VATICAN CITY — Pope Francis convened a meeting of Roman Catholic leaders worldwide on Thursday to grapple directly with clerical child sexual abuse, a scourge that has for decades devastated some corners of his vast church while being utterly ignored and denied in others.

The meeting was a potentially defining moment for Francis’ papacy and the most visible step taken by the Vatican to impress upon bishops and other church leaders, some of them still skeptical, the enormity of a crisis that has shaken the faithful.

Expectations for action were amplified by victims and victim advocates, who converged in Rome to apply pressure from outside the Vatican walls on the meeting in a Holy See conference hall.

Scandals have repeatedly emerged around the world even decades after the problem first came to light in the United States, where the systemic shuffling of predatory priests from parish to parish spread abuse like a virus.

A lack of forceful action by the Vatican has disheartened and disgusted many victims and their advocates, who are demanding a policy of zero tolerance with a dismissal from the clerical state for abusive priests and the bishops who protect them.

The issue has drastically devalued the moral authority that is the currency of the clergy and their pope, who is often a lonely voice in support of migrants and the poor. As the abuse crisis has festered, critics have asked why anyone should listen to a moral leader unable, or unwilling, to clean up his own house.

On Thursday, addressing the 190 leaders of the church who had assembled from around the world, Francis sought to reassure his flock that ‘‘we hear the cry of the little ones asking for justice.”

Still, despite his acknowledgment that people ‘‘expect from us not simple and obvious condemnations, but concrete and effective measures,” he offered remedies disappointing to many victims.

Instead, Francis — who intends the meeting to be a “catechesis,” educating bishops and religious leaders so they could undergo a conversion of spirit on the severity of the crisis — provided those assembled with 21 “reflection points.”

“They are a road map for our discussion,” Archbishop Charles Scicluna, the Vatican’s leading sex crimes investigator, said at a news conference.

They included weighing whether priests and bishops found guilty of abuse should be dismissed from ministry, but fell short of what most advocates consider zero-tolerance — the automatic dismissal from the clerical state.

“You have to take it on a case-by-case basis,” Archbishop Scicluna said, promising no blanket remedies.

Some of the victims who had traveled to Rome, where they hovered outside news conferences, gave hours’ worth of interviews, observed vigils and planned a Saturday march through the city, expressed exasperation.

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Campaigners against sexual abuse by members of the clergy, at the Vatican on Wednesday.CreditGregorio Borgia/Associated Press

“Same old, same old,” said Tim Law, president of the survivor’s support group, Ending Clergy Abuse. “For six years of his papacy he has said, ‘zero tolerance, zero tolerance,’ ” he added. “He’s backed down.”

Advocates for other victims of abuse and secrecy in the church, including for the children of priests and for nuns raped by clerics, also came to Rome to meet with top officials and take advantage of the intense media interest.

The meeting itself included the presidents of many of the world’s bishops’ conferences, men’s and women’s religious orders and powerful cardinals from his committee of top advisers.

[Read more about the Vatican’s hopes for the meeting.]

At Thursday’s session, they heard searing prerecorded video testimonials from abuse survivors, including one made pregnant three times by a priest who started abusing her at age 15, and who beat her and forced her to have abortions.

None, however, addressed the congress in person. “Victims need to be believed,” one pleaded by video, urging bishops to collaborate with civil authorities.

Francis, who had initially inspired hopes for action after his election in 2013, placed himself in the ranks of abuse skeptics early last year, when he accused victims of slandering bishops during a trip to Chile.

The outcry from victims was fast and furious. Criticism reached a fever pitch last summer, when the Pennsylvania attorney general released a scathing grand jury report and prelates in Francis’ own hierarchy also accused him of covering up for abusers.

Since last year, Francis has undergone something of a conversion on the issue, admitting errors, asking forgiveness and toughening his stance toward those who covered up the crimes. He has pushed out bishops in Chile and last week defrocked the American former cardinal Theodore McCarrick.

[Gay priests, secret rules and the abuse of nuns: Read about some of the Vatican controversies as bishops meet.]

Francis called for the four-day meeting at the Vatican last September, with the apparent aim of relieving some pressure, but it has also increased expectations.

Some of the bishops have long denied that clerical sex abuse was a problem, or suggested that it exists only in the Anglo-Saxon world, or is a result of homosexuality in the church, a contention discredited by most scientific studies.

When bishops have acknowledged abuse, they often treated it as a sin to forgive rather than a crime to prosecute, reflexively protected their own and believed bishops over victims.

After the pope spoke, the Holy See said the assembled bishops watched video presentations of testimony from victims, who were not identified to the news media. It was an exercise in spreading the word that the abuses were real.

“The first thing they did was to treat me as a liar, turn their backs and tell me that I, and others, were enemies of the Church,’’ one victim, apparently from Chile, said of the church leaders.

“Wounds have been inflicted by us bishops” on the faithful, said Cardinal Luis Antonio Tagle of the Philippines, who has himself come under criticism from victims’ groups for his apparent lack of commitment to zero-tolerance policies.CreditEloisa Lopez/Reuters

‘‘This pattern exists not only in Chile,’’ the victim added. ‘‘It exists all over the world, and this must end.”

A 53-year-old priest also addressed the conference on a prerecorded video and recounted his own abuse by another priest.

One victim spoke of being sexually molested more than a hundred times, and of having the abuse covered up by religious superiors.

“I’ll request the bishops to get their act clear because this is one of the time bombs happening in the church of Asia,” the victim said.

Cardinal Luis Antonio Tagle of the Philippines, widely considered a contender to be the next pope, also addressed the gathering.

“Wounds have been inflicted by us bishops” that they needed to face, said Cardinal Tagle, who has himself come under criticism from victims’ groups for his apparent lack of commitment to zero-tolerance policies.

But he also sought to balance the faith’s belief in “unconditional love for those who have done wrong” with the need for justice for victims.

That emphasis on mercy was in keeping with Pope Francis’ own past remarks and the concerns of many of the bishops who fear that clergy are being unfairly targeted.

But such suggestions were likely to enrage victims’ groups, who have grown tired of abstract responses, filled with biblical allegory, and demand concrete solutions.

Archbishop Scicluna, the Vatican’s sex crimes investigator argued that the pope’s reflections points were ‘‘very, very concrete.”

They included codifying the participation of lay experts in sexual abuse investigations; preventing the names of accused clerics being published before convictions; and requiring reporting to civil authorities and church superiors.

He gave the bishops a detailed step of what exactly they were supposed to do when confronted with abuse cases and said that candidates for the priesthood needed to undergo more rigorous screening.

The faithful, he said, “have the duty and the right” to report abuse and that “civil or domestic laws should be obeyed.” Guilty verdicts, he said, should be promptly communicated publicly.

But some of the bishops in the hall said this was not a new lesson.

“These things are known,” Bishop Ricardo Ernesto Centellas Guzmán, president of the Bolivian Bishops’ Conference, said as he walked out of the Vatican on his lunch break. “There is nothing new.”

Orignially published in NYT.

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