The Ohio Department of Health rolled back several rules and regulations that would have restricted access to gender-affirming medical care for transgender adults.
In January, Republican Gov. Mike DeWine directed the department and the state Department of Mental Health and Addiction Services to file rules for public comment to ensure that individuals do not pursue a gender transition hastily.
DeWine’s order served as a concession to opponents of gender-affirming care after he vetoed a bill that would prohibit doctors from prescribing gender-affirming treatments to transgender minors.
The Republican-led legislature overrode his veto.
The law is set to take effect in April. However, opponents of the law, including the American Civil Liberties Union, could sue and potentially obtain an injunction that would block state authorities from enforcing the ban.
Among the proposed regulations were a ban on surgical interventions on people under age 18, a requirement for state agencies to gather and report on data regarding the effects of gender-affirming treatments, and measures meant to slow-walk a person’s transition by requiring them to receive “adequate counseling” before pursuing gender-affirming care.
Under those measures, patients younger than 21 would have had to receive at least six months of mental health counseling before pursuing transition-related care. Healthcare facilities would have been unable to administer care to transgender people of any age without a treatment plan created and approved by a team of psychiatrists, endocrinologists, and medical ethicists.
The restrictions drew fire from transgender advocates, who argued that they would force smaller or independent clinics, which lack the financial resources to hire specialists like medical ethicists, to close.
They also argued that the limited number of medical or mental health professionals who would be permitted to provide care to patients would create significant backlogs for patients seeking to comply with the regulations. This would create additional obstacles to accessing gender-affirming care and further delay a person’s transition.
The proposed rules were also largely panned by the larger public. Thousands of individuals submitted more than 6,800 pages of emails commenting on the regulations, according to the Ohio Capital Journal. In response to overwhelmingly negative feedback, the Ohio Department of Health announced on February 7 that it was striking several of the proposed restrictions on gender-affirming care.
“The Department is grateful to those individuals and organizations who took time to offer comments as we seek to adopt rules to protect Ohio’s children,” the department wrote in a memo. “Having reviewed the submitted comments and considered the feedback, the Department has revised the proposed rules.”
Among the revisions are a clarification that any data collected regarding the short- and long-term effects of gender-affirming treatments will not identify individual patients. Moreover, restrictions on the type of care individuals can receive, where they can receive it, and the mental health counseling and treatment plan requirements will only apply to minors.
Also, under the revision, the types of medical and mental health professionals who can administer gender-affirming treatments have been expanded and modified.
The Department of Health also clarified that “[t]he requirement for review [of a personal treatment plan] by a medical ethicist was never applicable to individual patient care plans but rather to institutional operations.” But to avoid confusion, the ethicist requirement has been removed.
Provisions remaining in place are the requirement that transgender minors undergo six months of mental health counseling before being prescribed puberty blockers or hormones and one prohibiting doctors from referring minor patients to out-of-state facilities for gender confirmation surgeries in order to circumvent Ohio’s ban on the practice.
