In response to conservative outcry over his veto of the anti-trans bill H.B. 68, Ohio Governor Mike DeWine (R) held a press conference on the first Friday of 2024. The bill would have prohibited transgender women from participating in female academic sports and all gender-affirming medical procedures for minors (including medication).
He then announced a list of proposed new laws and regulations, saying that he had discussed trans rights with people on both sides of the aisle.
The majority of media attention was focused on his executive order banning gender-affirming surgery for minors, which is generally not practiced. However, his regulations for Ohio health agencies are far more severe. These regulations propose the nation’s strictest standards for child trans treatment.
According to Carson Hartlage, an Ohio trans health student, “as they stand, these have the ability to reduce care for hundreds of trans children and adults in Ohio.” “Waiting time and costs may increase for those who do access care.” Trans people of color and transgender people in rural areas who now face barriers to treatment may be disproportionately affected by this.
The proposed regulations are divided into three separate documents, one each serving as a draft rule under the Ohio Department of Health (ODH) and the other two as addiction services rules.
A draft rule must first go through a review process by interested parties before being filed with Ohio’s Joint Committee on Agency Rule Review (JCARR) for passage into law. Although the ODMH rules only have a comment period of two weeks, this first period usually lasts 30 days. JCARR holds a second public comment period after this one, this time with verbal evidence. A review rule may become law after the Committee conducts more reviews and one last round of their review.
The main focus of the ODH draft rules (3701-3-17, 3701-59-07, and 371-83-61) is on limiting adult transgender care. Mandating that each individual receiving gender-affirming treatment have a care team made up of an endocrinologist, psychiatrist, and bioethicist who each approves or facilitates their treatment is one of their main objectives.
This is completely implausible and will hide crucial clinical care behind administrative barriers. An oversight like this will effectively stop all gender-affirming care, as we’ve seen in Florida and Missouri. Because it’s simpler than trying to get around these new restrictions, some clinics may decide to stop providing this care.
According to Hartlage, “Providers may also… leave the state immediately, depriving Ohio of medical professionals who treat cisgender patients as well.”
These regulations are particularly dangerous when you consider that, according to my research, Ohio does not have any recognized bioethicist certifications, raising questions about how clinics can follow them while locating an impartial and competent candidate. Additionally, there aren’t many people in the state who identify as professional bioethicists, which puts an additional strain on both trans people and the medical community.
In fact, thousands of transgender people will be forcefully detransitioned, and it may take them months or even years before they are able to try to move once more without leaving the state. The proposed rules have been compared with anti-abortion TRAP regulations, which have closed clinics in states that limit access to abortion.
Additional limitations are imposed on those under 21. There would be no grandfather clause for those who are now transitioning, but the proposed rules would require “minors” to undergo therapy and medical evaluations for a minimum of six months prior to transition. This will compel some transgender people to detransition for at least six months, without also taking into account the effects of the different suggested restrictions.
A request for widespread surveillance of transgender people is included in the ODH rules’ conclusion. They would mandate that services send the state authorities particular care plans, statistical data, and details about who the providers are. It may also necessitate keeping track of each individual gender dysphoria diagnosis. Even though some of these would be anonymized, it still creates a repository of all Ohioans who are transitioning. This gives the state far too much control over transgender people and creates a risky precedent for the rest of the nation.
Hartlage expresses his frustration at having to teach in a state where our state continues to try to meddle in the practice of medicine. “According to what has been happening with trans medicine, I’ve now heard from several colleagues that they no longer intend to pursue internship training in Ohio.”
Regarding the ODMH rules, as previously stated, they are split into two distinct regulations. O.A.C. 5122–26–19 essentially mirrors the ODH regulations that aim to limit who can get gender-affirming treatment.
O.A.C. 5122-14-12 is noteworthy because it would forbid transitioning for people in medical facilities under the age of 21. This is extremely risky because the population of people in clinical units is already very vulnerable. Denying people in these units access to necessary treatment may result in dire consequences.
These rules had, in essence, prevent crucial, life-saving treatment. If they go into effect, several people will be compelled to leave the state, and those who are unable to do so may have their transitions subject to state-managed detransitions.
I’m a trans Ohioan who is now attempting to come up with an abrupt plan for leaving the state in order to continue transitioning. I will have to detransition if the rules are followed and I remain.
It’s still possible to fight back, though.
Therapist Jessica Kant compiled a thorough list of ways to express opposition to Ohio lawmakers, including how to contact the ODH and ODMH (public comment deadlines are February 5 and January 19, respectively), as well as the committee that will be examining the suggested rule changes.
According to Hartlage, “Folks can offer public commentary, amplify trans voices, heighten advocacy organizations’ messages, and contribute to mutual aid and emergency funds like the Trans Ohio Emergency Fund.”
“Please speak up if you are invested in transgender existence. To convey that this is not what people want and that it will unnecessarily harm and take away so many transgender persons, we need all hands on deck. We cannot let harsh, anti-trans legislation affect another state.”
