A new Vatican document released April 8 details how the Catholic Church approaches human dignity, but it has raised concern among LGBTQ parishioners and their allies about how it describes gender-affirming surgery.

The document, entitled “Dignitas Infinita” (“Infinite Dignity”), was five years in the making and lays out the ways the Vatican believes the inherent dignity that each person possesses can be honored and protected. Though largely in line with positions the Catholic Church has expressed in the past, it’s notable for elevating some of the church’s most conservative views into doctrine — essentially, official church teachings — during a period in which the current pope has been seen as trying to steer the organization in a more progressive, inclusive direction.

Broadly, the document highlights “grave violations” of human dignity, including war, poverty, mistreatment of migrants, and abuse of women. It also lists other perceived threats, including abortion and what the Vatican describes as “gender theory” and “sex change.” In these provisions, the document criticizes gender-affirming procedures and stresses that the Vatican views gender as a clear binary between men and women.

“While Pope Francis has made greater strides in affirming LGBTQ+ Catholics than any of his predecessors, his endorsement of ‘Dignitas Infinita’ will be seen as turning the clock back by transgender individuals, both within and outside the church,” R. Andrew Chesnut, the Bishop Sullivan Chair in Catholic Studies at Virginia Commonwealth University, told Vox.

The release of “Dignitas Infinita” comes amid a larger political, cultural, and social discourse about trans rights and medical care, including a recent UK report on the subject. LGBTQ Catholics and advocates fear, too, that it will worsen a climate in which some governments have enacted laws that attack trans people — including numerous GOP bans on gender-affirming care for children in the US — and be used to fuel more discrimination.

“The document should not be dismissed as simply an abstract theological conversation with few human consequences,” Francis DeBernardo, the executive director of New Way Ministries, an LGBTQ Catholic group, said in a statement. “Rather, the Vatican is again supporting and propagating ideas that lead to real physical harm to transgender, nonbinary, and other LGBTQ+ people.”

The Vatican document challenges attempts at inclusion

Under Pope Francis, the Vatican has sought to lead a more inclusive Catholic Church, including approving blessings for same-sex couples and allowing women to vote in a major bishops’ meeting for the first time.

Francis has also personally made overtures to the trans community, approving the baptizing of trans parishioners and welcoming a group of trans women to a weekly gathering. However, as “Dignitas Infinita” exemplifies, such progress toward inclusivity has been halting, with the church still declining to permit marriage for same-sex couples and barring women from becoming priests.

The document’s treatment of trans people continues this pattern by emphasizing the need to acknowledge every person’s human dignity while offering “limited dignity” to trans people, DeBernardo said.

In particular, it argues that gender-affirming procedures threaten the dignity that a person is born with at conception, claiming that such medical care interferes with “the need to respect the natural order of the human person.” The document also broadly denounces “gender theory,” which includes “argu[ing] that a person’s gender can be different from the sex that person was assigned at birth,” NPR’s Jason DeRose explains.

“​​That ‘Dignitas Infinita’ rebukes gender transition interventions as a rejection of God’s plan of human life implies that those individuals who have elected to transition … have violated divine will,” said Chesnut.

Jason Steidl, a professor of religious studies at St. Johns University who specializes in Catholicism, put it more bluntly. “This is the Newsmax version of Catholic theology,” he said.

The Vatican’s statements have been widely lambasted by trans members of the Catholic Church who view them as undermining their experiences and their place in the church. “Transgender people are beloved, intentional creations of God the same as cisgender men and women are,” Michael Sennett, a trans man and practicing Catholic in Massachusetts, told the Associated Press.

Steidl and others, however, see the doctrine as satisfying a more conservative arm of the Catholic Church.

The pope’s announcement in late 2023, for example, that the Vatican would support priests blessing same-sex couples in certain contexts drew ire from numerous clergymen globally. Those opposed to Francis’s more progressive actions included some in Africa, one of the places where the Catholic Church has seen high growth in recent years, who called it “contrary to the will of God.”

According to Steidl, who is also the author of LGBTQ Catholic Ministry, the provisions going after trans people in the Vatican’s document were likely an attempt to appease this segment of the church. “Cardinal Fernandez, the head of the Dicastery for the Doctrine of Faith, had essentially said that they were going to be throwing traditionalists a bone,” Steidl told Vox.

The church doctrine adds to policies attacking trans people

LGBTQ advocates worry the Vatican’s document will only be further ammunition for conservatives in the political and social spheres as they advance discriminatory policies, particularly as political attacks on trans people have surged in recent years.

At least 19 GOP-led state legislatures in the US have passed laws either restricting or outright banning access to gender-affirming care, even though major physician organizations have deemed such care medically necessary. As the number of anti-trans laws has spiked, a report from the National Center for Transgender Equality has documented an increase in homicides of transgender people in the US between November 2022 and November 2023.

European countries are also taking a more restrictive approach to health care for trans people — particularly for minors. Recently, a report commissioned by the United Kingdom’s National Health Service questioned current transition practices in pediatrics and reiterated recommendations to reduce the use of puberty blockers, a treatment the NHS has already stopped offering for minors with gender dysphoria.

LGBTQ advocates are concerned that the Vatican’s document will just add to rhetoric globally that has sought to curtail trans rights.

“This document … tells trans people that they are a threat to the world, that they are a threat to order, to the systems that God has set up,” Steidl told Vox. “Unfortunately, the Vatican is contributing to these movements that seek to hurt trans people, that seek to eliminate them.”