The Ohio Department of Medicaid estimates that at least 61,826 Ohioans would lose access to Medicaid under the new rules. However, research from the Center for Community Solutions — a health policy think tank in Cleveland — found that 450,000 Ohioans could lose health coverage if the work requirement goes into effect. Photo: Karolina Grabowska, Pexels

Local families and organizations are still processing the recent news out of Columbus that threatens young Ohioans’ right to access gender-affirming care in the state.

On Jan. 10, the Ohio House voted 65-28 to override Gov. Mike DeWine’s veto on House Bill 68, a bill that would outlaw gender-affirming care for minors in the state. The vote sends HB 68 to the Ohio Senate where it will likely get the 20 votes needed to put the law into effect. The next Senate session is Jan. 24.

DeWine told reporters on Jan. 11 that he believes Republicans voted to override his veto because of the portion of HB 68 that bars transgender athletes from playing women’s sports at schools and universities in the state.

“The sports issue affects only a minute number of people,” DeWine said. “It was not the reason that I vetoed the bill. So I think, by combining those two, a lot of members, at least members I talked to this weekend, had latched on to the issue of sports they felt very strongly about.”

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Should HB 68 go into effect, which is almost guaranteed, transgender minors in the state won’t be able to start medical care related to their transition, but those who are already receiving treatment could continue, according to the bill’s language.

TransOhio, a trans rights advocacy organization, addressed trans Ohioans directly on social media following the veto override:

“Trans people have always been and will always be here. You have never and will never need the government’s permission to be trans. You don’t need to tell the government you are trans. Connect with other trans people, you’re not alone and we’re going to deal with this together,” the organization said on Instagram.

Gender-affirming care in practice

Gender-affirming care is an umbrella of evidence-based mental health and medical services that helps a person transition from their gender assigned at birth to the gender by which they want to be known. For children and teens, gender-affirming care focuses on mental health therapy and sometimes hormone replacement therapy (HRT). This can come in the form of puberty blockers, a medicine that delays the start of puberty, or hormones, which are used to change an individual’s body to be more consistent with their gender identity.

CityBeat interviewed Larkin Overton and his family in September about the possibility of lawmakers banning gender-affirming care. CityBeat checked in with Larkin’s dad, Andy Overton, after news of the veto override broke.

“He has enough T to last until he’s 18, then at that point I think he’s good. As for the younger kids, they’re fucked,” he told CityBeat.

“T” refers to testosterone, the hormone Larkin was approved to begin self-administering after extensive mental health therapy, consultations between his parents and doctors and years of socially-supported transition changes.

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Andy is frustrated that the legislature is ignoring not only medical science, but the will of voters.

“The people voted to protect trans youth,” he said. “Then, GOP tries to overturn it. Then, somewhat surprisingly, DeWine vetoed it. And now we’re back to the GOP messing with children’s lives again. Is this not a democracy? It should have been the end of it when the polls closed.”

Andy is referring to Issue 1, the pro-choice amendment to the state’s constitution which Ohioans overwhelmingly passed in November. While the bill did not reference gender-affirming care, many opponents interpreted Issue 1 as potentially limiting the rights of parents to decide whether or not their child could receive gender-affirming care based on the amendment language, which focused on an “individual right to one’s own reproductive medical treatment.”

So far, it doesn’t appear that anyone is challenging HB 68 based on the passage of Issue 1. CityBeat reached out to Cincinnati Children’s Medical Center to ask how the veto override will impact its Transgender Health Clinic, but the hospital declined to comment, instead saying: “Cincinnati Children’s complies with Ohio law.”

Administrative rules

There could be more restrictions on gender-affirming care for all Ohioans, not just children.

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After DeWine announced his veto on HB 68, he proposed a set of new post-veto administrative rules that restrict healthcare options for transgender Ohioans as a concession to his fellow Republicans.

According to the Buckeye Flame, these rules would be “the harshest and most restrictive in the United States for transgender adults seeking healthcare.”

For adults, the rules would:

  • Restrict the ability of hospitals and clinics to diagnose gender dysphoria in transgender adults.
  • Require healthcare providers to report all transgender patients’ “de-identified” medical information to the state of Ohio, including any diagnosis of gender dysphoria and “any medical or surgical service (including physician services, inpatient and outpatient hospital services, or prescription drugs or hormones).”
  • Require transgender adults to obtain a detailed care plan and medical consent from a psychiatrist, an endocrinologist and a bioethicist before the “prescription, initiation or provision of treatment for a gender-related conditions” can take place, including access to HRT.
  • Require transgender adults under the age of 21 to “receive a comprehensive mental health evaluation” over the course of “not less than six months” in order to access gender-affirming healthcare.

The Transgender Advocacy Council (TAC), a Greater Cincinnati-based nonprofit that serves as an umbrella organization for individuals and grassroots transgender support organizations, is asking people to reach out to the Ohio Department of Health (ODH) with complaints over the administrative rules.

“This would devastate our trans youth and adults, put an increased burden on providers and most importantly, unnecessarily cause harm to the lives of transgender people,” said Jay VanLandingham, TAC board president. “We ask that people reach out directly to ODH by Jan. 19 to issue grievances and complaints. Meanwhile, TAC will continue to provide support, referrals and resources to the community while also offering our emergency funds to local trans folx in need.”

DeWine’s proposed rules would take effect once approved by the Joint Committee on Agency Rule Review.

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This article appears in Jan 10-23, 2024.