Adults wouldn’t have restricted access to transgender health care and transgender youth wouldn’t need to get medical consent from a bioethicist before starting treatment, according to Ohio Gov. Mike DeWine’s revised proposed administrative rules on transgender care.
The Ohio Department of Health released the new proposed administrative rules Wednesday after reviewing the thousands of submitted comments. DeWine laid out the original proposed rules on Jan. 5 — a week after vetoing a bill that would ban gender-affirming care for trans youth.
“Clarifying that these draft rules are not applicable to adult care was of critical importance and will be a massive relief to thousands of transgender people receiving care in Ohio who have spent the last few weeks scrambling to make contingency plans in case their care is cut off,” Equality Ohio Co-Interim Executive Director Siobhan Boyd-Nelson said in a statement.
“However, we continue to have deep reservations regarding the remaining provisions, and we maintain that the best course of action would be for both agencies to rescind the draft rules in their entirety.”
The revised rules have been submitted to the Common Sense Initiative (CSI) Office for review. People can submit comments on the revised rules by emailing [email protected] or [email protected] by Wednesday at 5 p.m.
Transgender health care
The original proposed rules applied to transgender adults, but the revised rules only apply to treating youth with gender dysphoria.
Kathryn Poe, a researcher at Policy Matters Ohio, was relieved to see the provisions restricting adult transgender removed.
“My wife is a trans woman,” Poe said. “I immediately went into the other room and hugged my wife. … The adult provisions were so extreme and so startling that I think it’s just really affected community members for weeks just having this hanging over people’s heads.”
Transgender advocates said the initial proposed rules around adult transgender health care would have made Ohio one of the most restrictive states when it comes to accessing care.
“I don’t think we’re totally out of the woods yet,” Poe said. “But I am feeling cautiously optimistic for the immediate future, which is nice.”
However, when it comes to the proposed rules regarding kids, Poe said they are “wildly unnecessary, especially given the passage of HB 68.”
House Bill 68 bans all gender-affirming care for transgender youth. DeWine vetoed HB 68, but the lawmakers overturned his veto and the bill is set to become law on April 23. The ACLU of Ohio plans to take legal action and file a lawsuit in the coming weeks.
HB 68 has a grandfather clause that would allow youth who are already receiving care to continue treatment, but Poe said the new proposed rules would apply to them as well.
“The ones who have been grandfathered in — who thought that they were still going to be able to receive treatment — these rules still affect those kids and that is still unacceptable,” Poe said.
“We still believe that the best course of action is to rescind these rules entirely, and allow for the already established standards of care to continue,” Jennifer Kuhn, spokesperson for Kaleidoscope Youth Center, said in a statement.
The proposed rules say transgender youth can only receive drugs or hormones for a gender transition at a hospital that has both a mental health professional and an endocrinologist who can treat minors. They also must receive at least six months of comprehensive mental health counseling and evaluation by a mental health professional.
“Recognizing concerns about the limited availability of certain medical specialties, options for the mental health professionals included in the required multi-disciplinary care team were expanded and modified,” the ODH letter said.
Vincent-Natasha Gay, a trans adult who lives in central Ohio, said the proposed rules are “attacking a very, very, very small group of kids.”
“I just feel for these kids that just want puberty blockers so those trans girls don’t start growing facial hair or having a deep voice and then having all of that dysphoria that comes with that or trans boys developing breasts,” Gay said.
Bioethicist
The revised proposed rules no longer require getting medical consent from a bioethicist before starting treatment.
“We complained about it so much that you had to walk it back,” said Ares Page, a transgender man from Akron.
Poe is glad this requirement was removed.
“I think it was just really unnecessary,” Poe said. “I think that there was so much ambiguity and confusion about what exactly their role would be that I’m really glad that they were responsive to that and just decided to remove that completely.”
Data collection
Data collection for transgender health care — which includes adults and youth — still remains in the proposed rules with some tweaks.
“In response to privacy concerns, the rules are now even more clear that the data collected will not identify individual patients,” the ODH letter said.
A health care provider would be required to report ODH within 30 business days a diagnosis of a gender-related condition, gender reassignment surgery, gender-transition services and genital gender reassignment surgery.
The health care provider must also submit forms including a person’s age and biological sex, but the forms wouldn’t include a patient’s names, addresses or “other personally identifiable information,” according to the proposed rules.
The forms would also require specific information about the treatment, including the names of drugs and hormones.
ODH would share the aggregate data collected with the General Assembly and the public by Jan. 31 and July 31 of each year, “absent any information that would lead to the disclosure of individual identities as determined by the director of health,” according to the draft rules.
The data collection portion of the rules is concerning to transgender Ohioans and advocates.
“They’re being very ambiguous on why they’re collecting this data,” Gay said. “What’s the data for why and why is there even a need to collect data? … It only raises a lot of questions and makes me fear that they’re using this data to continue to discriminate against transgender adults and minors.”
“They’re quantifying how many trans people are here,” Page said. “Anytime a populace is starting to be numbered that’s for a reason. You’re wanting to know how many of us there are for reasons that bring about suspicion.”
Poe said the data collection part is “very, very clearly a malicious attempt to create a narrative about trans people.”
Poe said it’s normal for a transgender person to come off their medication for a period of time or take a lower dose of their medicine during their course of treatment.
“It’s kind of attempting to cite all of those things as proof of detransition because the definition of detransition is pausing or stopping treatment for gender-affirming care,” Poe said. “… But the way that this data tracking would work is that that could very easily show up as someone has detransitioned.”
Poe wonders what the lawmakers would then do with that data.
“They could very easily claim, without clarification, that that is a detransition,” Poe said. “And we know that that’s not necessarily true, that it’s much more nuanced than that.”
This story was originally published by the Ohio Capital Journal and republished here with permission.
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