“In many ways, this outcome is even worse than the lack of a veto,” wrote Zinnia Jones, a researcher and writer of Gender Analysis, about DeWine’s new strategy. Jones has been analyzing and reporting on similar efforts at using administrative rules to limit access to gender-affirming care, as Florida Governor Ron DeSantis attempted in 2022. “While this was previously a question of whether gender-affirming medical care for youth would be banned or not, this veto has instead been used as an opportunity to target and restrict care for transgender adults, a vastly larger segment of the trans population than youth.”
Some of the rules proposed concern health care providers, such as requiring they report every “diagnosis of a gender-related condition” to the Ohio state Department of Health within thirty business days. The rules also mandate that providers track and report the age, “biological sex,” “specific information about the nature of any diagnosis,” their “treatment plan” (such as hormone replacement therapy, or HRT), and if those individuals cease treatment or “detransition.” The health department is directed to “share aggregate data collected pursuant to this rule” every six months with the state legislature and the public. Anything can be made public so long as it is “in summary, statistical, or aggregate form.” How, or if, this data is meant to improve health outcomes is not proposed or described. It’s also unclear why the state wants to publish a public summary of all the reasons expressed by individual adults about why they are seeking transition care. Other proposed rules could directly impede access to care by mandating treatment from multiple, costly, and already difficult-to-access specific medical professionals. These new policies would mandate that, to lawfully provide gender-affirming care to adults or minors, including even “diagnosis of a gender-related condition,” the patient must get in-person, direct services from a psychiatrist, an endocrinologist, and have a “written, comprehensive, multi-disciplinary care plan … which has been reviewed by a medical ethicist.” For many trans people in Ohio, this will be nearly impossible to obtain. It is a rule of exclusion.
“The rules as written seem tailor-made to eliminate care from smaller clinics, and leave standing larger hospital networks,” Cam Ogden, a member of Trans Allies of Ohio, told me this week. If these rules went into effect, Ogden said, “the clinic that I get my HRT from would not be able to meet these demands and would likely have to shut down their gender-affirming care provision.” While a number of pediatric hospitals in the state provide care involving the multidisciplinary teams the new rules would now require of adults, as Ogden explained, there are only so many. “If every single transgender person in the state is mandated to be a part of one of those teams, then we’re going to have to go out of state for care.”