DULUTH — A Catholic group for students at the University of Minnesota Medical School in Duluth that opposes gender-affirming care is fracturing the small, rural-focused program.

The student section of the Catholic Medical Association, which also includes students enrolled in the U's Duluth campus College of Pharmacy, formed in 2021. It aligns with Catholic beliefs that largely oppose gender-affirming care for minors, which includes medications to suppress puberty and hormones for older teens, as well as contraception and abortion, according to its website.

"My days were filled with so many lectures and guidelines that I knew were not right or ordered at all and they were most definitely against our beliefs as Catholics," wrote Emma Pero, the first president of the group, in an essay on the site.

The Duluth campus of the U's medical program, where most students stay for two years before moving on to the Twin Cities or a rural town for training, focuses on family medicine in rural areas and Native American communities. The rural focus has some fellow students worrying how those beliefs will affect future patient care, particularly where gender care is involved.

"My biggest concern is many of these students will be working in rural areas, and there's already a lack of access to that type of care," said third-year medical student Morgan Johnson. "These patients will be at a higher risk than they already were."

And this is in a city that bans conversion therapy, she said, and in a state with a "shield law" that says it won't support any state's prosecution of parents or doctors providing gender-affirming care for children.

Conversion therapy is the practice of attempting to change a non-heterosexual person's sexual orientation or gender identity to align with heterosexual or cisgender norms.

Messages to Pero and several past and present members of the group — which received $180 each of the past two years from the U of M's Medical Student Council, funded by the university — weren't returned.

Interim Regional Campus Dean Kevin Diebel said he wasn't aware of complaints made to faculty about the group and hadn't received any himself.

The school teaches its students to care for patients of all backgrounds, he said, and its approach to controversial topics is to teach them to transfer patients to another provider if they must, but to always ensure the patient receives care.

"Our hope is that message gets carried on and that students take that to heart and put it into practice," Diebel said.

To second-year medical student Jamey Sharp, it appears the group is "working against best practices" that students are taught regarding LGBTQ care, and it makes class uncomfortable, he said.

"It's really important for trans folks, queer folks, women, to feel comfortable working in this field and feeling like they would be safe and free of discrimination throughout the educational process," he said.

But the content of the group's website, tense class discussions and the very existence of the group "makes it hard to coexist with them and trust them as colleagues and fellow professionals," Sharp said. "I am Jewish, but my religion will never affect my practice and make it so someone gets different treatment than someone else because of their identity."

The student group is linked to the St. Raphael's Guild, the Duluth chapter of the national Catholic Medical Association, whose members include area medical providers. Two of its leaders, Dr. Dan Skorich, who is retired, and Dr. Gordon Harvieux, of Essentia Health, declined to be interviewed.

In 2022, members of the student group gathered in a conference room to watch a virtual lecture held by the guild. It featured Dr. Quentin Van Meter, a controversial Atlanta-based pediatric endocrinologist who in 2020 was discredited by a Texas court as an expert on puberty blockers and gender-affirming care.

He is the former president of the American College of Pediatricians, a group declared to be a hate organization by the civil rights nonprofit Southern Poverty Law Center.

During the lecture, he called the Southern Poverty Law Center a hate group and told the room full of students that professional medical societies, most of which support gender care, don't represent science.

He argued against using preferred pronouns with patients.

"This is just acquiescing to nonsense and pathology and plays into their delusional thoughts," he said in a recording of the lecture.

He advised avoiding referring minors to transgender care centers, calling them a "conveyor belt to hell." Affirming a child's chosen gender can worsen mental health, he told the students, who should refer minors instead to mental health providers.

The Duluth students applauded at the end.

Van Meter did not return messages for this story.

Physicians shouldn't be forced to do something they find morally objectionable, except in emergency situations or when no viable alternatives exist, said Joel Wu, a clinical ethics assistant professor in the University of Minnesota's Center for Bioethics.

"That doesn't include allowing clinicians who have a particular kind of influence and power by virtue of their license to be able to delegitimize the interests of other people in the community, particularly when they are patients," he said. Everyone in our society should have equal claim to appropriate medical care regardless of their personal identities or characteristics, he added.

Gender care beliefs across Catholicism are diverse, said Jaime Konerman-Sease, also a clinical ethics assistant professor for the bioethics center and an expert in religious bioethics.

Some Catholics in the medical field believe providing gender care is a form of harm reduction, because suicide rates are high for people with gender dysphoria, she said.

An estimated 40% of transgender people have attempted suicide, with the highest number coming from children.

"If we are able to provide medical care for these individuals, we can prevent greater harm," Konerman-Sease said of the argument.

Others take a more conservative, ideological view, she said.

A paper issued this month by the national Catholic Medical Association, "The Ideology of Gender Harms Children," calls on medical organizations that offer gender-affirming care to minors to stop.

"These organizations should consider the profoundly harmful long-term physical and psychological damage that awaits these children as they grow into adulthood," it reads.

Sharp said seeing children for who they are will do more to prevent harm, because they will continue to seek care.

"If you are denied care because your doctor doesn't see you for who you are, there is zero chance you will have a meaningful, trusting relationship with them," he said. "The people of Minnesota know that LGBTQ patients deserve the cutting edge gender-affirming care that we are taught in medical school."