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Organizational Comment on ODH and ODMHAS Draft Rules

Transgender Legal Defense & Education Fund

Jan 19, 2024

January 19, 2024

Bruce Vanderhoff


Ohio Department of Health

LeeAnne Cornyn


Ohio Department of Mental Health & Addiction Services

Submitted electronically to and

RE: Comments on Draft Rules: 3701-3-17; 3701-59-06; 3701-83-61; 5122-26-19; and


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


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.


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)


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


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


Trans Allies of Ohio

The Trevor Project

True Colors United

cc: Governor Mike DeWine, submitted electronically via Giles Allen, Director of Legislative Affairs

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