The Vatican on Monday published a document setting out "grave violations of human dignity", listing abortion, surrogacy, and gender theory alongside discrimination against migrants and LGBTQ people.

The 20-page document, endorsed by Pope Francis, is the culmination of five years of work but comes amid splits in the Catholic Church over many social issues, most recently the blessing of gay couples.

Entitled "Dignitas infinita" (Infinite dignity) and published by the Vatican's powerful department of doctrine, the document covers the key themes of the Argentine's 11-year papacy, from war to ecology and social justice.

It reaffirms the church's long-held opposition to abortion, euthanasia, and surrogacy, but now puts them alongside issues such as poverty, conflict, sexual abuse, marginalization of migrants, and human trafficking as "grave violations of human dignity".

"The new text thus contributes to overcoming the dichotomy that exists between those who focus exclusively on beginning-and-end-of-life issues, while forgetting so many other attacks against human dignity," wrote Andrea Tornielli, editorial director of the Vatican's communication department, in a commentary.

It also speaks to those who "conversely... focus only on defending the poor and migrants while forgetting that life must be defended from conception to its natural conclusion".

 'Unfair laws' 

The document reasserts the Vatican's opposition to the criminalization of homosexuality, which still exists in many countries, particularly in Africa.

"It should be denounced as contrary to human dignity the fact that, in some places, not a few people are imprisoned, tortured, and even deprived of the good of life solely because of their sexual orientation," it said.

"We do not talk much about this violation of human rights ... and it is painful that some Catholics defend these unfair laws," Victor Manuel Fernandez, head of the dicastery, told a press conference.

But the document forcefully denounces gender theory, which is broadly the idea that you do not have to adhere to the gender you were born with and that gender is a product of societal norms, rather than purely biology.

"Any sex-change intervention, as a rule, risks threatening the unique dignity the person has received from the moment of conception," the document from the Dicastery for the Doctrine of the Faith states.

Francis, 87, has previously called gender theory "dangerous".

Some Catholic LGBTQ groups said the document did not go far enough, including Francis DeBernardo, head of the US group New Ways Ministry.

"While it lays out a wonderful rationale for why each human being, regardless of condition in life, must be respected, honored, and loved, it does not apply this principle to gender-diverse people," he said in a statement.

Since his election in 2013, Pope Francis has insisted on the importance of a church open to all, including LGBTQ believers, but he has faced strong resistance from conservative Catholics.

There was a particularly strong reaction when Pope Francis opened the door to the blessing of gay couples last year, particularly in African countries.

Asked about official church doctrine that still states same-sex acts are "intrinsically disordered", Fernandez acknowledged that there could be "other, more suitable words".

But he rejected accusations that Francis was betraying Catholic doctrine.

"Some people who years ago almost adored the pope, now say that you must listen to the pope only when he speaks ex-cathedra" when he makes an official pronouncement on dogma, he said.