When San Diego Bishop Robert McElroy received his prestigious red hat at the Vatican on Saturday, he brought to the College of Cardinals a fervent loyalty to Pope Francis that has often put him at odds with the conservative majority in the U.S. Conference of Catholic Bishops.

McElroy, 68, is the only American among the 21 clerics being installed as cardinals by Francis in a ceremony at St. Peter’s Basilica. He was chosen over numerous higher–ranking American archbishops, including two from his home state — outspoken conservative Salvatore Cordileone of San Francisco and José Gomez of Los Angeles, the president of the U.S. bishops conference.

McElroy has been among the few American bishops who questioned why the conference insists on identifying abortion as its “preeminent” priority. Echoing the pope’s concerns, he has questioned why greater prominence is not given to issues such as poverty, immigration and climate change.

“The death toll from abortion is more immediate, but the long–term death toll from unchecked climate change is larger and threatens the very future of humanity,” McElroy said in 2020.

The Rev. James Martin, editor–at–large of the Jesuit magazine America, described McElroy as “one of the foremost articulators in the United States not only of Pope Francis’ vision but also the vision of the Second Vatican Council and, more basically, the vision of the Gospel.”

“He has been the special champion of people on the margins, both in society and in the church,” Martin said via email. “It’s not surprising that the Holy Father would have singled him out for this honor and that he would want the future Cardinal McElroy present in the conclave that will elect the next pope.”

Chad Pecknold, a theology professor at The Catholic University of America who has been critical of many Vatican decisions under Francis’ papacy, said McElroy “often speaks from the ideological margins” and thus would be seen, in this papacy, as an appropriate candidate to be a cardinal.

“But mostly, his elevation reminds me that more senior and substantial prelates like Archbishop Cordileone and Archbishop Gomez have, once again, been very deliberately passed over,” Pecknold said in an email.

Among his notable stances, McElroy has been one of a minority of U.S. bishops denouncing the campaign to exclude Catholic politicians who support abortion rights from Communion.

“It will bring tremendously destructive consequences,” McElroy wrote last year. “The Eucharist is being weaponized and deployed as a tool in political warfare. This must not happen.”

Cordileone, in contrast, said earlier this year that he would no longer allow House Speaker Nancy Pelosi to receive Communion because of her support for abortion rights.

Last year McElroy was among a small group of bishops signing a statement expressing support for LGBTQ youth and denouncing the bullying often directed at them.

The bishops said LGBTQ youth attempt suicide at much higher rates, are often homeless because of families who reject them and “are the target of violent acts at alarming rates.”

“We stand with you and oppose any form of violence, bullying or harassment directed at you,” the statement read. “Most of all, know that God created you, God loves you and God is on your side.”

McElroy received a bachelor’s degree in history from Harvard in 1975 and a master’s in history from Stanford in 1976.

He studied at St. Patrick Seminary in Menlo Park, California, and in 1985 received a theology degree at the Jesuit School of Theology in Berkeley. He obtained a doctorate in moral theology at the Gregorian University in Rome the following year and a doctorate in political science at Stanford in 1989.

He was ordained in 1980 and assigned to the Archdiocese of San Francisco, where he served in a parish before becoming personal secretary to Archbishop John Quinn. Other California parish assignments included Redwood City and San Mateo.

He became an auxiliary bishop in San Francisco in 2010. In 2015, early in Francis’ pontificate, he was named bishop of San Diego. For the past three years, he has served as president of the California bishops conference.

Monsignor Stephen Doktorczyk, vicar–general for the Diocese of Orange, said McElroy’s leadership skills have been impressive.

“One thing I respect about him is that while he is confident in the positions he takes, he truly is open to hearing the take of others and engaging in a dialogue with those who have different points of view,” Doktorczyk said.

Allan Figueroa Deck, a distinguished scholar of pastoral theology at Loyola Marymount University, said McElroy’s elevation represents a “clear message” from the pope about the direction the church should move in.

McElroy “understands and takes seriously what Pope Francis means by ‘epochal change’ and the challenge of finding better models, a more effective and inclusive style for the Church to proceed,” Deck said via email. “He approaches hot–button issues like the pastoral care of LGBTQ persons and the abortion issue with balance and prudence.”

Conservative Catholic activist Michael Hichborn of the Lepanto Institute has been a frequent critic of McElroy, for example condemning his strong support for the Association of United States Catholic Priests. The association is a relatively liberal group whose priorities include expanding the role of women in church leadership and creating “priestless parishes” that potentially could be overseen by laypeople as a way of countering the shortage of priests.

McElroy’s elevation “is a sign of Pope Francis’ desire to marry the Church with the world,” Hichborn said via email. “There can be little doubt that McElroy currently stands as the model for the kind of priest, bishop, and cardinal Pope Francis desires for the future of the Church.”

The Diocese of San Diego runs the length of California’s border with Mexico and serves more than 1.3 million Catholics in San Diego and Imperial counties. It includes 98 parishes, 49 elementary and secondary schools and, through Catholic Charities of the Diocese of San Diego, various social service and family support organizations.

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More from AP at the Vatican

Of the 20 churchmen named new cardinals in the consistory ceremony, 16 are younger than 80 and thus eligible to participate in a conclave — the ritual–shrouded, locked–door assembly of cardinals who cast paper ballots to elect a new pontiff.

The 85–year–old Francis has now named 83 of the 132 cardinals currently young enough to join a conclave. The others were appointed by the previous two popes, St. John Paul II and Benedict XVI, whose unexpected retirement in 2013 paved the way for Francis to be elected.

With the eight batches of cardinals Francis has named, prospects are boosted that whoever becomes the next pontiff will share his vision for the future of the church.

Francis reminded the cardinals of their mission, which he said includes “an openness to all peoples, to the horizons of the world, to the peripheries as yet unknown.”

Underlining Francis’ attention to those on society’s margins, among the new cardinals is Archbishop Anthony Poola of Hyderabad, India. The prelate, 60, is the first member of the Dalit community, considered the lowest rung of India’s caste system, to become a cardinal.

One by one, the newest cardinals, whose red cassocks and headgear symbolizes the blood they must be prepared to shed if necessary in their mission, knelt before Francis, who placed on their head the prestigious biretta, as the three–peaked hat is known.

In choosing San Diego Bishop Robert Walter McElroy, Francis passed over U.S. churchmen leading traditionally more prestigious dioceses, including San Francisco Archbishop Salvatore Cordileone.

Among the newest cardinals is Bishop Richard Kuuia Baawobr from Wa, Ghana, who has spoken out against LGBTQ rights. The African prelate felt ill when he arrived in Rome on Friday and was hospitalized for a heart problem, the pope told the other cardinals, asking them to pray “for this brother who should have been here.”

Asked by The Associated Press about such contrasting views among church leaders, McElroy replied that “there are always cultural differences within the life of the church as there is within in the human family. And different cultures approach these questions in different ways.”

McElroy added: “My own view is that we have an obligation in the church to make the LGBT persons feel equally welcome in the life of the church, as everyone else.” . . .

Archbishop Ulrich Steiner of Manaus, Brazil, became the first cardinal from the Amazon, the vast, environmentally–vulnerable region in South America on the Argentine–born pontiff’s home continent. In remarks to The AP, Steiner expressed concern about increasing violence in the Amazon.

“But this violence was not born there, it came from outside,‘’ Steiner, 71, said. ”It is always violence related to money. Concessions, deforestation, also with the mines, also with the fishing.”

At 48, the youngest member among the cardinals’ ranks is an Italian missionary in Mongolia, where Catholics number some 1,300. Francis “knows how important it is supporting these little communities,‘’ said the new cardinal, Giorgio Marengo.

Associated Press religion coverage receives support through the AP’s collaboration with The Conversation US, with funding from Lilly Endowment Inc. The AP is solely responsible for this content.