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Ohio Governor Orders Restrictions on Transgender Care After Vetoing Ban

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Just a week after vetoing a ban on gender-affirming care for minors, Gov. Mike DeWine of Ohio issued an executive order on Friday banning gender-transition surgeries for anyone under 18 at state hospitals or ambulatory clinics.

The governor also directed Ohio health agencies to propose rules that require a team of medical providers, including an endocrinologist, a bioethicist and a mental health specialist, be involved in prescribing gender-affirming care to people.

Gov. Mike DeWine at a news conference last month in Columbus, Ohio.Credit…Carolyn Kaster/Associated Press

Background

The moves come as the state’s House of Representatives prepares to return early next week in an effort to override the governor’s veto on the bill that would have barred transgender minors from receiving puberty blockers, hormone therapy and surgeries. Mr. DeWine’s veto was a rare rejection of transition care bans from a Republican governor.

Though gender-transition surgeries in adolescents are extremely rare, minors are increasingly seeking top surgeries, or breast removal procedures, to better align their bodies with their gender identities.

Medical professionals have debated which children should be receiving gender-affirming treatments and at what age. But leading medical groups in the United States, including the American Academy of Pediatrics, say such care should be available to minors and oppose legislative bans. Under the proposed rules that Mr. DeWine directed health agencies to draft, parents would also need to explicitly give consent for all treatments.

On Friday, Mr. DeWine said his executive order would take the thornier question of surgeries “off the table.” But the governor stood by his veto of the broader ban on gender-affirming care.

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

Why It Matters

It’s possible the governor is trying to compromise with Republican lawmakers in the state by reinstating a part of the bill that he had vetoed. His directives also appeared to add new restrictions to adult transition care that weren’t included in the bill.

For transgender adults, many studies have shown that transition care can improve psychological well-being and quality of life. But several states have sought to impose adult-care regulations, including requirements that doctors, instead of a nurse practitioner, oversee hormone therapy, and that such care be provided through in-person visits.

Under the proposed rules, transgender people must provide “sufficient informed consent” for gender-affirming care after “comprehensive” and “lengthy” mental health counseling. Hospitals and clinics would also be required to report diagnoses of gender dysphoria and treatments to state health officials every six months.

The debate over medical care for transgender minors is one strand of a concerted effort by the Republican Party to mobilize cultural conservatives around transgender issues. Just last year, 22 states passed bans on transition care for minors. Some also put in place legislation affecting other facets of transgender people’s lives, including ones on sports participation, bathroom use and drag performances.

What’s Next

The Ohio House has scheduled a special session for Wednesday, where representatives are expected to vote on whether to override the governor’s veto. The State Senate is expected to vote later in the month.

Mr. DeWine said his administration would pursue the new rules regardless of a veto override.

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