Over the last half decade, Roman Catholic nuns in the United States have been under investigation.

In 2008, the Church began a formal inquiry into all the women's orders in America. A year later, another investigation was launched, specifically about the organization that represents the majority of U.S. sisters, the Leadership Conference of Women Religious. On Tuesday, the Vatican released its findings from the first investigation, concluding that "a more incisive female presence in the Church is needed."

Getting there, though, won't be easy.

Sisters in the United States have awaited the report with a degree of anxiety. In terms of scale and methodology, the report was largely unprecedented—the Vatican does not typically commission this intimate a look at individual religious communities. In 2009, the Vatican official who launched the investigation, Cardinal Franc Rodé, explained his reason for launching the report: "You could speak of a certain secularist mentality that has spread among these religious families, perhaps even a certain 'feminist' spirit." As Sister Sharon Holland, the president of the Leadership Conference of Women Religious, said during Tuesday's press conference in Rome on the report's findings, some sisters "thought their entire lives had been examined, and found wanting."

But in general, the tone of Tuesday's press conference was optimistic. The report mostly focuses on the challenges facing American sisters and their contributions to Church life, rather than condemning them. Mother Mary Clare Millea, the American nun who led the investigation on behalf of the Holy See, thanked Vatican leaders for listening to the concerns of American sisters. "Your message to us today shows that you do understand our ongoing struggle to faithfully serve the Church in challenging times, despite our shortcomings and limitations," she said, crying.

"It is the realism of the text which appealed to me," added Holland. The report outlines the many challenges facing American sisters, who are referred to as "women religious." Today, there are roughly 50,000 sisters in the United States—a figure that represents a decline of about 125,000 women religious since the mid-1960s, when the number of American women who had taken vows to the Church reached its peak. Many sisters' religious institutions are struggling financially, despite what the report calls "careful stewardship." Women religious often make money by holding jobs in their local areas, or by running businesses like bookstores or schools. But decreased membership means fewer women can work, and those who do work often have low-paying jobs. Like other Americans, many sisters have lost their positions when the places where they work have closed or downsized.

Plus, U.S. sisters are getting old—their median age is mid- to late-70s. More and more women religious are no longer able to work and rely fully on Catholic institutions to support them. Although they can get some support through programs like Medicare, "changes in the healthcare system in the United States, resulting in uncertainty regarding the availability of government funding for the future needs of the elderly, is a particular cause for concern," the report says.

And yet, on Tuesday morning, the nuns and priests who presented the findings of the report seemed hopeful—for the future of American nuns, but also for the relationship between U.S. sisters and the Vatican, which has been strained. The report recognizes some women's "perception of not having enough input into pastoral decisions which affect them or about which they have considerable experience and expertise." And the Vatican let Millea fully design and execute the report, which other women religious appreciated: When representatives visited her congregation, Holland said, "it was evident that these were sisters like us, to whom we could speak openly and honestly."

Holland's reaction is particularly revealing, because she speaks for an organization of American sisters that has long been criticized by the Vatican. Women religious in the United States are represented by two organizations: The Leadership Conference of Women Religious, or LCWR, an association of congregation leaders that represents about 80 percent of American sisters; and the Council of Major Superiors of Women Religious, or CMSWR, which represents the other 20 percent. The Council is typically characterized as more "conservative," or traditional: Most of the women it represents wear habits, and some live in cloisters. The LCWR, on the other hand, represents many congregations whose members wear street clothes and work in their local communities.

The chairwoman of the more conservative CMSWR, Mother Agnes Mary Donovan, was very positive about the report, saying the information-gathering process "was overwhelmingly a beautiful experience." She noted that the average age of women religious represented by the CMSWR is 53, which is "well below the average trend." Nearly 1,000 women are preparing to take their final vows into CMSWR organizations, which she said was a good sign for recruitment.

But the report warned that the less traditional lifestyles of the majority of U.S. congregations might be a turn-off for women who are interested in religious life. "Candidates often desire the experience of living in formative communities and many wish to be externally recognizable as consecrated women [by wearing habits]," it says. "This is a particular challenge in institutes whose current lifestyle does not emphasize these aspects of religious life."

Among the women who live in those less traditional congregations, the report will likely be met with mixed reactions. As Holland said during the press conference, "The visitation was met by some ... with suspicion and apprehension." Not all congregations agreed to participate in the study, which representatives of the Vatican called "a painful disappointment." And this report says nothing about the ongoing investigation into the activities and teachings of the LCWR, which "often contradict or ignore magisterial teaching," as a 2012 Church document put it.

Although there may be hope for healing between American nuns and the Vatican, and although there's clearly a strong will to address the issues facing women religious, this report mostly surfaces issues, rather than resolving them.

"I'm concerned about those who may still be angry," Holland said.