Bishop Francis X. DiLorenzo — who traveled to the Vatican as head of the Roman Catholic Diocese of Honolulu to advocate for Hawaiian hymns and “hula gestures” in church while opposing same-sex marriage and physician-assisted suicide in the islands — died Thursday in Virginia while serving as bishop of the Catholic Diocese of Richmond.

He was 75.

DiLorenzo, who was troubled by health problems for years, had a minor heart attack in 2001 while in Hawaii. After arriving in Richmond in 2004, he was hospitalized briefly that year for a heart catheterization procedure.

In Hawaii, DiLorenzo was appointed apostolic administrator in 1993 and named bishop a year later. He served for nearly 11 years until his unexpected transfer to Virginia, closer to his birthplace of Philadelphia.

“Before he had gotten this assignment in Richmond, he was very happy here and said he would like to retire as bishop of Honolulu,” said Patrick Downes, editor of the Hawaii Catholic Herald. “It wasn’t to be. He was the first bishop of Honolulu to move on to another place. Everyone else retired or died in office. … He just fell in love with Hawaii. He had a special interest in Hawaiian culture and history. After he got here, he made it a point to do his homework and learn about the place he was serving at.”

DiLorenzo tried to make the church more accessible in Hawaii while — often bluntly — challenging the way individual churches operated; recruited priests from the Philippines and South Korea to the islands; instituted a “Welcoming Parish” program; visited all 66 parishes and Catholic schools every two years; promoted a youth ministry; actively recruited young men into the priesthood; and convened Synod 2000, the first diocesan gathering of its kind in almost 50 years.

And DiLorenzo had no tolerance as the church’s sex-abuse scandal hit the islands during his tenure, resulting in the removal of five priests who allegedly molested eight victims.

“He was very tough on this subject,” Downes said. “He gave the priests who were accused very little slack. He was a strong proponent of ‘one strike, you’re out’ regarding sexual abuse.”

Before DiLorenzo’s arrival some churches — especially in tourism-heavy areas — were getting complaints about “hula” performances during services that sometimes were followed by applause from those in attendance.

“Some people were going overboard with the performance part,” Downes said. “There were complaints he had to deal with.”

As part of his homework, DiLorenzo consulted with Hawaiian culture experts and officials at Kamehameha Schools and wanted to allow “sacred gestures” in church, Downes said.

“He called them ‘sacred gestures’ — he tried to avoid the word ‘dance,’” Downes said. “He actually went to Rome to get permission to allow what he called ‘sacred gestures,’ or ‘cultural gestures.’ He clarified that, as long as it’s not a performance but a prayer, you can have a Hawaiian hymn, a song of prayer, and a ‘hula gesture.’”

DiLorenzo’s attitude, Downes said, was, “We’re in Hawaii. We have a different way of expressing ourselves. Why not include cultural expressions in our liturgy and in our Mass and in our worship as long as it’s not hip grinding, with everyone applauding at the end?”

At the same time, DiLorenzo got pushback for trying to deal with a priest shortage in the islands by merging smaller parishes into one — a policy that was later reversed by his successor, Larry Silva, Downes said.

“It was one of the ways he was trying to address a shrinking priest population as the Catholic population grows,” Downes said. “It was met with mixed success.”

DiLorenzo was born April 15, 1942, in Philadelphia, attended St. Callistus School, St. Thomas Moore High School and St. Charles Borromeo Seminary and was ordained May 18, 1968.

After leaving the islands in 2004, he was installed as the 12th bishop of the Richmond diocese and vowed to bring the practices and values of the diocese back in line with the Scriptures and began rolling back some of the more liberal policies instituted by his progressive predecessor, the former Bishop Walter E. Sullivan.

DiLorenzo suspended the diocese’s Sexual Minorities Commission, which had been the first official group to reach out to gay and lesbian Catholics in the late 1970s. He also sparked controversy by dismissing an advocate for ordaining women as priests from a diocesan women’s commission.

DiLorenzo said he would not refuse to give Communion to a lawmaker who believed in abortion rights, but he would have reservations about it.

“Going to Communion says something,” DiLorenzo said in an interview in 2004. “Communion has a meaning that says you are completely in union with the pope. … If you are welcomed into a family, there is a culture or set of values you need to be comfortable with.”

The Associated Press contributed to this report.