COLUMBUS, Ohio — Sweeping new restrictions on rights for transgender youth are coming to Ohio in April, with further restrictions on the horizon for transgender people of all ages.
On Wednesday, Jan. 24, the Ohio Senate voted to override Gov. Mike DeWine’s veto of House Bill 68, which will ban transgender healthcare for Ohio youth and bar trans girls and women from participating in school sports. This followed a Jan. 10 override vote by the Ohio House.
When DeWine initially vetoed the legislation earlier this month, he proposed his own rules to restrict transgender healthcare.
Jessie Hill, a legal expert with Case Western Reserve University, previously told the Independent that both HB 68 and DeWine’s draft administrative rules invite litigation, which could ultimately block or stall portions of the law from taking effect.
Earlier this week, the ACLU of Ohio announced a lawsuit against HB 68’s ban on gender-affirming care for youth.
However, Hill previously described the Sixth Circuit Court of Appeals, which oversees Ohio, as “hostile to trans people.”
Despite legal challenges, Republican state legislators are pursuing even further restrictions on transgender rights.
At a small online gathering of Michigan and Ohio Republican legislators to discuss future policy, HB 68’s primary sponsor, Rep. Gary Click, recently said it was a “very smart thought” to ban transgender healthcare for everyone, regardless of age, independent journalist Erin Reed reported. Click added, “We have to take one bite at a time, do it incrementally.”
Youth healthcare
HB 68 will prohibit transgender minors in Ohio from accessing gender-affirming care, including hormone replacement therapy and puberty-blocking medications. The bill also requires mental health providers to notify parents or guardians prior to providing treatment for a “gender-related condition.”
The bill allows minors already prescribed hormonal treatment or puberty-blockers in Ohio to continue their care. Still, at least 100 Ohio families with transgender members plan to leave the state as a result of Ohio’s anti-trans legislation.
Local professional counselor and Rock Riffle Wellness Co-Owner Mosha Trout, who specializes in working with queer youths and whose business follows World Professional Association for Transgender Health standards, said she’s seen firsthand the fear and discomfort HB 68 has incited in her 22 clients this past week. She described the legislation as “destabilizing” to her clients’ mental health.
“I wish … the people that had the power that made this happen, I wish they would have just sat with me, with my families, with my clients, and just watched us in therapy — to see the harm that was actually caused,” Trout said.
For Trout, what is now important is to stress that care is still available — there are professionals ready to jump through hoops to get clients the care they need, whether it be counseling or a referral out of state.
“There’s several clients … they have this fear of, ‘I’m never going to be able to start this process, because now there’s this block,’ and I want that to be debunked,” Trout said.
Trout also voiced concerns about the potential for a chilling effect on queer youth.
“It’s the silence that keeps people in the closet — like families in the closet — it’s like, ‘We can’t speak because now we have to hide,’” Trout said.
Trout recommended affected parents and families consult the Ohio: Resource Guide on HB 68 by the Campaign for Southern Equality.
Trout said, “I’ve been planning for this, so it is not going to change my work. I think the way that it will change is the referral sources I’ve had.”
Regarding the healthcare portions of the bill, Athens City Schools Superintendent Tom Gibbs said in an email, “those are decisions and discussions outside of what a school would be directly involved, with the exception of the parental notification requirements now imposed on school psychologists, counselors, etc. … We are awaiting specific legal guidance on those matters.”
Gibbs added, “These changes and restrictions will certainly have very negative impacts on the specific students and families targeted by the law, a very small population that is already marginalized in schools and society as a whole. … While I am not at liberty to speak for our entire Board of Education on these matters, I know that several of our Board Members and Administrators, including myself, have significant concerns about the negative impacts for specific children we serve.”
Sports
The bill also forbids transgender children from participating in sports with children with whom they share the same gender identity. It separates children’s sports by “sex,” with the exception of co-ed teams. The law also forbids complaints “against a school or school district for maintaining separate single-sex interscholastic athletic teams or sports.”
In reference to the restrictions on athletics, Gibbs told the Independent in an email, “for those specific students impacted, I can only imagine this change will cause significant stress.”
Gibbs previously told the Independent transgender students have participated on school athletic teams in Athens City Schools “and there have been no complaints or issues of which I am aware.”
Gibbs said, “There are legal questions, yet to be answered, that center around the apparent conflict between Ohio’s new statute and Federal Title IX Guidance. I would expect that the legal representatives for each District are reviewing those apparent discrepancies and will be providing additional guidance to us as we get closer to the implementation date of the new law.”
Other Athens County superintendents did not respond to a request for comment by press time.
Hill, the Case Western legal expert, previously told the Independent she expects legal challenges to athletics restrictions in HB 68 based on Title IX, which prohibits sex-based discrimination by schools that receive federal funding. However, Hill said it is currently unclear if Title IX would offer legal protections for transgender students in the context of school sports.
Asked to comment on the bill’s impact on OU students and athletics, OU Media Relations Specialist Sam Pelham told the Independent, “We are currently reviewing its potential impact on existing University policies, procedures and processes before it officially becomes law.”
Hocking College did not respond immediately to a request for comment.
HB 68 was sponsored by Athens County representatives Jay Edwards (R-94, Nelsonville) and Don Jones (R-95, Freeport). Edwards previously told the Independent the bill was necessary because “minors should be protected” from gender-affirming healthcare, and cisgender girls “should be protected” from transgender girls “competing against them in sports.”
The 2024 Democratic candidate for Ohio Senate District 30, Ari Faber, who is trans, and the Democratic candidate for Ohio House District 94, Wenda Sheard, both previously shared their opposition to HB 68.
Restrictions on care for people of all ages
When DeWine vetoed HB 68, he signed an executive order banning gender-affirming surgeries for minors in Ohio, despite the fact that no such surgeries were being performed in the state.
He also announced draft administrative rules that would broadly restrict healthcare for transgender people of all ages by setting up many more hurdles for both patients and providers.
Although the administrative rules were proposed in part because DeWine vetoed HB 68, his press secretary Dan Tierney said the legislature’s override vote will not impact the proposed rules.
“The Governor and the administration plan to proceed with the rulemaking process,” Tierney said in an email. “Some of the rules cover policies not addressed in HB 68. Other aspects of the rules would be triggered if HB 68 is enjoined by lawsuit.”
If the rules go into effect as they are currently written, Ohio will have some of the most restrictive regulations on transgender healthcare for adults in the country.
The rules would:
- Require healthcare providers to report data regarding gender-affirming care for transgender people to the Ohio Department of Health, and require the data to then be shared in aggregate with the state legislature.
- Require hospitals that provide gender-affirming healthcare to engage a board-certified psychiatrist and endocrinologist in the patient’s care.
- Require hospitals to create a “written, comprehensive, multi-disciplinary care plan” for patients receiving gender-affirming care, which is reviewed by a medical ethicist.
- Require that patients younger than 21 years old receive “comprehensive mental health evaluation at the hospital seeking to provide treatment” over a period of at least six months.
The public has until next Monday, Feb. 5 to submit comment to the Ohio Department of Health on DeWine’s proposals. The new rules would collect data “addressing gender-related conditions and treatment” and provide it to the General Assembly every six months, and restrict gender-affirming healthcare for people of all ages. Comments may be sent to [email protected].
Tierney said DeWine’s administration will soon publish “amended rules that reflect the results of the public comment period.”
“While we are not yet at a point where I can discuss specific changes, the administration takes the public comment period seriously and respects those who participated in the process,” Tierney said.
Restrictions on transgender healthcare for adults are unusual in the United States, with proposed laws regulating such care having failed in multiple states. With these administrative rules, Ohio would join Florida in restricting transgender healthcare for adults.
DeWine’s proposed regulations are so extensive that, according to the American Civil Liberties Union, they could constitute a “de facto ban” on any and all gender affirming healthcare for all transgender Ohioans.
At minimum, the regulations would likely require significant staffing and procedural changes if hospitals continue providing gender-affirming treatments such as hormone replacement therapy, health researcher Kathryn Poe previously told the Independent.
Such restructuring would pose a financial burden for health systems and could potentially prevent smaller providers in rural and suburban areas from offering care at all, given the multiple providers required to be involved in patient care, Poe said previously.
Equitas Health’s Director of Marketing Communications Anthony Clemente told the Independent the Ohio LGBTQ+ healthcare provider stands by its previous statement that it will “jump through whatever administrative hurdles we need to jump through to continue providing gender-affirming care to our patients and to avoid any disruptions in care.”
Planned Parenthood of Greater Ohio President and CEO Erica Wilson-Domer told the Independent, “Gender-affirming care is still available for adults at all 15 of our health centers, including the Athens Health Center, and online via telehealth through our Virtual Health Center. We are proud to provide high-quality gender-affirming care to adults in our communities, and we will continue to do so in accordance with Ohio law. Currently, we are working on ensuring we can continue to provide this critical care to patients in compliance with all legal requirements.”
Following the public comment period on the rules and the release of amendments, the rules would need to be approved by Ohio’s Joint Committee on Agency Rule Review.
Tierney said he expects “final rule approval within several months.”
