The U.S. Conference of Catholic Bishops voted Friday to develop for the first time directives to Catholic hospitals outlining the Church’s position on sex-change surgeries and hormone treatments.

At their annual meeting, the Doctrine Committee voted unanimously to create a revision to the Ethical and Religious Directives, which are binding for healthcare workers at Catholic institutions. A proposal will be drafted and will build upon previous work, such as a doctrinal note released in March entitled “On the Moral Limits to Technological Manipulation of the Human Body.”

According the doctrinal note, interventions to treat gender dysphoria or gender incongruence “are not morally justified either as attempts to repair a defect in the body or as attempts to sacrifice a part of the body for the sake of the whole.”

“Such interventions, thus, 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 note reads. “Catholic health care services must not perform interventions, whether surgical or chemical, that aim transform the sexual characteristics of a human body into those of the opposite sex or take part in the development of such procedures.”

The section which is to be changed, dealing with patient relations, has not been altered since 1994. Doctors and other medical professionals in Catholic hospitals, while they haven’t been operating under directives, have pursued a generally cautious approach. Catholic institutions oversee about 1 in 7 hospitals beds in the U.S.

Surgeries that could affect a person’s fertility are not offered, while appearance-altering surgeries are generally unavailable.

However, it is common for Catholic medical professionals to continue existing hormone treatment and oversee it, the Washington Post reported.

Once the committee comes up with a draft, it will be subject to review and a vote by all the bishops.