Public Comments Submitted to the Ohio Department of Health

Public Comments Submitted to the Ohio Department of Health

Proposed Draft Rule 3701-3-17 Released by the Ohio Department of Health (ODH)[1] Outlines extreme reporting requirements for physicians who provide gender-affirming care, which will create the potential for false positives and overly complicate data to provide safe, best-practice medical care for adults[2].The bottom line is that the data tracking request being made is intentionally malicious and designed to create a narrative around deconversion/reconversion that is not supported by other evidence[3]. Proposed rule to mandate private reporting, protected health information and Medical records Ohioan to the publicin violation of state and federal laws.

The data reporting requirements outlined in the rule require ODH to report within 30 days any diagnosis or treatment of transgender adults in Ohio, including any prescriptions, visits or maintenance of routine medical care. The department also requires reporting of any treatment discontinuations during the same period, reasons for changes and plans to cancel transitions.

However, this data collection is flawed in several ways.First, the definition proposed by the Department gender The rule would limit the department’s ability to accurately collect data because the definition explicitly excludes gender diversity, transgender people, non-binary individuals and intersex people. This would lead to misclassification of individuals within the population, particularly those who have had their medical and legal records updated to match their gender identity.Second, stop treatment or change treatment no An indicator of a person’s gender identity. It is common to pause treatment, change providers, and adjust personal dosage for a variety of reasons, including insurance changes, relocation, changes in personal medical history during the transition, side effects, and other natural changes in an individual’s treatment course.

A 2021 study[4] Research shows that people who stop treatment often have external reasons, such as family stress, employment or social reasons.Most people who meet the definition of “detransitioning” (or suspending or discontinuing medical treatment related to gender-affirming care) still identify as transgender[5] Or continue seeking medical attention later. Simply put, transgenderism is a diverse experience that includes binary (male-to-female) and non-binary (gender diverse) experiences and often needs to be explored over time with the help of a medical provider . But the proposed rule would treat all of these situations as signs of derailment in data collection, potentially creating trends where none exist.exist no other circumstances Do we change someone’s dose or try a different medication to indicate that someone is no longer receiving treatment for a diagnosis?

Overall, transitions remain rare.A 2022 study released by the American Academy of Pediatrics found that the vast majority of transgender teens in the study (94%) still identified as transgender 5 years later, and only 1.3% of patients in the study reverted to their birth-assigned sex and other gender. People choose non-binary identities[6]. This does not mean that de-transitioning does not occur, nor does it mean that support services should not be provided to those who de-transition, but it does mean that it should not be at the center of the department’s data collection efforts.

The medical information the department requested was also troubling.Requiring health care providers to share information such as medications, diagnoses, providers, and other personal health information that patients are taking with health departments and legislators is an invasion of personal medical privacy that goes well beyond what the Department of Health typically aggregates, especially It’s in consideration protected health information[7].

protected health information[8] is defined as “information in any form, including oral, written, electronic, visual, pictorial, or physical, that describes an individual past, present or future physical or mental health condition or condition, receive treatment or care, or purchase health care products. ” Although there are exemptions[9] Obtain “information that the (health) director determines, based on an evaluation of the relevant information… to avert or lessen an apparent threat to personal or public health.” The section states that medical information may be “released only for the purpose of control, prevention, or mitigation The person or entity required for the disease.” However, gender dysphoria or gender-related disorders These criteria are not met because transgenderism is not a disease or a clear threat to public health. Given the details of the data provided to the health department, including intimate details such as age, medications, providers and other information, it is likely that the data provided fell within the definition of protected health information.

associated with — public record[10]the current definition of public records outlined in the ORC does not include medical records. medical records[11] Defined as any document or combination of documents that relates to a patient’s history, diagnosis, prognosis, or medical condition and is generated and maintained during the course of medical care. also, pProtected Health Information (PHI)[12]also as defined in federal law[13]defines PHI as “a claim for payment of a health care product, service, or procedure, and any other health claims data in another document that reveals the personal identity of the data subject or Can be used to reveal the person’s identity”. Again, due to the specificities of the data, such as age, personal care plan, medication dosage, gender, and other characteristics reported, Data triangulationGiven the small population size, especially in rural areas of the state, the odds of matching multiple data sources to identify someone are very high.

Given these existing state and federal laws, the breadth of the reported records should be questioned. The proposed rule specifically provides that reported records will be released to the General Assembly and the public twice annually.While the following line in the proposed rule specifies that the information shared must comply with existing regulations regarding protected health informationgiven the nature and specificity of this data, it will be impossible obey. The government has zero interest in collecting such detailed medical information on transgender Ohioans, and it should not replace Ohioans’ medical privacy.


[3] James, SE, Herman, JL, Rankin, S., Keisling, M., Mottet, L., & Anafi, M. (2016). 2015 U.S. Transgender Survey Report. Washington, DC: National Center for Transgender Equality. Can be found at: https://transequality.org/sites/default/files/docs/usts/USTS-Full-Report-Dec17.pdf

[4] Turban, JL, Loo, SS, Almazan, AN, & Keuroghlian, AS (2021). Factors leading to “transition” among transgender and gender diverse people in the United States: A mixed methods analysis. gay health, 8(4), 273-280. Can be found at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8213007/

[6] Olson, KR, Durwood, L., Horton, R., Gallagher, NM, & Devor, A. (2022). Gender identity five years after social transformation. Pediatrics, 150(2). Can be found at: https://publications.aap.org/pediatrics/article/150/2/e2021056082/186992/Gender-Identity-5-Years-After-Social-Transition?autologincheck=redirected

[7] Orc Level 2 3701.17(A)(2)

[9] Orc Level 2 3701.17 (B)(4)

[10] ORC II 149.43 (A)(1)(a) “Medical Records”

[11] Orc Level 2 5120.21 (C)(1), ORC seconds. 3701.74 (A)(8)

[12] Orc Level 2149.43 (A)(1)(hour)

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