Gender-affirming care access for Ohio trans adults to be restricted under new administrative rules

[Leroy N. Soetoro]

https://thehill.com/homenews/state-watch/4391617-gender-affirming-care-
access-ohio-trans-adults-restricted-new-administrative-rules/

Ohio’s Republican Gov. Mike DeWine on Friday announced new administrative
rules meant to restrict access to gender-affirming health care for
transgender adults, one week after vetoing legislation that would have
banned care for minors.

DeWine said during a press conference that Ohio’s Department of Health and
Department of Mental Health and Addiction Services would be filing rules
for public comment Friday that, once effective, will provide additional
protections for transgender minors and adults receiving care.

One of the rules, he said, will require transgender adults seeking access
to medications like hormones to retain a multidisciplinary team “including
but not limited to an endocrinologist, a bioethicist and a psychiatrist.”
Transgender adults in Ohio may currently receive care from a single
clinician, though treatment plans differ based on a patient’s individual
needs.

“Candidly, as I expressed a week ago, I am concerned that there could be
fly-by-night providers and clinics that might be dispensing medication to
adults with no counseling and no basic standards to assure quality care,”
DeWine said Friday. “The rules that we are announcing today will take care
of that. We need to ensure that adults, as well as children, are
protected.”

DeWine added that the rules will require transgender adults to obtain from
their providers a “comprehensive care plan” including “lengthy” mental
health counseling before they can be considered for any medical
interventions.

DeWine’s proposal is among the nation’s most stringent for transgender
adults seeking access to gender-affirming medical care, and it is likely
to bottleneck resources and worsen financial strain on people seeking
gender-affirming care.

In Florida, thousands of transgender adults have struggled to access
prescription medications since May, when a law signed by Gov. Ron DeSantis
(R) quashed the ability of most of the state’s health care providers to
administer gender-affirming services.

A second rule announced Friday by DeWine will require health care
providers across Ohio to report de-identified data on cases of gender
dysphoria and subsequent treatments.

“In plain English, that means that no one will be able to look at the data
and tell who it is,” DeWine said. “We do this all the time to protect
privacy.”

“The reporting of aggregate data occurs frequently in Ohio,” DeWine added,
“from flu cases to causes of food poisoning to data on abortions. This
data is used by policymakers, legislators and the public so they can make
informed decisions.”

The governor on Friday also signed an executive order prohibiting gender-
affirming surgeries for minors. It is the second state to explicitly ban
surgeries for minors, after Arizona did so in 2022.

Gender-affirming surgeries, according to guidelines set by the World
Professional Association for Transgender Health and the Endocrine Society,
are not recommended for transgender children and adolescents younger than
18.

While announcing his veto of House Bill 68, which had sought to ban
gender-affirming health care in its entirety for minors, DeWine during a
Dec. 29 press conference called the notion that such surgeries were being
performed on minors in Ohio “a fallacy.”

On Friday, DeWine, who spent the last few weeks of 2023 talking to medical
professionals and families of transgender children, said the executive
order is “a good way to take this issue off the table and assure everyone
that there are no surgeries going on with minors.”

“You can’t prove a negative; I can’t say that there’s never been a surgery
on a minor,” DeWine said Friday. “I have no way of knowing that. I just
know the issue never came up in discussions, other than telling me there
are no surgeries going on in regard to minors.”

“But again, if there are, we should ban them,” he said.

DeWine’s rejection of House Bill 68, which would have also barred
transgender women and girls from competing on female school sports teams,
has drawn sharp criticism from conservative Republicans including former
President Trump and DeSantis, who is campaigning for the GOP presidential
nomination.

Ohio’s Republican-controlled House is expected to hold a vote to override
DeWine’s veto next week. The bill passed both the state House and Senate
with veto-proof majorities.


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