 In most circumstances, they cannot receive the anointing of the sick, which is meant to provide physical or spiritual healing to those who are seriously ill. The guidance was issued in July, but only recently sparked a debate after a prominent priest and advocate for LGBTQ Catholics shared it on Twitter. The document says the experience of incongruence in one's sexual identity is not sinful if it does not arise from the person's free will, nor would it stand in the way of Christian initiation. However, deliberate, freely chosen and manifest behaviors to redefine one's sex do constitute such an obstacle.