AP PHOTOS: A month of Pope Francis's longest hospital stay with lenses focused everywhere he is not

ROME (AP) — Pope Francis on Friday marked one month in the hospital where he is being treated for double pneumonia, with signs in recent days that indicate he is gradually recovering.

The 88-year-old pope has not been seen by most faithful since a general audience on Feb. 12 in the Vatican’s Paul VI Hall. Rollercoaster medical updates during the first three weeks of his treatment sparked an outpouring of concern from Catholics worldwide — and speculation about whether he had plans to resign.

In recent days the initial dread has given way to cautious relief as fears of imminent death have been lifted.

Associated Press photographers have been capturing the hope and the anguish that have accompanied Francis’s health journey as the faithful arrive in higher-than-usual numbers in Rome for Holy Year celebrations, which come once every quarter-century.

Pilgrims arriving in Rome for the Catholic Church’s Jubilee Year have added a stop at the Gemelli Hospital where Francis is being treated to pray for his recovery. Cameras have been trained on a suite of mostly shaded 10th-floor windows where the pope is staying, but he has yet to make an appearance.

Church officials have emphasized that the pope continues his ministry from the hospital. Experts note that it has only been in recent church history –- chiefly since John Paul II’s 1978-2005 papacy -- that the faithful have grown accustomed to seeing popes on a regular basis.

“We’re … used to seeing a pope who’s everywhere all the time,’’ said Kurt Martens, a Washington, D.C.-based canon lawyer. “But don’t forget that in the past, not that long ago, popes would show up only rarely,’’ he said, delegating routine and even Holy Week celebrations to cardinals.

Francis has not been seen since Feb. 14 private audiences, his last official appearances before being admitted to the hospital following a weeks-long bout of bronchitis. He increasingly found it hard to speak publicly.

He marked the 12th anniversary of his papacy on March 13 in the hospital. The only sign of life has been a recording of his soft, labored voice broadcast to the faithful in St. Peter’s Square on March 6 thanking them for their prayers.

Since Feb. 19 the Vatican had started each day by issuing a brief, reassuring statement noting with small variations that the pope has slept a tranquil night. Medical bulletins have been reduced from daily, to every other day.

The first three weeks were marked by slight improvements punctuated by alarming setbacks: a polymicrobial (bacterial, viral and fungal) infection on Day 4, double pneumonia on Day 5 and mild kidney failure on Day 10, along with respiratory crises on Day 9 and Day 18, and a severe coughing fit on Day 15.

But earlier this week, doctors lifted a guarded prognosis, indicating the pope was no longer at immediate risk of death from the infection. The latest medical bulletin said that the pope’s condition remained stable but indicated a complex picture considering his overall fragility, which includes his age, limited mobility often requiring a wheelchair and the removal of part of a lung as a young man.

While it is the longest hospitalization of Francis’s papacy, John Paul II holds the record: 55 days in the same specially outfitted papal apartment at the Gemelli, which includes a chapel.

A statue of late Pope John Paul II is lit outside the Agostino Gemelli Polyclinic in Rome, Thursday, March 13, 2025, where Pope Francis is being treated for bilateral pneumonia since Feb. 14. (AP Photo/Domenico Stinellis)

A view of St.Peter's Basilica at the Vatican, Monday, March 10, 2025. (AP Photo/Andrew Medichini)

Tourists and locals walk in St. Peter's Square on a rainy day at the Vatican, Wednesday, March 12, 2025. (AP Photo/Francisco Seco)

Vatican Swiss guards surveil the Bronze Door, the main entrance to the papal apartments, at The Vatican, Sunday, Feb. 23, 2025, as Pope Francis was admitted on Feb. 14, at Rome's Agostino Gemelli Polyclinic. (AP Photo/Alessandra Tarantino)

St. Peter's Basilica at The Vatican is seen at dusk across the river Tiber in Rome, Italy Friday, Feb. 28, 2025. (AP Photo/Kirsty Wigglesworth)

A figurine of Pope Francis is displayed in a shop window in Rome, Thursday, Feb. 27, 2025. (AP Photo/Kirsty Wigglesworth)

A Catholic worshipper holds a rosary during a vigil prayer for Pope Francis in St. Peter's Square at The Vatican, Sunday, March 9, 2025. (AP Photo/Francisco Seco)

Deacons take part in a mass for their jubilee in St. Peter's Basilica at The Vatican, Sunday, Feb. 23, 2025, that was supposed to be presided over by Pope Francis who was admitted over a week ago at Rome's Agostino Gemelli Polyclinic for pneumonia. (AP Photo/Alessandra Tarantino)

Catholic worshippers gather to pray the rosary for Pope Francis' health in St. Peter's Square at The Vatican, Monday, Feb. 24, 2025. (AP Photo/Bernat Armangue)

Nuns attend a rosary prayer for Pope Francis' health in St. Peter's Square at the Vatican, Monday, March 10, 2025. (AP Photo/Andrew Medichini)

Catholic nuns listen to a recorded message from Pope Francis during a vigil rosary for his health in St. Peter's Square at The Vatican, Thursday, March 6, 2025. (AP Photo/Francisco Seco)

Catholic worshippers pray the rosary for Pope Francis in St. Peter's Square at The Vatican, Friday, March 7, 2025. (AP Photo/Francisco Seco)

A Catholic woman attends a nightly rosary prayer for the health of Pope Francis in St. Peter's Square at the Vatican, Wednesday, Feb. 26, 2025. (AP Photo/Bernat Armangue)

People pray for Pope Francis in front of the Agostino Gemelli Polyclinic, in Rome, Thursday, March 13, 2025, where he is hospitalized since Friday, Feb. 14. (AP Photo/Andrew Medichini)

A marble statue of late Pope John Paul II is backdropped by the Agostino Gemelli Polyclinic in Rome, Saturday, Feb. 15, 2025, where Pope Francis was hospitalized Friday, Feb. 14, after a weeklong bout of bronchitis worsened and is receiving drug therapy for a respiratory tract infection. (AP Photo/Alessandra Tarantino)

A television shows news about Pope Francis in a room of the Agostino Gemelli Polyclinic, in Rome, Sunday, Feb. 23, 2025, where the pontiff is hospitalized for pneumonia since Friday, Feb. 14. (AP Photo/Andrew Medichini)

Pope Francis meets with Czech Republic's Prime Minister Robert Fico, right, and his entourage at The Vatican Friday, Feb. 14, 2025. (Vatican Media via AP, HO)

Pope Francis blesses the faithful during his weekly general audience in the Paul VI Hall, at The Vatican, Wednesday, Feb. 12, 2025. (AP Photo/Alessandra Tarantino)

Pope Francis arrives to hold his weekly general audience in St. Peter's Square, at the Vatican, Wednesday, Sept. 25, 2024. (AP Photo/Gregorio Borgia)

Pope touches his eyes as he presides over a mass for the jubilee of the armed forces in St. Peter's Square at The Vatican, Sunday, Feb.9, 2025. (AP Photo/Alessandra Tarantino)

Rain falls on the auspicious candles with images of Pope Francis left outside the Agostino Gemelli Polyclinic, where he is being treated for bilateral pneumonia in Rome, Monday, Feb. 24, 2025. (AP Photo/Gregorio Borgia)

WASHINGTON (AP) — Becky Pepper-Jackson finished third in the discus throw in West Virginia last year though she was in just her first year of high school. Now a 15-year-old sophomore, Pepper-Jackson is aware that her upcoming season could be her last.

West Virginia has banned transgender girls like Pepper-Jackson from competing in girls and women's sports, and is among the more than two dozen states with similar laws. Though the West Virginia law has been blocked by lower courts, the outcome could be different at the conservative-dominated Supreme Court, which has allowed multiple restrictions on transgender people to be enforced in the past year.

The justices are hearing arguments Tuesday in two cases over whether the sports bans violate the Constitution or the landmark federal law known as Title IX that prohibits sex discrimination in education. The second case comes from Idaho, where college student Lindsay Hecox challenged that state's law.

Decisions are expected by early summer.

President Donald Trump's Republican administration has targeted transgender Americans from the first day of his second term, including ousting transgender people from the military and declaring that gender is immutable and determined at birth.

Pepper-Jackson has become the face of the nationwide battle over the participation of transgender girls in athletics that has played out at both the state and federal levels as Republicans have leveraged the issue as a fight for athletic fairness for women and girls.

“I think it’s something that needs to be done,” Pepper-Jackson said in an interview with The Associated Press that was conducted over Zoom. “It’s something I’m here to do because ... this is important to me. I know it’s important to other people. So, like, I’m here for it.”

She sat alongside her mother, Heather Jackson, on a sofa in their home just outside Bridgeport, a rural West Virginia community about 40 miles southwest of Morgantown, to talk about a legal fight that began when she was a middle schooler who finished near the back of the pack in cross-country races.

Pepper-Jackson has grown into a competitive discus and shot put thrower. In addition to the bronze medal in the discus, she finished eighth among shot putters.

She attributes her success to hard work, practicing at school and in her backyard, and lifting weights. Pepper-Jackson has been taking puberty-blocking medication and has publicly identified as a girl since she was in the third grade, though the Supreme Court's decision in June upholding state bans on gender-affirming medical treatment for minors has forced her to go out of state for care.

Her very improvement as an athlete has been cited as a reason she should not be allowed to compete against girls.

“There are immutable physical and biological characteristic differences between men and women that make men bigger, stronger, and faster than women. And if we allow biological males to play sports against biological females, those differences will erode the ability and the places for women in these sports which we have fought so hard for over the last 50 years,” West Virginia's attorney general, JB McCuskey, said in an AP interview. McCuskey said he is not aware of any other transgender athlete in the state who has competed or is trying to compete in girls or women’s sports.

Despite the small numbers of transgender athletes, the issue has taken on outsize importance. The NCAA and the U.S. Olympic and Paralympic Committees banned transgender women from women's sports after Trump signed an executive order aimed at barring their participation.

The public generally is supportive of the limits. An Associated Press-NORC Center for Public Affairs Research poll conducted in October 2025 found that about 6 in 10 U.S. adults “strongly” or “somewhat” favored requiring transgender children and teenagers to only compete on sports teams that match the sex they were assigned at birth, not the gender they identify with, while about 2 in 10 were “strongly” or “somewhat” opposed and about one-quarter did not have an opinion.

About 2.1 million adults, or 0.8%, and 724,000 people age 13 to 17, or 3.3%, identify as transgender in the U.S., according to the Williams Institute at the UCLA School of Law.

Those allied with the administration on the issue paint it in broader terms than just sports, pointing to state laws, Trump administration policies and court rulings against transgender people.

"I think there are cultural, political, legal headwinds all supporting this notion that it’s just a lie that a man can be a woman," said John Bursch, a lawyer with the conservative Christian law firm Alliance Defending Freedom that has led the legal campaign against transgender people. “And if we want a society that respects women and girls, then we need to come to terms with that truth. And the sooner that we do that, the better it will be for women everywhere, whether that be in high school sports teams, high school locker rooms and showers, abused women’s shelters, women’s prisons.”

But Heather Jackson offered different terms to describe the effort to keep her daughter off West Virginia's playing fields.

“Hatred. It’s nothing but hatred,” she said. "This community is the community du jour. We have a long history of isolating marginalized parts of the community.”

Pepper-Jackson has seen some of the uglier side of the debate on display, including when a competitor wore a T-shirt at the championship meet that said, “Men Don't Belong in Women's Sports.”

“I wish these people would educate themselves. Just so they would know that I’m just there to have a good time. That’s it. But it just, it hurts sometimes, like, it gets to me sometimes, but I try to brush it off,” she said.

One schoolmate, identified as A.C. in court papers, said Pepper-Jackson has herself used graphic language in sexually bullying her teammates.

Asked whether she said any of what is alleged, Pepper-Jackson said, “I did not. And the school ruled that there was no evidence to prove that it was true.”

The legal fight will turn on whether the Constitution's equal protection clause or the Title IX anti-discrimination law protects transgender people.

The court ruled in 2020 that workplace discrimination against transgender people is sex discrimination, but refused to extend the logic of that decision to the case over health care for transgender minors.

The court has been deluged by dueling legal briefs from Republican- and Democratic-led states, members of Congress, athletes, doctors, scientists and scholars.

The outcome also could influence separate legal efforts seeking to bar transgender athletes in states that have continued to allow them to compete.

If Pepper-Jackson is forced to stop competing, she said she will still be able to lift weights and continue playing trumpet in the school concert and jazz bands.

“It will hurt a lot, and I know it will, but that’s what I’ll have to do,” she said.

Heather Jackson, left, and Becky Pepper-Jackson pose for a photograph outside of the U.S. Supreme Court in Washington, Sunday, Jan. 11, 2026. (AP Photo/Jose Luis Magana)

Heather Jackson, left, and Becky Pepper-Jackson pose for a photograph outside of the U.S. Supreme Court in Washington, Sunday, Jan. 11, 2026. (AP Photo/Jose Luis Magana)

Becky Pepper-Jackson poses for a photograph outside of the U.S. Supreme Court in Washington, Sunday, Jan. 11, 2026. (AP Photo/Jose Luis Magana)

The Supreme Court stands is Washington, Friday, Jan. 9, 2026. (AP Photo/J. Scott Applewhite)

FILE - Protestors hold signs during a rally at the state capitol in Charleston, W.Va., on March 9, 2023. (AP Photo/Chris Jackson, file)