The Roman Catholic bishop of Springfield, Ill., who famously held an exorcism in response to marriage equality, has now gone after transgender people.

Bishop Thomas Paprocki’s pastoral guide to gender identity, finalized in January but just now being widely circulated, calls for students in Catholic schools as well as adult church employees and volunteers to be referred to according to the sex and name assigned them at birth, and to “conduct themselves in accord to their biological sex at all times.” The penalty for violation is expulsion or firing.

The guide is in line with official church teaching that gender is fixed at birth and immutable, and is determined exclusively by genitalia. But while some individual Catholic clergy members have taken a conciliatory approach to trans people, the guide’s language is harsh.

“Gender dysphoria can be reasonably compared to anorexia,” one section reads. “Each is a condition in which a person, for a complex set of reasons, has a self-perception of his or her physical biology that is dislocated from reality. Just as it would be pastorally reckless to provide weight-loss resources to a visibly gaunt anorexic who thinks she is overweight, it is equally reckless to encourage someone with gender dysphoria to undergo hormone treatment and/or genital mutilation.”

The document says that sexual identity is “God-given” and that gender cannot be changed. “We should accept and care for our bodies as they were created,” it says, although granting that “appropriate medical care” may be acceptable for people who are intersex (although, in fact, not all intersex people desire medical intervention).

The guide goes on to say that everyone should use restrooms and locker rooms designated for their birth sex when on church property, and that students who participate in sports must be assigned to teams according to their “biological sex.”

It notes that Pope Francis has spoken out against gender transition. (Also, however, he once met with a transgender man from Spain who later said he found Francis to be “kindness personified.”)

Catholic LGBTQ groups were outraged by the Springfield diocese’s guide. “The approaches prescribed in this document are of deep concern,” said Marianne Duddy-Burke, executive director of DignityUSA, in a press release. “The guidance this document gives to schools and other Catholic organizations on dealing with transgender and nonbinary people and families could cause real harm. It denies the truth of their realities and says parents who help their transgender kids get the kinds of services they need are subjecting them to ‘child abuse and genital mutilation.’ Once again, Bishop Paprocki is displaying a dangerous and willful ignorance of current medical and mental health standards.”

She also noted the high rate of suicide attempts among trans people due to societal rejection, and that many leave their faith communities because of rejection there.

Linda Roberts, a transgender woman who heads DignityUSA’s Transgender Support Caucus, added, “The demands that students be called by names and pronouns consistent with the sex assigned at birth, that they be denied use of restroom and locker facilities consistent with who they know themselves to be, and that they play sports based on the gender assigned at birth add tremendous burdens to children who have probably struggled for years to accept the truth of their identity. This policy will add to their sense of exclusion and shame and will make it more difficult for families to do the right thing for their transgender and nonbinary children.”

DignityUSA has started a petition against the guide. “We ask Bishop Paprocki to immediately withdraw this policy, and to enter into real dialogue with transgender people, families, and their medical and mental health care providers,” it states.

Robert Shine of New Ways Ministry likewise condemned the document. “Threatening to fire an employee or expel a student who may already be marginalized is in no way consistent with church teaching,” he wrote on the group’s website. “Bishop Paprocki’s nearly unparalleled crusade against LGBTQ people is shameful. His dangerous wielding of authority harms many people not only in his diocese, but in the wider church.”

Paprocki’s previous anti-LGBTQ actions have included holding an exorcism “for the sin of same-sex marriage” in 2013 when the governor of Illinois signed a marriage equality bill into law; saying that Satan is behind the marriage equality movement; and ordering the priests in his diocese to deny communion or church burials to people in same-sex marriages unless they have repented of the “sin” of being gay. He recently objected to a new Illinois law mandating that public schools teach about the contributions of LGBTQ people (it doesn’t affect Catholic or other private schools), saying they should not be considered “role models to be emulated.”