Transgender Legal Defense & Education Fund
Jan 19, 2024
January 19, 2024
Bruce Vanderhoff
Director
Ohio Department of Health
LeeAnne Cornyn
Director
Ohio Department of Mental Health & Addiction Services
Submitted electronically to ODHrules@odh.ohio.gov and MH-SOT-rules@mha.ohio.gov
RE: Comments on Draft Rules: 3701-3-17; 3701-59-06; 3701-83-61; 5122-26-19; and
5122-14-12
Dear Directors Vanderhoff and Cornyn:
We, the undersigned, represent a small section of the transgender, nonbinary, and
intersex community and their allies. We are submitting comments on the above-listed
rules related to gender-affirming medical care for transgender people in Ohio. As
experts in our lives and our health, and experts in the field of transgender health, we
condemn these proposed rules.
The primary practical effect of the proposed rules is to constrain health care options for
transgender adults in Ohio. If allowed to go into effect as written—or at all—these rules
will amount to the single most sweeping restrictions on medical care for transgender
adults anywhere in the United States.
It is patently clear that these rules did not arise from knowledge about or any concern
from within the transgender, nonbinary, and intersex communities. In fact, it is clear
from the proposed rules that expertise on trans health was not only ignored, but directly
contradicted.
Like all people, transgender people deserve comprehensive, competent care that
improves our health and well-being, instead of creating more barriers to care. The
imposition of burdens untethered from science or medical need will ultimately affect the
safety and appropriateness of medication management.
There are widely accepted clinical guidelines governing this area of health—standards
set by doctors and other medical professionals—that help ensure transgender people
get the highest levels of care possible. Treatment of transgender individuals with gender
dysphoria is governed by the World Professional Association for Transgender Health’s
Standards of Care, now in its eighth edition, and the Endocrine Society’s Clinical Practice
Guideline. The treatment protocols for treating gender dysphoria outlined in these
guidelines are recognized and accepted by every major medical association in the
United States.
Ohio’s proposed rules bear no resemblance to existing medical guidelines, and though
the majority of concerns outlined by Governor DeWine and in legislative debate
regarding HB 68 focused on care for minors, the proposed rules will severely constrain
care for adults.
These rules will not only impact transgender and nonbinary adults across Ohio: these
regulations deliberately continue the practice of nonconsenting surgeries on intersex
populations. Medical providers will leave Ohio or withdraw services, devastating not just
transgender patients but their cisgender patients as well.
Transgender people and their doctors are experts in determining what care each person
should access. These proposed rules take these individualized decisions out of the hands
of medical professionals and consenting patients, into the hands of politicians with no
expertise in health care, much less gender-affirming care.
Trans liberation and health rely on bodily autonomy and trusting us to make decisions
about our health and our bodies. We, the undersigned organizations, urge ODH and
ODMHAS to fully rescind these proposed rules.
Thank you for the opportunity to comment on the Draft Rules. If you have any questions,
please do not hesitate to contact us.
Sincerely,
American Civil Liberties Union of Ohio
Center for Constitutional Rights
CenterLink: The Community of LGBTQ Centers
City Counseling
Cleveland Aquatic Team
Clintonville Counseling and Wellness
Columbus Gay Men’s Chorus
Community AIDS Network/ Akron Pride Initiative (CANAPI)
Colors+
CWRU AIDS Clinical Trials Unit
Equality Federation
Equality Ohio
Human Rights Campaign
interACT: Advocates for Intersex Youth
Kaleidoscope Youth Center
LGBT Community Center of Greater Cleveland
LOVEboldly
Margie’s Hope
Movement Advancement Project
National Center for Lesbian Rights
National Center for Transgender Equality (NCTE)
OCTOPUS LLC (Organizing Communities Transgender Outreach Promoting United Support)
PFLAG National
Plexus LGBT & Allied Chamber of Commerce
Tandem Columbus
Transgender Law Center
Transgender Legal Defense & Education Fund (TLDEF)
Trans Joy Akron
TransOhio
Trans Allies of Ohio
The Trevor Project
True Colors United
cc: Governor Mike DeWine, submitted electronically via Giles Allen, Director of Legislative Affairs