BALTIMORE -- The nation's Catholic bishops adopted guidelines saying that those who minister to gay people should help them live chastely -- a document criticized by many gay Catholics but also by a group of conservative bishops who thought it should also exhort gay people to try to change their sexual orientation.

On another sexual issue, the bishops voted 220-11 without debate to approve a brochure for engaged couples that explains church teaching against artificial contraception and urges them to use natural family planning based on the woman's fertility cycle. But contraception figured heavily into a debate over a document on reception of communion, with the bishops rejecting an effort to name contraception as a reason to refrain from receiving communion.

That three difficult and intertwining documents on gay sex, contraception and communion were on the docket together was coincidence, but Archbishop George Niederauer of San Francisco called it a reminder that the Catholic faith is challenging.

The document about ministry to gay people passed 194-37, after lengthy debate about its terminology, purpose and pastoral advice.

"Ministry to Persons with a Homosexual Orientation: Guidelines for Pastoral Care" says that the inclination is not wrong but that acting on it is. It condemns bigotry against gay people -- while arguing that not permitting gay people to marry is not bigotry because marriage is intrinsically heterosexual. None of the teaching is new, but there is an attempt to explain it in more clear, positive language than some documents of the past.

Dignity USA, a group for gay Catholics that dissents from church teaching, called it "deeply flawed" and had asked the bishops to delay it to consult with gay Catholics. However, it was a group of very conservative bishops who tried to postpone the document for more consultation, because they wanted an endorsement of psychotherapy to change sexual orientation.

An earlier draft had said that there was "no moral obligation" for gay people to undergo therapy. The final draft eliminated that sentence, but did not endorse such therapy, saying there was no consensus on it.

The document on reception of communion grew out of disputes in 2004 about whether politicians who support abortion rights should be refused communion.

Some bishops thought both topics should have been included, and also wanted to add contraceptive use to a list of reasons that Catholics should refrain from communion. An earlier report indicated that only 4 percent of Catholic married couples of child-bearing age practice the church-recommended natural family planing.

Bishop Arthur Serratelli of Paterson, N.J., said that the drafters did not include contraception because it was not intended to be a comprehensive list of sins and there was a concern that this "particularly difficult pastoral problem" would distract from everything else in the document. Bishop Salvatore Cordileone, auxiliary of San Diego, argued that not mentioning it would draw even more attention.

"If we are silent on this issue, perhaps people won't go so far as to say we are winking at it, but at least we would easily create the misperception that this is not an issue involving grave matter." "Grave matter," along with informed reflection and willful intent, constitutes mortal sin.

The move to name contraception as a reason to refrain from communion failed 148-75.

An attempt failed to single out politicians among those who should refrain from communion if they "knowingly and obstinately" reject and repudiate the key church teaching.

Bishop Lawrence Brandt of Greensburg said he hoped the document will help resolve less contentious but deeply troubling issues, such as Catholics who regularly skip Mass. "Sunday Mass is our spiritual food. You wouldn't think of going without food for two weeks, yet we starve our souls if we don't go to Mass every week," he said.