Doctors in Ohio’s major children’s hospitals say a bill that would regulate and restrict gender-affirming care puts both the patients and the doctors at risk, and brings government overreach into medical decisions.
House Bill 454 had its fourth hearing in the Ohio House Families, Aging and Human Services Committee on Wednesday, where opponent testimony was heard from leaders of gender programs and treatment centers, all of whom said not only is a disconnect between a gender assigned at birth and one’s identity a medical condition, but it is one that should get the treatment that is needed.
The decision as to how that treatment is conducted should not be made by the Ohio legislature, the medical professionals argued, but by those going through the process.
“Decisions regarding treatment of gender dysphoria should be left to parents and their adolescents in consultation with their health care providers,” Dr. Armand Antommaria, of the Cincinnati Children’s Hospital & Medical Center, told the committee on Wednesday.
The bill, introduced by Republican state Reps. Gary Click and Diane Grendell, bars health professionals from providing “gender transition procedures” to minors, or even referring minors to doctors for the procedures.
Medical professionals who provide such services could be accused of engaging in “unprofessional conduct,” which could affect their medical license, and could even expose doctors to lawsuits.
The bill also restricts public funds from going to organizations who provide the procedures and would keep insurance coverage from going to gender-affirming care in minors, including Medicaid.
All school staff, including school nurses, would be banned from “withholding, or encouraging or coercing a minor to withhold, from the minor’s parent or legal guardian, information that a minor’s gender identity is inconsistent with the minor’s biological sex.”
But the physicians who spoke on the bill on Wednesday said the parents are engaged in the entire process when treatment for gender dysphoria – when a person’s gender identity differs from their gender assigned at birth – is conducted at Ohio medical facilities.
“As a lifelong conservative, I implore you not to legislate personal family decision-making or override the professional practice of medicine,” said Nick Lashutka, president and CEO of the Ohio Children’s Hospital Association.
Supporters of the bill include the religious lobby group Center for Christian Virtue, whose leaders deny that a person can be anything other than the biological gender they were assigned at birth. Dr. David Axelson, head of the Department of Psychiatry and Behavioral Health at Nationwide Children’s Hospital, said starting from the standpoint that gender dysphoria is a medical diagnosis, not an elective procedure, is vital to helping with children’s health.
“Fundamental to our understanding of gender dysphoria is understanding and recognizing that medically, it is absolutely possible that a person’s gender identity can differ from their body for many reasons, and that these experiences are not choices or ideologies,” Axelson said.
Lashutka submitted estimates that the OCHA member hospitals have seen about 3,300 patients in clinics under the age of 18 for gender dysphoria.
Other data provided by Lashutka said patients receive a comprehensive evaluation by mental health specialists, and only 7% of minor patients have been prescribed “puberty blockers.” Only 35% of minor patients are prescribed hormone treatments, according to the OCHA data.
“No minor can or has received any treatment without parental or legal guardian consent,” Lashutka said. “There has never been evidence presented to the contrary.”
Antommaria said HB 454’s passage would “threaten the safety of some of Ohio’s most vulnerable children; it would threaten the mental health of adolescents with gender dysphoria.”
The committee did not conduct a vote on the bill Wednesday, but one clarification was made by Click. He said questions had arisen about the bill’s regulation of therapy as a “gender transition procedure.” The Legislative Service Commission decided counseling does not meet the definition of gender transition procedure under the bill, according to Click.
“In all the things (opponents and sponsors) disagree on, I think that’s one of the things we can all agree is that children do deserve to have counseling, and so we want to make sure that that’s possible,” Click said.
Late Wednesday evening, another trans bill was pushed through the House along party lines, despite having not had a hearing in committee since June of last year.
State Rep. Jena Powell’s bill to ban transgender athletes from competing in sports alongside others of their gender was added to a bill regarding local mentorship while it went through floor debate Wednesday night.
Republican supporters said the issue centered on fairness in sports, and several female legislators talked of their own experiences in sports, arguing about the biological differences between boys and girls.
“I got no issue with trans people,” said state Rep. Sara Carruthers, R-Hamilton. “I do have an issue with physically being able to outdo women in women’s sports.”
Democrats, wearing rainbow lapel pins in honor of June’s designation as LGBTQ+ Pride month, heavily criticized the bill.
“How nice it is that it’s 11 p.m. at night and we’re attacking trans kids in Ohio,” said state Rep. Kent Smith, D-Euclid.
State Rep. Richard Brown, D-Canal Winchester, called out sponsors for bringing an amendment that “is not germane at all” to the original bill’s purpose, and multiple Democrats criticized legislation of youth in Ohio, especially without passage by a House committee before it was presented on the floor.
“This is an issue searching for a problem that doesn’t exist,” said state Rep. Phil Robinson, D-Solon.
The bill must now go to the state Senate before it can move to the governor for signature.
Last June, when the House tried to push through the bill the first time, Gov. Mike DeWine criticized the measure.
“This issue is best addressed outside of government, through individual sports leagues and athletic associations, including the Ohio High School Athletic Association, who can tailor policies to meet the needs of their member athletes and member institutions,” the governor said in a statement.
Also as previously reported, only five transgender girls competed in women’s high school sports as of April of last year.
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