Pope Francis’s remarks today opposing “the biologic and psychological manipulation of sexual difference” show that he doesn’t understand the situation of transgender people, say LGBT Catholic groups.

The pope made the comments while addressing the Pontifical Academy for Life’s general assembly in Rome. “The biological and psychical manipulation of sexual difference, which biomedical technology allows us to perceive as completely available to free choice — which it is not! — thus risks dismantling the source of energy that nurtures the alliance between man and woman and which renders it creative and fruitful,” he told members of the academy, which was created by Pope John Paul II in 1994 to deal with bioethical concerns.

“By referring to transgender people’s desires to transition as ‘manipulation’ and a ‘free choice’ Pope Francis shows that he does not understand that for transgender people, a transition is a discovery and affirmation of who God created them to be,” said a statement issued by Francis DeBernardo, executive director of New Ways Ministry, which works for LGBT equality within Catholicism. “Gender is more than a biological reality. It also includes psychological, emotional, cultural, and spiritual dimensions. When some people seek surgery to confirm their gender identity, they are celebrating their God-given identities. A decision to transition is often made after many years of confusion and turmoil, as well as many forms of discernment with medical, psychological, and spiritual authorities.”

DignityUSA, another LGBT Catholic group, released a similar statement, saying in a press release, “Pope Francis’s statement denouncing technologies that support gender confirmation demonstrates the pontiff’s tragic ignorance on the challenges faced by transgender people, and puts this population at risk of increased discrimination and violence.”

In the release, DignityUSA executive director Marianne Duddy-Burke added, “The reality is that transgender people experience tremendous stress in trying to live as who the world believes them to be. It takes incredible strength and commitment for them to risk living as who they are. Not all transgender people can or want to access technological supports that confirm their true genders. Throughout history, we have seen our transgender neighbors use whatever tools are available to live in their truth. Technology that makes this easier should be embraced as a blessing.” She noted that Francis’s words affect trans people’s lives in many ways. “Here in the U.S., where one in six hospital beds is in a Catholic hospital, it is difficult for transgender people in some areas to get the respectful, informed, appropriate care that they need,” she said.

Far from denying the significance of gender, DeBernardo said, “Transgender people actually acknowledge the importance of gender since they recognize how important it is for them to live as their authentic gender, not by the gender assigned to them at birth which was based on the minimal evidence of external genitalia. … Their quest for authenticity is a quest for holiness. They seek to ‘honor the care’ of the identity and life that they have been given. To say that transgender people are acting against the plan of God is actually itself a rejection of God’s plan for these sacred human beings.”

This is a case where Pope Francis’s words conflict with some of his actions. In 2015 he met with a Spanish transgender man who had been rejected by his Catholic parish, and the Spaniard, Diego Neria Lejárraga, later said he found the pope to be “kindness personified.” However, Francis has similarly denounced the concept of gender transition on other occasions, and during his papacy the Vatican has ruled that trans people cannot be godparents.

“We strongly urge Pope Francis to take time to meet with more transgender people and their families, and to listen to their stories of hope and struggle,” Duddy-Burke continued. “Our church must start from the needs of the people, not from some dogma that more and more is discredited by science and the experience of millions of people. And the church must immediately end its persecution of sexual minorities in direct contrast to the open fellowship and embracing love Jesus himself would have shown.”

In today’s address, the pope also dealt with gender roles, saying, “The forms of subordination that have sadly marked the history of women must be definitively abandoned,” but without “radically neutralizing sexual difference.” Among the differences in the Catholic Church’s treatment of men and women: Women are barred from being members of the clergy.