information” on the internet or among peers can be factors. Having a sympathetic ear for the person does not mean being inattentive to all the potential factors involved in discomfort with one’s biological sex.

On the topic of Pubertal Blockade: I’m not a medical expert, and I can’t cover every conceivable medical and pastoral scenario. But the basic approach of the Catholic tradition is and must be a presumption against this intervention. Evidence shows strongly that nearly all those with gender dysphoria who have their normally timed pubertal development artificially stopped go on to take cross-sex hormones. This is not an end we can affirm, so this is not a path we can approve.

I ask Catholic hospitals, physicians, and counselors to use their expertise, fidelity, and creativity to discover and follow paths that can help, paths that are in accord with a genuine Catholic understanding of the person.

On the topic of Cross-Sex Hormones and Surgery I must say, very simply: the Church does not and cannot approve this. The National Catholic Bioethics Center has given excellent guidance which is worth citing at length:

Taking up or engaging in behavioral changes, including mannerisms, social cues, clothing, or modes of speaking that social mores ascribe to the opposite sex, does not alter the innate sexual identity of the embodied spirit, which is the human person. Hormonal interventions, to block the body’s sex-specific hormones or provide the sex-specific hormones of the opposite sex, likewise alter nothing of a person’s innate sexual identity … So-called sex reassignment surgeries of any kind, designed to give the body an appearance with more of the culturally expected qualities of the opposite sex, also cannot modify the true sexual identity of the person, who was created male or female.

Directly intending to transition one’s given bodily sex into a “new” one (even though this may be perceived as the “real” and “true” one) means intending to alter what is unalterable, to establish a false identity in place of one’s true identity, and so to deny and contradict one’s own authentic human existence as a male or female body–soul unity. Such an action cannot be consonant with the good of the whole person.12  

Hormonal and surgical interventions seem to promise hope. But it is, in the end, a false hope because it is not rooted in the truth about the body.
I know that Catholic hospitals, physicians, and counselors have to deal with complex cases. I simply ask you to treat all patients and clients in accord with a genuine Catholic anthropology, with the understanding that anything contrary to Catholic teaching is not genuine care for the person.

Finally, we should also bear in mind a parallel. The Church does not and cannot approve of abortion. After an abortion has taken place, however, the Church continues to care for the person. Healing ministries like Project Rachel and Project Joseph are an important part of the Church’s approach to the issue of abortion. Similarly, the Church can and must continue to offer care to those who have taken irreparable steps to alter the sexual appearance and function of their body.



Some people are uncomfortable with their biological sex, and some consider themselves as having a gender identity at odds with their biological sex. The world tends to do two things with that: celebrate it or revile it. As Catholics we’re called to neither. I ask all of us to take to heart the lesson of Divine Mercy Sunday: let’s make a pivot. As we have experienced the merciful love of Jesus, let’s bring that merciful love to the world. And let’s remember that his love always has two parts: compassion, and the challenging truth about God’s plan. If we lack either – the compassion or the challenge – our love isn’t fully Christian.
Do you not know that your body is a temple of the Holy Spirit within you, which you have from God? You are not your own; you were bought with a price. So glorify God in your body.” (1 Cor 6:19-20)


Basic Documents

Catholic Websites

Other Websites

The following are not Catholic websites, but contain some helpful resources and approaches.

Scientific and Medical Resources

  • Gender Dysphoria Resource for Providers.
    This document is meant primarily for health care providers who wish to learn more about gender dysphoria and the harm caused by gender affirmation therapy. This document is not meant to be exhaustive, but to give a starting point for further reading.
  • Pediatric and Adolescent Gender Dysphoria Working Group: An International Discussion Space for Clinicians and Researchers.
    An international group of psychiatrists, psychologists, clinical social workers, researchers, and psychoanalysts that have a special interest in the treatment of Gender Dysphoria in children, adolescents, and young people.
  • The Society of Evidence-based Gender Medicine.



1 People with disorders of sexual development who have both male and female biological features represent a unique and separate medical and pastoral case.
2  Congregation for the Doctrine of the Faith, Persona Humana, paragraph 1.
3  Catechism of the Catholic Church, 2333.
4  “Chastity means the successful integration of sexuality within the person and thus the inner unity of man in his bodily and spiritual being…The chaste person maintains the integrity of the powers of life and love placed in him. This integrity ensures the unity of the person.” Catechism of the Catholic Church, 2337-2338.
5  Besides, if disagreement always indicates hatred, then those who disagree with the Church are equally guilty of hating Catholics.
6  Amoris Laetitia, 56.
7  Amoris Laetitia, 307.
8  Amoris Laetitia, 60.
9  The Church does not support transgender therapies and/or surgeries that assist a person in “transitioning” his or her sex characteristics. But it does recognize that appropriate medical care is necessary in those rare cases of genetic or physical disorders of sexual development.
10  Humanae Vitae, #29. (Dr. Janet Smith translation.)
11  See Catechism of the Catholic Church, 2358.  “Every sign of unjust discrimination in their regard should be avoided.”
12  National Catholic Bioethics Center, “Brief Statement on Transgenderism.”