Thousands Submit Comments on Proposed Ohio Administrative Rule on Transgender Health Care

Thousands of people sent emails to the Ohio Department of Mental Health & Addiction Services during the comment period for a proposed administrative rule that would change health care treatment of those with gender dysphoria, including adults.

People submitted more than 6,800 pages of emails to MHAS regarding Gov. Mike DeWine’s proposed rule, according to records obtained by the Ohio Capital Journal. 

“Any restrictions or banning of transgender healthcare for minors or adults is murder,” an email said. “I do not support the state of Ohio interfering in the medical care or the pursuit of happiness of transgender people.”

DeWine told reporters on Tuesday there will be revisions to the proposed administrative rule that will be announced in the next couple of days. 

“We’re looking at those comments,” he said. “We’ve listened to those comments. We never had any intention to limit access.”

What is the proposed rule?

The proposed rule would require patients under 21 to go through six months of counseling before getting more treatment. 

It would also require obtaining medical consent from a psychiatrist, an endocrinologist and a bioethicist before proceeding with treatment. DeWine’s spokesperson Dan Tierney said this rule would only apply to people who start receiving treatment after the rule takes effect. 

The rules are just proposals at this point and have not gone into effect.

What was in the emails?

People who sent emails raised many concerns ranging from saying how folks will leave Ohio to saying how care should be between a patient and their doctor. 

“This policy amounts to a near ban on gender-affirming care for adults in Ohio.”

“Gender transition care should be between the patient and their healthcare provider, not the state government.”

Others said how this will overwhelm an already overburdened medical system. 

“There are not enough bioethicists to look over each and every trans person’s case in the state of Ohio, and it is unnecessary for the purposes of determining if a patient needs gender-affirming care. These issues need to be left between a person and their current provider.”

“These new rules would jam up desperately needed psychiatric appointments. You likely know what the wait lists for psychiatric care are now (very long) and how much more this would use time which could be better spent with people who have schizophrenia or bipolar disorder or opiate use disorder. … But to additionally add an endocrinologist … AND a bioethicist is cruel.”

“Adding a requirement for adult transgender patients to get psychiatric care as a requirement to access transgender treatment will further burden an overtaxed system.”

“Bioethicists are rare, and requiring this of all clinics would result in a huge stoppage of transition care as many clinics will be unable to provide a bioethicist for the care. These rules are unnecessarily draconian and among the worst proposed in the United States.”

The parent of a transgender adult who receives gender-affirming care at the Cleveland Clinic said she has talked to some of the providers there about the proposed rules. 

“They all tell us that under these rules even a major hospital system like the Cleveland Clinic will not be able to provide care to any of their transgender patients anymore because they do not have the staff and there is no way for them to hire or contract with enough staff to meet these requirements.”

Politicians submit letters

Lawmakers including the Ohio Senate Democratic Caucus and House Minority Leader Allison Russo also submitted comments.

“While these rules may have been drafted with the intention of taking a more pragmatic approach than the legislature, in reality, this proposal could make it more difficult for trans Ohioans to receive the life-saving medical care that they need,” the Ohio Senate Democratic Caucus wrote.

Russo wrote in her letter the rules “create unnecessary and impractical obstacles to accessing life-saving care.”

“The generalized requirement for transgender individuals to form a specialized team including a psychiatrist, endocrinologist, and bioethicist is both impractical and not supported by the extensive standards established by World Professional Association of Transgender Health (WPATH), which outlines evidence-based standards of care that encompass wraparound services,” Russo wrote in her letter. 

Data collection

The second proposed administrative rule would require data collection around gender-affirming care, including requiring a health care provider to report non-identifying treatment for “gender-reassignment surgery, gender-transition services, genital gender reassignment surgery,” according to the proposed administrative rules.  

Comments on the data collection proposal must be sent to [email protected] by Monday.

This story was originally published by the Ohio Capital Journal and republished here with permission.