DeWine Administration Releases Revised Gender Transition Services Rules

On February 7th, the DeWine Administration released updated rules for Gender Transition Services that were proposed by OhioMHAS and the Ohio Department of Health.  

As a result of the previous public comment period, OhioMHAS has made substantive changes to the proposed Gender Transition Services Rules, which we are pleased to see address many of the concerned raised by the Ohio Council and many others.  Highlights of the proposed new rules are the following:

  • The comments revealed a significant interest in the original drafts’ impact on adult patients. The revised rules are now applicable only to minors.
  • Recognizing concerns regarding limited availability of certain medical specialties, options for professionals included in the required multi-disciplinary care team were expanded and modified.
  • A point of confusion existed surrounding the review of care plans by a medical ethicist. The requirement for review by a medical ethicist was never applicable to individual patient care plans but rather provider operations. However, to alleviate confusion and because of assurances from healthcare leaders that providers already appropriately engage medical ethics professionals in this type of care, the proposed rules do not contain this requirement.

The OhioMHAS rules have been submitted to the Common Sense Initiative (CSI) Office for review. Links to the rules and Business Impact Analysis (BIA) are included below.  Comments regarding the rules can be submitted through the link on the OhioMHAS web site. Alternatively, comments may be sent separately to OhioMHAS at [email protected] and to the CSI Office at [email protected].  Comments are due by 5:00PM on Wednesday, February 14, 2024. 

5122-14-12.1 | Gender Transition Care (IP Hospitals)

5122-26-19 | Gender Transition Care.

Business Impact Analysis

Similarly, the Ohio Department of Health (ODH) issued a revised rule package with updates that partially address concerns raised for reporting on gender-related conditions and more narrowly define requirements for hospital and healthcare settings to those serving minors. Highlights of the ODH rule revision include:

  • In response to privacy concerns, the rules are now even more clear that the data collected will not identify individual patients.
  • The comments revealed a significant interest in the original draft’s impact on adult patients. The revised quality standard rules are now applicable only to care for minors.
  • Recognizing concerns about the limited availability of certain medical specialties, options for the mental health professionals included in the required multi-disciplinary care team were expanded and modified.
  • A point of confusion existed surrounding the review of care plans by a medical ethicist. The requirement for review by a medical ethicist was never applicable to individual patient care plans but rather to institutional operations. However, to alleviate confusion and because of assurances from healthcare leaders that institutions already appropriately engage medical ethics professionals in this type of care, the proposed rule’s requirement has been removed.

The updated ODH rules are available here.  ODH will now proceed with the rule adoption process, which includes review by the Ohio Common Sense Initiative (CSI) Office and subsequent filing with the Joint Committee on Agency Rule Review (JCARR).