On the Unity of Body and Soul: Accompanying Those With Gender Dysphoria
Most Rev. Paul S. Coakley, Archbishop of Oklahoma City
In the beginning was the Word, and the Word was with God, and the Word was God. He was in the beginning with God.
All things came to be through him, and without him nothing came to be. What came to be through him was life, and this life was the light of the human race; The light shines in the darkness, and the darkness has not overcome it.
And the Word became flesh and made his dwelling among us,
and we saw his glory, the glory as of the Father’s only Son, full of grace and truth.
Go Make Disciples: Accompaniment and Community
In my earlier pastoral letters, “Go Make Disciples: A Vision for the Archdiocese of Oklahoma City” (2013) and “Go Make Disciples!: Building a Culture of Conversion and Discipleship” (2019), I cast my vision for the Archdiocese of Oklahoma City in broad terms as I called each of us to “joyfully witness to our Catholic faith.”(3) Witnessing involves “accompanying” those we encounter so that they see in our lives, our actions, and our words that God is Love, and that He sent his only begotten Son to bring us into a communion of Love. Accompaniment requires us “to love and accept all people in a way that invites each person to a deeper relationship with Christ and a greater alignment of their lives with his teachings.”(4)
Vatican II emphasized that “the Church has always had the duty of scrutinizing the signs of the times and of interpreting them in the light of the Gospel. Thus, in language intelligible to each generation, she can respond to the perennial questions which men ask about this present life and the life to come, and about the relationship of the one to the other.”(5) This pastoral letter takes the broad themes of my previous letters to address two related but distinguishable phenomena prevalent in our times, namely those who in increasing numbers identify as transgendered6 and the political, cultural and ideological transgender movement.
While this letter will address the anthropology underlying the transgender movement, the purpose of the letter is to provide pastoral guidance on how the Church, its ministers and the lay faithful can accompany – walk with – those who struggle with their gender identity, especially those who identify as transgendered. Following Pope Francis, I distinguish “between what pastoral care is for people who [identify as transgendered] and what is [trans]gender ideology.”(7) Persons who identify as transgendered are created by God, are loved by God, and we as faithful
Christians are called to love each of them as our neighbor (Cf. Mark 12:31). To love others means at its heart to will and desire their good.
The Beauty and Truth of Creation
As Catholics we recognize through faith and reason that God created everything good.(8) This is particularly true of the human person, who is “very good” (Genesis 1:31) and exists as a unity of body and soul (cf. Thessalonians 5:23).(9) The two so integrally comprise the person that any attempt to separate body and soul inevitably diminishes our very humanity. We don’t have bodies; we are bodies enlivened by souls.
God created humanity in love to share in love. Reason tells us that we give and receive love through the powers of the soul, our intellect, and will. And the body participates, tangibly expressing our love and making visible the invisible. In other words, the givens of body and soul are gifted to us so we may give ourselves to others in love.
Furthermore, as Christians, we learn from the Bible that the human person has a far greater dignity than we can know by reason alone: “God created man in his own image, in the image of God he created him; male and female he created them” (Genesis 1:27).
Michelangelo, The Creation of Eve. 1510, Sistine Chapel, Vatican.
Here we find the revealed truth that we image God in body and soul.10 But what does it mean to image God? “This likeness reveals that man, who is the only creature on earth that God willed for itself, cannot fully find himself except through a sincere gift of himself.”(11) This is why the next verse12 and the first command is to be fruitful and multiply — man and woman most fully image God by their own self-giving love, a truth reflected in bodies that were designed for fruitful union. Scripture confirms what we can know through reason alone — that there are two sexes (13) and they are made for each other for the sake of life-giving love.
God’s definitive statement on the goodness of the human person, the body in particular, is found in the Incarnation of Jesus, the Word made flesh ( cf. John 1:14). That God became fully man, even assuming a human body, is the ultimate affirmation of the entire human person. Following His Resurrection, Jesus didn’t shed His human body,(14) but is and will be embodied for all eternity.
Jesus reaffirms for us that there are two sexes designed by God for each other.(15) Saint John Paul II called the sexes “two different incarnations.”(16) That is, two distinct but related ways of being human. While only the body is sexed, each soul is adapted to a particular body, so there is a sense in which the body feminizes or masculinizes the soul.(17) And because the sexed body causes this effect in a sexless soul, the two always align.
The two God-given sexes give rise to the two genders, whose lived expression varies across and within cultures, creating the beautiful diversity among men that is masculinity and among women that is femininity. Since gender should reflect the entirety of the person, Pope Francis emphasized that the “biological sex and the socio-cultural role of sex (gender) can be distinguished but not separated.”(18) If gender is to serve the individual, it must neither be confined to rigid stereotypes nor untethered from the sex that grounds its meaning.
It is especially in regard to gender that humanity’s complexity and freedom come to bear. Although biology sets hard limits,(19) it is influenced by culture and choice. Upbringing, societal norms, religious beliefs, and individual choice are a handful of the many factors that affect how we think and feel about ourselves.
Distorted by the Fall
Since the Fall – the sin of Adam and Eve in the Garden of Eden – our freedom as human beings has been complicated and distorted by sin. We seek goods, including identities, that fall far short of our ultimate Good in God. These lesser goods inevitably leave us feeling unsatisfied and unfulfilled. Saint Augustine eloquently captures this reality: “You have made us for yourself [God], and our hearts are restless until they rest in you.”(20) It is not hard to see this reality all around us. We fill ourselves and our lives with work, the desire for power, sex, alcohol, the internet and constant noise in a futile attempt to satisfy the aching in our soul, or alternatively, as a way of numbing the pain of not finding satisfaction. Some of those suffering from gender dysphoria seek respite from their pain by identifying as the opposite sex or some “non-binary” variation. We can all empathize with these individuals because each of us in our own unique circumstances has sought to rest in something other than God.
Sins and injustices against us can create wounds that make it difficult to recognize the body as a gift. Our own fallen natures exacerbate the internal and external disharmony we experience in varying ways.(21) These factors add to the challenge of recognizing the goodness of our bodies and foster discord within the unity of body and soul. Both often are keenly experienced by those who struggle with gender dysphoria, which is defined as “strong, persistent feelings of identification with another gender and discomfort with one’s own [biological] gender and sex.”(22) What tremendous suffering it must be to feel a lack of congruity between one’s sex and gender! We must tread lightly and with great compassion as we seek truth related to situations filled with pain.
Michelangelo, The fall and expulsion from garden of Eden. 1510, Sistine Chapel, Vatican.
Loving Persons in Pain
Let us first acknowledge the immense pain found within this small segment of the population.23 According to the largest study of persons who identify as transgendered in the United States, 40 percent have attempted suicide at least once — a rate almost nine times higher than the general population.24 Nearly half (47 percent) have been sexually assaulted (25) and more than half (54 percent) have experienced verbal harassment.(26) They also are more likely than the general population to suffer from issues such as eating disorders, dissociative disorders and substance abuse. (27) This picture is alarming, and as Catholics we must be concerned for the welfare of persons who identify as transgendered and categorically condemn all forms of violence and unjust discrimination against them.
In addition to eschewing all injustices, Jesus commands us to love as we have been loved (John 13:34). Each person who identifies as transgendered is loved by God and is a person Jesus Christ died to redeem. To love like Christ means to desire the good of the individuals in our lives and to walk with them, regardless of their degree of openness to the good. Given the foundation laid by reason and revelation, what is an authentic Catholic response to gender dysphoria? We must avoid the extremes: to ignore the pain of the person and dogmatically assert that biological sex is the end of the conversation or to jettison the truth of the body in the false hope of relieving pain. A Catholic response must both affirm God-given sex and recognize the struggle of the person in front of us. It requires listening with empathy as well as extending the invitation to receive God’s gift of the sexed body. It means recognizing that all desires are rooted in something good, including the desire to identify as the opposite sex, which can be fueled by a wide range of good things, such as a desire for beauty, a desire to be seen as a person and not be objectified, a desire to pursue relationships and activities that aren’t culturally acceptable but feel more authentic, a desire to be seen and known, etc., even though those desires can be misdirected.
Ultimately, it means inviting the suffering person to surrender to the truth. Through their trust in Jesus Christ, they can receive assurance that despite the challenges and pain of bringing gender into alignment with one’s God-given sex, it will ultimately be for their happiness, holiness, and peace.
To Those Experiencing Gender Dysphoria
God knows us and loves us — all of us. He knows our joy and sorrow, our strengths and weaknesses, our sense of humor and idiosyncrasies. He sees in us the sons and daughters He created. He also sees our pain and struggle around gender and invites us to follow Him more deeply. To those for whom gender has been an ongoing struggle, I offer Pope Benedict XVI’s words: “It is not by sidestepping or fleeing from suffering that we are healed, but rather by our capacity for accepting it, maturing through it and finding meaning through union with Christ, who suffered with infinite love.”(28)
Admittedly, the path the Church lays out — accepting the gift of your biological sex and working to heal your felt incongruity mentally, emotionally somatically and spiritually — is arduous and currently countercultural. But it also is a glorious, grace-filled, path on which Jesus offers ever deepening wholeness and holiness.
As a Church, we want to walk alongside you as you struggle with gender dysphoria, for as Saint Paul notes, “If one member suffers, all suffer together; if one member is honored, all rejoice together” (1 Cor 12:26). We want to help you know the unconditional love of Jesus and to bring Him to you in the Sacraments. You are a part of the Church—you belong here and, truly, you are welcome here. I pray that the Lord will send wise and faith-filled individuals into your lives in order to accompany you with and through your struggles.
I ask each person who is experiencing this confusion to trust Jesus with your pain. As Pope Francis notes, “Believing means entrusting oneself to a merciful love that always accepts and pardons, which sustains and directs our lives, and which shows its power by its ability to make straight the crooked lines of our history. Faith consists in the willingness to let ourselves be constantly transformed and renewed by God’s call.” (29) That transformation and renewal can be painful, but it’s the path to wholeness and, ultimately, sanctity. Today, maybe more than ever, holiness is desperately needed! As Saint Catherine of Siena quipped and demonstrated by her own life, “Be who God meant you to be and you will set the world on fire.” (30)
To Parents Whose Children Are Experiencing Gender Dysphoria
It is always heart wrenching to see a child in pain. There aren’t quick fixes to gender dysphoria, but through unconditional love, patience and humility, families can navigate these tough topics.
I encourage parents to become curious and to ask gently about what their child is experiencing. The idea isn’t to interrogate but to better understand. Questions like:
In what way do you feel like [the opposite gender/both genders/neither gender]? When is the earliest/first time you remember feeling this way?
Are there situations where that desire feels stronger?
Are there situations where the pain of the struggle lessens?
How does your faith influence your thinking on this topic? Are you considering your faith in relation to this topic?
These questions can start important conversations that help children and young people better understand themselves as well as help them feel heard, known, and loved.
As young people continue to sort through feelings and experiences, the conversation can be on- going. Keeping in mind that gender does not make up the whole of anyone’s life or identity, these conversations should only be a fraction of what parents discuss. If a child doesn’t want to engage in such conversations, please respect that choice, but continue to check in and offer to listen. If a child believes a parent will listen with empathy and without judgment, he or she will be more likely to share experiences and concerns.
As I write this letter, many leaders in the United States are stridently promoting what has been dubbed “gender affirming therapy,” which seeks to bring the body into alignment with one’s felt gender rather than working to align one’s felt gender with biological reality. It is our responsibility to help children, family and friends understand that our Catholic faith (31) and scientific research (32) confirm this is not a helpful option. About a dozen studies show that for the vast majority of children, gender dysphoria resolves itself in adolescence. (33)
While some like to tout the short-term benefits of gender transition surgery, (34) the most reliable long-term study shows that those who surgically transitioned had vastly higher rates of suicide and suicide attempts than their peers. (35) A report from the Centers for Medicare and Medicaid Services under President Obama showed “there is not enough evidence to determine whether gender reassignment surgery improves health outcomes.” (36)
Others tout puberty blocking medications for adolescents as an option to “pause” their development. But in truth it is a transitioning on-ramp because more than 95 percent of children who use puberty blockers eventually transition to opposite sex hormones. (37) It also is worth noting that puberty blockers and opposite-sex hormones are experimental, with long-term effects still unknown. Studies on how they impact a child’s brain development, bone mass, and fertility are only just beginning. (38)
So how should a parent support a child through gender dysphoria? I encourage you to consider Catholic counseling (see the resources section), both for children and parents. If a Catholic counselor isn’t available, the resource section includes counselors focused on a psychotherapeutic approach to gender dysphoria. This type of counseling offers an avenue for exploring identity questions in the overall context of mental health issues, ideally within the broader context of a Christian anthropology. Counseling is important since gender dysphoria often stems from rejection, trauma, or abandonment, which must be addressed for genuine healing.
Although pronouns in keeping with a child’s God-given biological sex must be maintained, some parents have found using nicknames or terms of endearment (champ, ace, sweetheart, etc.) ease some of the relational tension when their children want opposite-sex names or pronouns. Unconditional love requires boundaries and flexibility, and compassion rooted in the truth of your child’s biological sex is a good guide as you navigate difficult terrain.
It is also important for parents to seek support and avoid isolation. Talking to a trusted friend or parish priest can be helpful in sharing your burden as is turning to Jesus through prayer and the Sacraments. Ask the Lord what healing He desires in our hearts during difficult circumstances. As Pope Francis offered for strength and consolation, “Let yourself be transformed. Let yourself be renewed by the Spirit, so that this can happen, lest you fail in your precious mission. The Lord will bring it to fulfilment despite your mistakes and missteps, provided that you do not abandon the path of love but remain ever open to his supernatural grace, which purifies and enlightens.” (39)
To All Catholics and People of Good Will
We are called to bear witness to the truth inscribed in every human body and to do so with great love. Most of us will not directly accompany someone struggling with gender dysphoria but may interact with friends or family who support “gender affirming” treatment and the transgender movement. What is our role? As Pope Francis famously said, “I see the church as a field hospital after battle. Heal the wounds, heal the wounds. And you have to start from the ground up.”(40) Confusion about the goodness of the human body, the gift of biological sex, and what it means to be male and female are foundational wounds.
Healing requires us to speak about gender and sex in logical and compassionate ways, doing our best to speak into the other’s worldview.
Love requires that we offer the truth at a time and in the manner that is appropriate to the relationship so that the truth can be received. Pope Benedict XVI put it this way: “In Christ, charity in truth becomes the Face of his Person, a vocation for us to love our brothers and sisters in the truth of his plan. Indeed, he himself is the Truth (cf. John 14:6).”(41)
Saint John Paul II noted, evangelization should be “joyful, patient, and progressive.” And as Pope Francis reminds us, “The pace of this accompaniment must be steady and reassuring, reflecting our closeness and our compassionate gaze, which also heals, liberates and encourages growth in the Christian life.” (42) So too the work of treating gender and sex confusion in our local “field hospital.”
I have encountered varying responses to our culture’s efforts to untether sex and gender. For Catholics, Jesus challenges us to “love your enemies, do good to those who hate you” (Luke 6:27). Truth without love is cruelty and though it may be instinctive to respond in kind, Jesus calls us to the harder road of blessing those who curse us. (43)
For Catholics inclined to a permissive “gender affirming” response, Pope Benedict XVI warned that “without truth, charity degenerates into sentimentality.” (44) Jesus exemplified the truth in love model when he spoke to the woman caught in adultery, “Neither do I condemn you; go, and do not sin again” (John 8:11). We must follow His lead of truth-centered compassion.
For those inclined to withdrawal, Jesus reminded us, “You are the light of the world. A city set on a hill cannot be hid. Nor do men light a lamp and put it under a bushel, but on a stand, and it gives light to all in the house” (Matthew 5:14–15). By virtue of our baptism, we have been sent on mission to evangelize the culture. (45)
Lastly, for Catholics inclined to dismissiveness, Jesus invites us, “Blessed are the peacemakers, for they shall be called sons of God” (Matthew 5:9). Scorning transgenderism misses the intense pain driving these ideas forward. Compassionate engagement fosters an openness to truth, but it requires that we seek first to understand.
Compassionate engagement is especially crucial for those of us who have or will have the opportunity to accompany someone struggling with gender dysphoria. Walking with someone who is facing pain can be healing in itself. We must always hold in view the fullness of our personhood and God-given vocation to love in truth. We all are wounded and, if we have entrusted our lives fully to Christ, we can share authentically how through struggle and pain, we can bring our wounds to Jesus, who ultimately works it all for good (cf. Rom 8:28).
A Brief Word about the Transgender Movement
Throughout human history, every generation has faced its own unique challenges with powerful forces rising to disfigure the human person and distort her relationship with God and neighbor. Vatican II’s Pastoral Constitution on the Church in the Modern World put it this way: “Although he was made by God in a state of holiness, from the very onset of his history man abused his liberty, at the urging of the Evil One. Man set himself against God and sought to attain his goal apart from God. Although they knew God, they did not glorify Him as God, but their senseless minds were darkened and they served the creature rather than the Creator.” (46)
In our present cultural moment, we are experiencing the rise of the transgender movement, which tragically attempts to promote and normalize transgenderism. Pope Francis has described gender ideology as “one of the most dangerous ideological colonizations.” (47) He asks, “Why is it dangerous? Because it blurs differences and the value of men and women.”(48)
As this letter emphasizes, this cultural and political movement is and must be distinguished from the individuals who, suffering from gender dysphoria, identify as transgendered. The promotion and societal acceptance of transgenderism as a movement is witnessed by the topic’s increasing media coverage, (49) the growing number of transgender characters in films (50) and political efforts (51) to further the ideology. As a cultural force, it has been particularly effective among young people where the number of youth identifying as transgender has doubled in the past five years. (52)
Jesus commands us to love as we have been loved (John 13:34). Each person who identifies as transgendered is loved by God and is a person Jesus Christ died to redeem. To love like Christ means to desire the good of the individuals in our lives and to walk with them, regardless of their degree of openness to the good. But what is good for human persons, and in this context, for human persons experiencing gender dysphoria? This is the foundational question, and it is where the fault lines emerge. The culturally dominant transgender movement has an understanding of nature and purpose radically at odds with the Catholic understanding of the human person.
The transgender movement is rooted in a modern form of dualism where body and soul/mind/spirit are separate realities. In this view, the human person is the immaterial inhabitant of a physical host. The material body therefore can be manipulated in service to the immaterial soul/mind/spirit. Where the transgender movement sees a disconnect between the material and immaterial, Catholics see a beautiful unity as described earlier in this letter.
Pope Francis has noted that “today children — children — are taught in school that everyone can choose his or her sex. Why are they teaching this? Because the books are provided by the people and institutions that give you money. These forms of ideological colonization are also supported by influential countries. And this is terrible!” (53) The movement is, simply put, an evil infecting our world in this time and place, and it must be rejected completely even as we love unconditionally those bound in its snares.
Before turning to Mary, our Mother, I leave you with this from Vatican II:
Though made of body and soul, man is one. Through his bodily composition he gathers to himself the elements of the material world; thus they reach their crown through him, and through him raise their voice in free praise of the Creator. For this reason man is not allowed to despise his bodily life, rather he is obliged to regard his body as good and honorable since God has created it and will raise it up on the last day. (54)
Mary, Mother of the Church
Mary’s motherhood started with Jesus but eventually extended to the whole Church. She who experienced the mystery of the Incarnation firsthand and accompanied her Son to the Cross had her share of pain and confusion. Yet she gave a full-hearted “yes” to God in all things. May we turn to her with trust, assured of her motherly care, as we end with Pope Francis’s prayer to Mary, Mother of the Church:
Mother, help our faith!
Open our ears to hear God’s word and to recognize his voice and call.
Awaken in us a desire to follow in his footsteps, to go forth from our own land and to receive his promise.
Help us to be touched by his love, that we may touch him in faith.
Help us to entrust ourselves fully to him and to believe in his love, especially at times of trial, beneath the shadow of the cross, when our faith is called to mature.
Sow in our faith the joy of the Risen One.
Remind us that those who believe are never alone.
Teach us to see all things with the eyes of Jesus, that he may be light for our path. And may this light of faith always increase in us, until the dawn of that undying day, which is Christ himself, your Son, our Lord! (55)
Most Reverend Paul S. Coakley
Archbishop of Oklahoma City
Eden Invitation – A community exploring personhood beyond the LGBT+ paradigm Courage – A ministry assisting those with same sex attraction live chaste lives
Person & Identity – Offers information, workshops, and pastoral guidance on transgender issues and the human person
Sex Change Regret – Stories and resources from those who have detransitioned
Society for Evidence Based Gender Medicine – Group of clinicians and researchers explaining the evidence for various gender dysphoria treatments
Doctrinal Note on the Moral Limits to Technological Manipulation of the Human Body – A USCCB document explaining why the Church cannot support transgender surgeries
Mental Health Professionals
Catholic Therapists – A directory of mental health professionals who are faithful to the Magisterium
Gender Exploratory Therapy Association – A secular directory of mental health professionals willing to focus on the psychological issues contributing to gender dysphoria
“Transgenderism and the Eclipse of Truth” by Archbishop Paul S. Coakley
“A Catholic Response to Gender Identity Theory” by Archbishop Alexander Sample
“A Catechesis on the Human Person and Gender Ideology” by Bishop Michael Burbidge “Gender theory”/“Gender ideology” – Quotes from Church documents on gender related topics compiled by the USCCB
“Gender Identity and Being Transgender” – Resources from Catholic ethicists by The National Center of Catholic Bioethics
Advocates Protecting Children – Videos, documentaries, podcasts, and books for parents and teachers
1 I am grateful for the wisdom and experience of the counselors, theologians and lay Catholics who shaped this pastoral letter. Their understanding and compassion with gender dysphoria are indispensable as we all discern with the Holy Spirit how best to teach, minister to and accompany those in pain.
2 John 1:1-5, 14.
3 Go Make Disciples: A Vision for the Archdiocese of Oklahoma City (2013), p. 5.
4 Go Make Disciples!: Building a Culture of Conversion and Discipleship (2019), p. 25.
5 Vatican II, Gaudium et Spes (1965), ¶ 4.
6 Transgender refers to persons who feel their gender is different from their biological sex and who typically try to bring the two into alignment through body-centered changes. Gender, according to the World Health Organization, is “the characteristics of women, men, girls and boys that are socially constructed.” See their overview: “Gender and health,” https://www.who.int/health-topics/gender#tab=tab_1, accessed February 6, 2023. Biological or genetic sex is determined by chromosomes – XX for female and XY for male. See e.g., Sadler, Langman’s Medical Embryology 10th ed. (2006) at p. 11.
7 Pope Francis: Gender ideology is ‘one of the most dangerous ideological colonizations’ today, Catholic News Service, May 11, 2023.
8 Cf. CCC 337ff; Gn 1.
9 See also Aquinas, Summa Theologica Pt. 1, Q. 76; Gaudium et Spes, supra, at ¶ 14.
10 Cf. CCC 363–64.
11 Gaudium et Spes 24.
12 Cf. Gn 1:28a: “And God blessed them, and God said to them, ‘Be fruitful and multiply, and fill the earth and subdue it.’”
13 The UN estimates .05% to 1.7% of persons are intersex, meaning their sex is not easily determinable from their sex characteristics (“Intersex Fact Sheet”, United Nations, https://www.unfe.org/wp- content/uploads/2017/05/UNFE-Intersex.pdf). These exceptions do not disprove the sex binary but are instead anomalous expressions of it. There are only two kinds of sex cells (sperm and eggs), and therefore only two sexes. In the rare cases where a person’s sex appears ambiguous, science can be of great help in understanding and aiding the sexed body. The difficulties inherent in these situations in no way detract from the truth that all such persons are made in God’s image and likeness and deeply loved.
14 Cf. Lk 24:36–43; Acts 10:41; CCC 999ff.
15 Cf. Mt 19:3–8.
16 John Paul II, Man and Woman He Created Them: A Theology of the Body, Trans. Michael Waldstein (Boston: Pauline Books & Media, 2006), 8:1 (p. 157).
17 Theologians refer to this as the commensuration of souls to bodies. Cf. Thomas Aquinas, Summa contra Gentiles II, ch. 81, para 8.
18 Pope Francis, Post-Synodal Apostolic Exhortation, Amoris Laetitia, March 19, 2016, https://www.vatican.va/content/dam/francesco/pdf/apost_exhortations/documents/papa- francesco_esortazione-ap_20160319_amoris-laetitia_en.pdf, no. 56.
19 For instance, a biological man will never be able to give birth nor a biological woman ever be able to inseminate. 20 St. Augustine, Confessions, 1.1.1.
21 Cf. CCC 397–401.
22 See “Gender Dysphoria,” Psychology Today, https://www.psychologytoday.com/us/conditions/gender- dysphoria.
23 According to the William Institute (ibid), an estimated 1.6 million children and adults identify as transgender (Ibid), which equates to less than 1% of the population. This estimate is much lower than Pew Research Center’s estimate that 1.6% of adults are transgender or nonbinary, which doesn’t include children (Anna Brown, “About 5% of young adults in the U.S. say their gender is different from their sex assigned at birth,” Pew Research Center, June 7, 2022, https://www.pewresearch.org/fact-tank/2022/06/07/about-5-of-young-adults-in-the-u-s-say-their- gender-is-different-from-their-sex-assigned-at-birth/). Neither of these estimates captures those who struggle with gender dysphoria but do not identity as transgender or nonbinary.
24 “The Report of the 2015 U.S. Transgender Survey: Executive Summary,” December 2016, https://transequality.org/sites/default/files/docs/usts/USTS-Executive-Summary-Dec17.pdf, p3.
26 “The Report of the 2015 U.S. Transgender Survey,” December 2016, https://transequality.org/sites/default/files/docs/usts/USTS-Full-Report-Dec17.pdf, p201.
27 Cf. María Paz-Otero et al “A 2020 Review of Mental Health Comorbidity in Gender Dysphoric and Gender Non- Conforming People,” Journal of Psychiatry Treatment and Research, vol. 3, is. 1, https://scholars.direct/Articles/psychiatry/jptr-3-007.php?jid=psychiatry .
28 Pope Benedict XVI, Encyclical Letter, Spe Salvi, November 30, 2007, ¶ 37.
29 Pope Francis, Encyclical Letter, Lumen Fidei, June 29, 2013, ¶ 13.
30 This is a paraphrase, and not her original quote. Cf. Oxford Essential Quotations, “St. Catherine of Siena,” https://www.oxfordreference.com/display/10.1093/acref/9780191843730.001.0001/q-oro-ed5- 00016659;jsessionid=65455431C4C3536439CF7EEE5A8C88C5.
31 Cf. Committee on Doctrine of the United States Conference of Catholic Bishops, “Doctrinal Note on the Moral Limits to Technological Manipulation of the Human Body,” March 20, 2023, https://www.usccb.org/resources/Doctrinal%20Note%202023-03-20_0.pdf.
32 For an excellent literature review, see Paul Dirk’s “Transition as Treatment: The Best Studies Show the Worst Outcomes,” Public Discourse, February 16, 2020, https://www.thepublicdiscourse.com/2020/02/60143/. Because of serious questions about the psychological benefits of the “gender affirming” approach, some European countries, coming at this from a purely secular vantage point, have pulled back on social and medical transitioning for minors. See Sweden Pulls Way Back from Gender-Affirming Care for Children, National Review, Dec. 27, 2022; U.K. Transgender Clinic to Close after Damning Report: ‘Not Safe’ for Children, National Review, July 28, 2022.
33 The World Professional Association for Transgender Health’s found gender dysphoria remitted for 73-94% of adolescents. Cf. “Standards of Care for the Health of Transsexual, Transgender, and Gender-Nonconforming
Pastoral Letter: On the Unity of the Body and Soul Archbishop Paul S. Coakley
April 30, 2023
People,” in International Journal of Transgenderism https://www.tandfonline.com/doi/abs/10.1080/15532739.2011.700873. For a summary of additional studies, see Sexual Identity, ed. John Desilva Finley (Steubenville, Ohio: Emmaus Road Publishing, 2022), pp.196–97. More research needs to be done on gender dysphoria that develops in adolescence, a phenomenon that has become increasingly common in recent years.
34 For instance, Dan Avery, “Gender-affirming surgery linked to better mental health, study finds,” NBC News, May 1, 2021, https://www.nbcnews.com/feature/nbc-out/gender-affirming-surgery-linked-better-mental-health-study- finds-n1266033.
35 Suicide was 19 times more likely and suicide attempts were 5 times more likely. Cf. Cecilia Dhejne et al “Long- Term Follow-Up of Transsexual Persons Undergoing Sex Reassignment Surgery: Cohort Study in Sweden,” PLoS One, February 22, 2011, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3043071/.
36 Cf. “Gender Dysphoria and Gender Reassignment Surgery,” June 2, 2016, https://www.cms.gov/medicare- coverage-database/view/ncacal-decision-memo.aspx?proposed=Y&NCAId=282.
37 97% transitioned to hormones in the study by Polly Carmichael et al “Short-term outcomes of pubertal suppression in a selected cohort of 12 to 15 year old young people with persistent gender dysphoria in the UK,” PLoS One, February 2, 2021, https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0243894 and 98% transitioned in the study by Chantal Wiepjes et al “The Amsterdam Cohort of Gender Dysphoria Study (1972-2015): Trends in Prevalence, Treatment, and Regrets,” Journal of Sexual Medicine, April 15, 2018, https://pubmed.ncbi.nlm.nih.gov/29463477/.
38 Cf. Henk Asscheman et al “A long-term follow-up study of mortality in transsexuals receiving treatment with cross-sex hormones,” European Journal of Endocrinology, April 2011, https://pubmed.ncbi.nlm.nih.gov/21266549/. 39 Gaudete et Exsultate, ¶24.
40 Fr. Antonio Spadaro, S.J. “Interview with Pope Francis,” https://www.vatican.va/content/francesco/en/speeches/2013/september/documents/papa- francesco_20130921_intervista-spadaro.html.
41 Pope Benedict, Encyclical Letter, Caritas in Veritate, June 29, 2009, ¶ 1.
42 Pope Francis, Encyclical Letter, Evangelii Gaudium, November 24, 2013, ¶ 169.
43 Cf. Lk 6:28.
44 Pope Benedict XVI, Encyclical Letter, Caritas in Veritate, June 29, 2009, ¶ 3.
45 Cf. CCC 1270. See also Go Make Disciples: A Vision for the Archdiocese of Oklahoma City (2013); Go Make Disciples!: Building a Culture of Conversion and Discipleship (2019).
46 Gaudium et Spes, supra, ¶ 13.
47 Pope Francis: Gender ideology is ‘one of the most dangerous ideological colonizations’ today, Catholic News Service, May 11, 2023.
49 Vikki Julian, “New research on reporting of trans issues shows 400% increase in coverage and varying perceptions on broader editorial standards,” IPSO, December 2, 2020, https://www.ipso.co.uk/news-press- releases/press-releases/new-research-on-reporting-of-trans-issues-shows-400-increase-in-coverage-and-varying- perceptions-on-broader-editorial-standards/.
50 “List of feature films with transgender characters,” Wikipedia, January 17, 2023, https://en.wikipedia.org/wiki/List_of_feature_films_with_transgender_characters.
51 For instance, White House Fact Sheet, “Biden-Harris Administration Advances Equality and Visibility for Transgender Americans,” March 31, 2022, https://www.whitehouse.gov/briefing-room/statements- releases/2022/03/31/fact-sheet-biden-harris-administration-advances-equality-and-visibility-for-transgender- americans/.
52 “How Many Adults and Youth Identify as Transgender in the United States?” Williams Institute, June 2022, https://williamsinstitute.law.ucla.edu/publications/trans-adults-united-states/. The number of adults identifying as
Pastoral Letter: On the Unity of the Body and Soul Archbishop Paul S. Coakley
April 30, 2023
transgender has remained constant in this same period. Compared to its January 2017 report, “Age of Individuals Who Identify as Transgender in the United States,” https://williamsinstitute.law.ucla.edu/wp- content/uploads/Age-Trans-Individuals-Jan-2017.pdf .
53 Pope Francis: Gender ideology is ‘one of the most dangerous ideological colonizations’ today, Catholic News Service, March 11, 2023. Pope Francis: Gender ideology is ‘one of the most dangerous ideological colonizations’ today, Catholic News Service, March 11, 2023.
54 Gaudium et Spes, supra, ¶ 14. 55 Lumen Fidei, ¶60.