(RNS) — A group of U.S. Catholic bishops has issued a statement discouraging Catholic health care groups from performing various gender-affirming medical procedures, suggesting they are “injurious” and do not respect the “intrinsic unity of body and soul.”

The 13-page document, officially known as a “doctrinal note,” was produced by the U.S. Conference of Catholic Bishops’ Committee on Doctrine on Monday (March 20) and focused on “the Moral Limits to Technological Manipulation of the Human Body.” In the document, the committee’s bishops argue that medical technology can and should be used to “repair a defect in the body” or “sacrifice part of the body … for the welfare of the whole body.”

But bishops said procedures that fall under the category of gender-affirming care, often sought out by transgender adults and adolescents, are “not morally justified.”

“Such interventions … do not respect the fundamental order of the human person as an intrinsic unity of body and soul, with a body that is sexually differentiated,” the document reads. “Catholic health care services 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.”

The bishops cite Pope Francis, who has repeatedly met with transgender people throughout his papacy but has also decried gender theory as “ideological colonization” and made no moves to alter existing church teaching regarding sexuality.

The members of the USCCB Committee on Doctrine, all of whom signed the document, are Bishop Daniel Flores of the Diocese of Brownsville, Texas; Bishop Michael Barber of the Diocese of Oakland, California; Coadjutor Bishop Richard Henning of the Diocese of Providence, Rhode Island; Bishop Steven Lopes of the Personal Ordinariate of the Chair of St. Peter; Bishop James Massa of the Diocese of Brooklyn, New York; Bishop Robert McManus of the Diocese of Worcester, Massachusetts; Bishop Michael Olson of the Diocese of Fort Worth, Texas; Bishop Kevin Rhoades of the Diocese of Fort Wayne-South Bend, Indiana; and Archbishop William Lori of the Archdiocese of Baltimore.

Francis DeBernardo, executive director of New Ways Ministry, a Catholic LGBTQ outreach organization, criticized the document on Tuesday in a statement, arguing that the Catholic prelates do not account for the experience of transgender people, nor engage with experts who say gender-affirming care betters the lives of transgender people.

“The bishops’ unwillingness to counter any of the evidence from the scientific community or the experience of transgender people is neither good theology nor acceptable pastoral care,” read DeBernardo’s statement.

DeBernardo cited the risk of suicide among transgender youth, which experts have long noted is significantly higher than in the rest of the population.

“When transgender people are denied appropriate medical care, many see their only alternative as suicide instead of living a painfully inauthentic life,” DeBernardo said, adding later in the statement: “Catholics who support transgender and nonbinary people’s access to medically-necessary gender transition care do so because they want to promote human flourishing and to help their transgender loved ones achieve integration.”

The group Catholics for Choice, which advocates for abortion access, also decried the document, calling it “outrageously transphobic.”

“The USCCB’s so-called ‘moral criteria’ directing Catholic hospitals to refuse to provide transgender patients with gender-affirming healthcare is anything but moral — it is an attack on basic human rights, an affront to Catholic social justice values, and with 1 in 6 U.S. hospital beds housed in Catholic hospitals, a very real threat to the lives, health, and well-being of transgender, non-binary, and gender-expansive patients,” Catholics for Choice President Jamie Manson said in a statement.

The doctrinal note comes amid rising political division over gender-affirming care across the U.S. Earlier this month, West Virginia’s Legislature passed a ban on gender-affirming care for transgender youth, and the Kentucky Legislature took similar action a few days later. Georgia Republican Rep. Marjorie Taylor Greene has promised to introduce a similar bill in the U.S. House of Representatives this term.

In Missouri and elsewhere, efforts to limit or ban gender-affirming care have received pushback led by both secular and faith-based advocates.