Ohio Department of Health changes stance on proposed restrictions on adult gender-affirming care

Ohio Department of Health changes stance on proposed restrictions on adult gender-affirming care

The Ohio health department said Wednesday it is rolling back multiple provisions in a set of proposed administrative rules that would limit access to gender-affirming health care for transgender adults in the state, citing a slew of public comments opposing the restrictions.

“The Department appreciates the individuals and organizations who took the time to provide input as we sought to adopt rules to protect Ohio’s children. After reviewing the submissions and considering the feedback, the Department has revised the proposed rule,” the state health department said in a statement reads a memo announcing the change.

Ohio Republican Gov. Mike DeWine said in January that he had directed the state’s Department of Health and Department of Mental Health and Addiction Services to submit rules for public comment that would make Ohio one of the U.S. states for adults seeking access. One of the most restrictive states. Gender Affirming Care.

A day earlier, DeWine vetoed legislation that would have banned gender-affirming care for minors and prevented transgender student-athletes from competing on sports teams consistent with their gender identity. On January 24, Ohio’s Republican-dominated Legislature voted to override the governor’s veto of the bill (House Bill 68).

The new law is set to take effect in April, but an upcoming legal challenge from the American Civil Liberties Union could halt its enforcement before then.

Shortly after DeWine made the announcement on Jan. 5, draft rules submitted by the Ohio health department almost immediately drew backlash from LGBTQ advocates and medical professionals over restrictions that would limit transgender minors and adults. access to care.

Patients under the age of 21 must receive mental health counseling for at least 6 months before they are eligible to receive gender-affirming drugs or surgery, and hospitals and medical facilities will not be able to provide care to transgender people of any age. A treatment plan developed by a team of psychiatrists, endocrinologists, and medical ethicists.

Experts worry the rules will close smaller or independent clinics that lack the funds needed to hire experts such as medical ethicists, who are often employed by large hospital systems. The American Civil Liberties Union and the American Civil Liberties Union of Ohio said the draft rule could amount to a “de facto ban” on care in the state.

Thousands of public comments poured in and more than 6,800 pages of emails were sent to the Department of Mental Health and Addiction Services about the rule, the Ohio Capital Journal reported late last month. The public comment period for the rule ends on January 19.

State health department officials said Wednesday that there is considerable public concern about the draft rule’s restrictions on adults’ access to gender-affirming care.

“These comments demonstrate significant interest in the impact of the initial draft on adult patients,” the department wrote in a memo Wednesday. “The revised quality standards rules now only apply to the care of minors.”

The department added that a common “point of confusion” among those submitting public comments centered on the requirement that treatment plans be reviewed by a medical ethicist.

“The requirement for review by a medical ethicist never applies to individual patient care plans, but rather to institutional operations. However, in an effort to alleviate confusion, and because healthcare leaders have provided assurances that institutions have appropriately engaged medical ethics professionals involved in such nursing, the requirement from the proposed rule has been removed,” the department wrote Wednesday.

The revised draft rules also expand the types of mental health professionals who can be part of multidisciplinary care teams, a change brought about “in recognition of concerns about the limited availability of certain medical specialties,” the department said.

Several provisions from the original draft remain in place, such as requiring transgender minors to receive six months of mental health counseling before receiving drugs such as puberty blockers or hormones. The rules also still prohibit doctors from referring minors to out-of-state facilities for gender-affirming surgeries, which are generally not recommended for transgender youth under 18 and, according to an executive order signed by DeWine on Jan. 5, The surgery is illegal for minors in Ohio.

The state proposal also would require transgender data collected by the state health department to be submitted to the Ohio Legislature. In response to privacy concerns, the department clarified Wednesday that the data collected will not identify individual patients.

The department will now move forward with the rule adoption process, including a review by the Ohio Common Sense Initiative and a submission to the Joint Committee on Agency Rule Review.

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