When San Diego Bishop Robert McElroy receives his prestigious red hat at the Vatican on Saturday, he will bring 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 frequently criticized Francis, said McElroy “often speaks from the ideological margins” and thus would be seen, in Francis’ 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.