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The Guardian - US
The Guardian - US
World
Ava Sasani

Trans care at stake as Ohio Republicans hope to revive restrictive bill

A person holds a sign that reads 'trans kids lives matter'
Transgender rights advocates rally outside the Ohio statehouse in Columbus on 24 June 2021. Photograph: Stephen Zenner/SOPA Images/LightRocket via Getty Images

Ohio lawmakers will return to the statehouse on Wednesday as house Republicans attempt to revive HB 68, a bill that would ban gender-affirming care for trans youth.

The special session comes after Mike DeWine surprised fellow Republicans by vetoing HB 68 late last month, a move celebrated by LGBTQ+ advocates and parents of transgender children in the state.

“I believe the parents, not the government, should be making these crucial decisions for their children,” the Ohio governor said.

But opponents of HB 68 were confused when, just one week later, DeWine proposed unprecedented new restrictions on the rights of transgender adults.

“These rules are, in some ways, worse than the proposed statute,” said Chase Strangio, deputy director for transgender justice at the ACLU. “This amounts to a de facto ban on trans care.”

The governor on Friday unveiled administrative rules that would “go well beyond” the scope of HB 68.

“I believe we can address a number of goals in House Bill 68 by administrative rules that will have a better chance of surviving judicial review and being adopted,” the governor said in his speech last month announcing his veto.

“I share the legislature’s concerns about clinics that may pop up and try to sell patients inadequate or even ideological treatments.”

Many advocates and parents of transgender children in Ohio, still heartened by DeWine’s decision to break from his party and veto HB 68, assumed that the rules proposal was a political maneuver to block the state’s Republican supermajority from sidestepping the governor.

“I’d like to give DeWine the benefit of the doubt, that he’s implementing these rules and proposals to try to appease Republicans and avert a veto override,” said Mallory Golski, civic engagement and advocacy manager at Kaleidoscope Youth Center, a Columbus-based non-profit that advocates for LGBTQ+ youth in Ohio. “But inadvertently or intentionally he has made things worse.”

In an apparent bid to stop his fellow Republicans from overriding the veto, the governor on Friday announced administrative rules that would “go well beyond” the scope of HB 68. If the rules are, as many advocates believe, an effort to dissuade Republicans from overriding DeWine’s veto, that effort appears unsuccessful. House Republicans are expected to successfully vote to revive the bill during a highly anticipated special legislative session on Wednesday.

Though HB 68 focused on minors, the governor’s new proposal would require all patients seeking gender-affirming care – including adults – to obtain the “care and supervision” of a team of medical providers, including an endocrinologist, bioethicist and a psychiatrist. All trans patients would also be required to undergo “lengthy” mental health counseling.

“We’ve seen this playbook before, with abortion,” said Strangio. “You start by focusing the legal restriction on minors’ access to care, then expand those laws to adults later on.”

Under the new rules, medical providers would also be required to report data about trans patients every six months, tracking the number of patients who are diagnosed and treated for gender dysphoria. The rules would be enacted and enforced by the Ohio health agencies after a public comment period.

“If you’re old enough to register for the draft, to enter a contract, to vote, then you’re old enough to make your own healthcare decisions without the government involving itself,” said Nick Zingarelli, whose 14-year-old daughter is transgender.

The Zingarelli family moved to Ohio by way of St Louis in 2022, after the Missouri legislature ramped up efforts to restrict trans minors’ access to gender-affirming care. Born and raised in Cincinnati, Zingarelli thought his home state of Ohio would offer his teenage daughter “a less politicized existence”.

“But we came back to Ohio and unfortunately had to continue to fight a lot of the same legislative battles here,” Zingarelli said.

When the governor blocked HB 68 late last month, Zingarelli breathed a sigh of relief. He and his wife were among the dozens of parents of transgender children who fought against the Ohio bill since its introduction nearly one year ago.

Zingarelli and the broader coalition of parents turned advocates anticipated some resistance from the legislature: Republicans hold a supermajority in both the Ohio house and senate, meaning lawmakers could override the governor’s veto. The parents were disappointed, yet unsurprised, when the Republican speaker, Jason Stephens, announced that the Ohio house would reconvene weeks earlier than scheduled in an attempt to revive HB 68.

The parents did not anticipate, however, that the governor might use executive authority to affect the lives of trans adults.

LGBTQ+ advocates compared DeWine’s proposed rules to the targeted regulation of abortion providers, or Trap laws – legal measures that regulate where abortions may be provided and performed. Major medical organizations oppose Trap laws and have called them clandestine attempts to limit abortion access through costly and medically unnecessary requirements.

“It’s a similar strategy here,” said Golski. “They’re telling us, don’t worry, care is still legal, but here are all the new hoops you have to jump through to make sure you’re complying with this vague and confusing rule.”

Golski and other LGBTQ+ advocates in Ohio spent the weekend scrambling to decode the proposed rules from DeWine.

“Does every single clinic need its own bioethicist, or do you need to assign one to every single patient? What qualifies as the legal definition of a bioethicist?” she said. “Not to mention, there’s already such a shortage of psychiatrists that are trained in caring for trans patients.”

Ohio, like most states, has suffered from a growing shortage of mental health workers in recent years. According to the US Department of Labor and Statistics, Ohio has approximately one psychiatrist per every 10,000 people in the state.

Adult trans patients at a Columbus-based clinic told the Guardian this week they were warned by providers that the clinic would likely have to shut down if the governor’s rules took effect.

Still, transgender Ohio residents hope that the senate, typically more moderate than the house, will lose its zeal for a veto override. Advocates are also working to alter the language of DeWine’s administrative rules during the public comment period, when Ohio health officials will take into account the public’s concerns about the proposed rules.

“We’re really hoping that the state takes the public’s feedback into account,” Golski said. “What the legislature is trying to do with the veto override would be harder to reverse, but the administrative rules could be just as – if not more – devastating for trans people in this state.”

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