Pope Francis, who has been suffering from flu, asked an aide to read out his prepared speech at a conference in the Vatican on Friday, saying he has not yet fully recovered from his latest ailment.
It has raised concerns about his capacity to continue leading the Roman Catholic Church.
The 87-year-old pontiff, who was taken to a Roman hospital on Wednesday for diagnostic testing after having to cancel some public audiences, handed his speech to his aide, Monsignor Filippo Ciampanelli.
“I still have a cold and I get fatigued after reading for a while,” he said.
Francis, who has been hospitalised three times since becoming Pope in 2013, began using a wheelchair and cane to walk last year.
Speaking off the cuff at the opening of the two-day conference, entitled Man-Woman Image of God – For an Anthropology of Vocations, he blasted what he called “gender ideology” as the “ugliest danger”.
“It is very important that this meeting is taking place, this encounter between men and women,” he told the audience.
“Because the ugliest danger today is the gender ideology … I have asked for studies to be done on this ugly ideology of our time, which cancels out differences and makes everything the same. To cancel difference is to cancel humanity,” he said.
The pontiff had cancelled appointments last Saturday and Monday due to a persistent, but “mild flu” but appeared as usual for the Sunday blessing from a window overlooking St Peter’s Square.
Last week, Francis coughed repeatedly as he presided over Ash Wednesday services at a Roman church, and opted not to participate in the traditional procession that inaugurates the church’s Lenten season.
Over the past few months, Francis had to cancel a few activities and one international trip due to his fragile health, which has recently raised worries over his capacity to continue to lead the Catholic Church.
The Argentine pope had part of one lung removed as a young man because of a respiratory infection, and in 2021 had a chunk of his colon removed because of an intestinal inflammation.
He has been using a wheelchair and cane since last year because of strained knee ligaments and a small knee fracture that have made walking and standing difficult.