DeWine announced rules on trans care on Friday in order to stave off a potential veto override of the state's youth gender affirming care ban. These rules would kick most adults off their care.
Again, anyone affected by this, consider coming to Pittsburgh. We're not that far away from Ohio, we have a good number of places that provide gender-affirming care for adults using an informed consent model, and we're a sanctuary city for gender-affirming care, which means we will not provide any info to out-of-state governments or law enforcement.
The problem is that as GAC de facto (or outright) bans continue to spread across conservative states, it increases demand for the resources available in the dwindling number of remaining states, thus increasing wait times and the availability of care providers - effectively limiting care even where it’s allowed.
The city governments of Cincinnati, Columbus, and Cleveland (at least) really need to step up and simply say that this order will not be enforced in their jurisdictions as it violates their local anti-discrimination ordinances for gender identity. Who's going to try to enforce it, the Ohio State Patrol?
So Cincinnati has already declared the city a sanctuary city for trans healthcare, but the Ohio Legislature has also passed pre-emption laws that prohibit local cities & municipalities for enacting any laws that conflict with state laws - essentially prohibiting any kind of sanctuary city protections. You’re right- enforcement may be a challenge, but the impact of these laws & regulations is that it will force clinics to shut down because they won’t want to run afoul of the law. If legislators override the veto on HB68 and it becomes law, it has a provision to criminalize doctors who provide gender-affirming care - even if they simply refer patients to find care out of state. It is Draconian. 😢
Yes, but you know what? Bullies (which is what these Rethuglican legislators are) need to be stood up to and fought, and 99 times out of 100 they will tuck their tails and run. Bullies cannot be reasoned with or catered to in any way. Just imagine that the DAs in Hamilton, Franklin and Cuyahoga counties simply announce that this unconstitutional "law" won't be enforced in their jurisdiction (e.g. they will not prosecute) and that it will be "lowest priority" for law enforcement (which is polite speak for "we will ignore it"). Obviously, these three cities are where the vast majority of clinics are in Ohio.
Unfortunately, providers are licensed by the state which means they will lose their ability to practice and face state penalties if caught, regardless of their location. It's an absolutely horrendous situation for all involved
Sure, because unbiased bioethicists that aren't affiliated with SEGM or Genspect or similar groups just grow on trees and can easily be accessed and don't cost (I assume) an absolute fortune to contract, right? And everyone can afford 6 months of ongoing mental health counseling and evaluation from a psychiatrist, right? And every endocrinologist has a relationship with psychiatrists and bioethicists in a formal team setting, right? And every trans person in the state has no problem with having all of the state-approved documentation of their treatment with the state as gatekeeper of what is and isn't acceptable, right? And going off of hormones or puberty blockers people are already on for 6 months won't, like, result in lasting unwanted changes that will cost a lot more money to undo, right? I can 100% see the Florida boards doing this next, since they are still in the process of updating and adopting the final non-emergency rules for Florida's healthcare ban. This is horrible and not surprising, but very disheartening. They've been following the TRAP-law/anti-abortion playbook for a while now. Sigh.
Wasn't it just a week ago that people were praising DeWine for standing up to the Ohio's legislature?
This is even worse than Spence Cox, Utah's governor who took a year to do his 180.
I'll be surprised if we make it to the end of next week without Utah and other states doing the same. Pretty sure Cox is reading about this and is upset that he didn't do this first (last year he was the first Gov. to sign a ban on care for kids).
The Christofascists are making a huge push to redefine 'healthcare' for vast swathes of the population. I just want to point out that it's really hard to keep up with Republican swerves. They bitch up, down and center about "burdensome regulations" while doing shit like this to make people they don't like suffer for no legitimate reason.
We have been fighting the good fight against all these awful anti-trans bills & policies for at least 3 years in Ohio. Yesterday, my young adult trans kids gave up & announced they plan to move to MN. Thank you, Erin, for the trans legislative map tracker. It has helped my kids find the safe states to move to. (Here’s hoping Trump doesn’t become President and ban being transgender nationally.)
All of these states aren't just making trans healthcare more difficult to get (or illegal altogether), they are also making LISTS of trans people. This is extremely frightening.
No GOP-leaning state is safe for trans people, either short or long-term. Sooner or later, all or most of them are going to come for adult GAC just like Ohio did. This is (and will continue to) spread across these states like a virulent cancer. As each state does this, it just lowers the activation barrier for the next GOP- leaning state to do the same. Targeting vulnerable groups for political purposes is sadly just too easy and convenient. As for safe “blue” states, they will only be such unless and until the GOP might win the presidency in Congress less than a year from now.
This is very bad, but nonetheless it needs to be pointed out that these are still proposed rules. There is a public comment period, and legally, those comments do have to be taken into account, and there is precedent of massive public outcry derailing rules like these. People from Ohio should make sure to speak up!
I hate to be doom and gloom, but history (recent history) shows that bills like this will pass one way or the other. The only remedy is to flip states blue at this point. But honest I even wonder how long blue states will be on our side.
It doesn't matter whether it's blue, red, Democrat, Republican. This is an extremist religion issue using politics to discriminate against people that are not exactly like them with the ultimate goal of genocide...no different than Hamas. Family Watch International is an extremist Christian group that's working on spreading this hate around the world as to take away any safe haven we may have. The cruelty is beyond comprehension.
It makes no sense to report information regarding gender care to the state. This information should be confidential between the individual and their healthcare provider.
The practical result of this order, if enacted as is, will be trans adults taking grey market or DIY hormones. That will lead to more trans people suffering adverse medical consequences from improper dosage, adulteration, and infections. The death toll will probably not be zero.
It will also lead to people traveling out of state for surgeries, just like abortion. That's an inconvenience for relatively well-off people and a big but not insurmountable obstacle for middle class folks, but it puts treatment out of reach for marginalized people.
A great deal of information is available about safe and effective doses of hormones. See for example the slides of my presentation on gatekeeping and hormone treatment at https://github.com/daira/transhealth (the first two sections mainly concern UK healthcare, but the third section has a lot of information about specific meds that is country-independent, and links to other reliable sources).
I take the point that the availability of such information does not guarantee that everyone who is self-medding will be taking the right dose. But neither do established healthcare systems, even in more trans-friendly states; too many doctors are just plain incompetent, frankly. And too many are transphobic or misled about risks and will intentionally under-dose you.
Hormones are considerably safer than a wide variety of other medical drugs. They're safer than some common over-the-counter drugs like acetaminophen: the latter's effective dose is very much closer to its potentially harmful dose than is the case for estradiol, progesterone, or testosterone.
At most, an inappropriate hormone dose can affect long-term risks of certain conditions such as breast cancer or VTE, but the actual extent of risks from that are often overemphasized as a gatekeeping tactic, as explained in my presentation linked above. I have never heard a report of anyone dying from any acute condition primarily caused by hormone usage. Unless the hormones are exacerbating some other condition like a hormone-sensitive cancer or a thyroid condition, that's implausible at doses that anyone is likely to take.
In fact, you are probably more likely to die or become long-term disabled from being forced to attend excessive gatekeeping appointments with doctors who don't take adequate infection-control precautions and getting acute or long COVID as a result, than you are to suffer those effects from self-medding.
I do not recommend DIY (meaning home-compounding from raw ingredients), for reasons I go over in the presentation. Grey-market is the way to go for most people who can't get hormones from an established health system. Yes many people cannot afford that, and that's the primary difficulty.
So let's not exaggerate self-medding risks; it's just not helpful. As you say, many trans people will have to consider that option now, and they are best served by accurate information, not scare stories about hypothetical deaths or infection.
Self-medicating can be done safely, and a whole lot of trans people have done it historically.
I just hope everyone who needs or chooses that route has access to good information and supplies, and ideally a good support system, especially with injections. The risks are a lot higher than with ingestion or transdermal delivery.
My biggest concern is for the people who don’t have good information or support. Needle reuse isn’t great, and needle sharing is downright dangerous.
These people hate regulations until it works out in their favor to hurt the people they consider the enemy. This whole country gets scarier for us by the minute.
Again, anyone affected by this, consider coming to Pittsburgh. We're not that far away from Ohio, we have a good number of places that provide gender-affirming care for adults using an informed consent model, and we're a sanctuary city for gender-affirming care, which means we will not provide any info to out-of-state governments or law enforcement.
The problem is that as GAC de facto (or outright) bans continue to spread across conservative states, it increases demand for the resources available in the dwindling number of remaining states, thus increasing wait times and the availability of care providers - effectively limiting care even where it’s allowed.
Well, providers can and should move to the remaining states then to handle the increased demand. They'll always be welcome here in Pittsburgh.
Vanessa Schmithorst, thank you for this information. Greatly appreciated.
The city governments of Cincinnati, Columbus, and Cleveland (at least) really need to step up and simply say that this order will not be enforced in their jurisdictions as it violates their local anti-discrimination ordinances for gender identity. Who's going to try to enforce it, the Ohio State Patrol?
So Cincinnati has already declared the city a sanctuary city for trans healthcare, but the Ohio Legislature has also passed pre-emption laws that prohibit local cities & municipalities for enacting any laws that conflict with state laws - essentially prohibiting any kind of sanctuary city protections. You’re right- enforcement may be a challenge, but the impact of these laws & regulations is that it will force clinics to shut down because they won’t want to run afoul of the law. If legislators override the veto on HB68 and it becomes law, it has a provision to criminalize doctors who provide gender-affirming care - even if they simply refer patients to find care out of state. It is Draconian. 😢
Yes, but you know what? Bullies (which is what these Rethuglican legislators are) need to be stood up to and fought, and 99 times out of 100 they will tuck their tails and run. Bullies cannot be reasoned with or catered to in any way. Just imagine that the DAs in Hamilton, Franklin and Cuyahoga counties simply announce that this unconstitutional "law" won't be enforced in their jurisdiction (e.g. they will not prosecute) and that it will be "lowest priority" for law enforcement (which is polite speak for "we will ignore it"). Obviously, these three cities are where the vast majority of clinics are in Ohio.
Unfortunately, providers are licensed by the state which means they will lose their ability to practice and face state penalties if caught, regardless of their location. It's an absolutely horrendous situation for all involved
Sure, because unbiased bioethicists that aren't affiliated with SEGM or Genspect or similar groups just grow on trees and can easily be accessed and don't cost (I assume) an absolute fortune to contract, right? And everyone can afford 6 months of ongoing mental health counseling and evaluation from a psychiatrist, right? And every endocrinologist has a relationship with psychiatrists and bioethicists in a formal team setting, right? And every trans person in the state has no problem with having all of the state-approved documentation of their treatment with the state as gatekeeper of what is and isn't acceptable, right? And going off of hormones or puberty blockers people are already on for 6 months won't, like, result in lasting unwanted changes that will cost a lot more money to undo, right? I can 100% see the Florida boards doing this next, since they are still in the process of updating and adopting the final non-emergency rules for Florida's healthcare ban. This is horrible and not surprising, but very disheartening. They've been following the TRAP-law/anti-abortion playbook for a while now. Sigh.
Might as well require trans people to get the approval of their local astronaut. Just about as common and available.
Wasn't it just a week ago that people were praising DeWine for standing up to the Ohio's legislature?
This is even worse than Spence Cox, Utah's governor who took a year to do his 180.
I'll be surprised if we make it to the end of next week without Utah and other states doing the same. Pretty sure Cox is reading about this and is upset that he didn't do this first (last year he was the first Gov. to sign a ban on care for kids).
What a bunch of evil fuckers!!!
Yep. Never about the kids. And bans are unconstitutional. So I guess the plan is to put so many hurdles up it's effectively banned. F these people.
Do we have another candidate for a DO NOT TRAVEL state? Sure seems that way. There is going to be a mass exodus out of Ohio now too.
The Christofascists are making a huge push to redefine 'healthcare' for vast swathes of the population. I just want to point out that it's really hard to keep up with Republican swerves. They bitch up, down and center about "burdensome regulations" while doing shit like this to make people they don't like suffer for no legitimate reason.
We have been fighting the good fight against all these awful anti-trans bills & policies for at least 3 years in Ohio. Yesterday, my young adult trans kids gave up & announced they plan to move to MN. Thank you, Erin, for the trans legislative map tracker. It has helped my kids find the safe states to move to. (Here’s hoping Trump doesn’t become President and ban being transgender nationally.)
All of these states aren't just making trans healthcare more difficult to get (or illegal altogether), they are also making LISTS of trans people. This is extremely frightening.
No GOP-leaning state is safe for trans people, either short or long-term. Sooner or later, all or most of them are going to come for adult GAC just like Ohio did. This is (and will continue to) spread across these states like a virulent cancer. As each state does this, it just lowers the activation barrier for the next GOP- leaning state to do the same. Targeting vulnerable groups for political purposes is sadly just too easy and convenient. As for safe “blue” states, they will only be such unless and until the GOP might win the presidency in Congress less than a year from now.
This is very bad, but nonetheless it needs to be pointed out that these are still proposed rules. There is a public comment period, and legally, those comments do have to be taken into account, and there is precedent of massive public outcry derailing rules like these. People from Ohio should make sure to speak up!
I hate to be doom and gloom, but history (recent history) shows that bills like this will pass one way or the other. The only remedy is to flip states blue at this point. But honest I even wonder how long blue states will be on our side.
It doesn't matter whether it's blue, red, Democrat, Republican. This is an extremist religion issue using politics to discriminate against people that are not exactly like them with the ultimate goal of genocide...no different than Hamas. Family Watch International is an extremist Christian group that's working on spreading this hate around the world as to take away any safe haven we may have. The cruelty is beyond comprehension.
Which is hilarious considering that they are literally not practicing what they preach (former beleiver speaking from experience)
Exactly!
It's the do as I say not as I do syndrome.
It makes no sense to report information regarding gender care to the state. This information should be confidential between the individual and their healthcare provider.
So he vetoed the bill because it wasn’t bad enough.
The practical result of this order, if enacted as is, will be trans adults taking grey market or DIY hormones. That will lead to more trans people suffering adverse medical consequences from improper dosage, adulteration, and infections. The death toll will probably not be zero.
It will also lead to people traveling out of state for surgeries, just like abortion. That's an inconvenience for relatively well-off people and a big but not insurmountable obstacle for middle class folks, but it puts treatment out of reach for marginalized people.
A great deal of information is available about safe and effective doses of hormones. See for example the slides of my presentation on gatekeeping and hormone treatment at https://github.com/daira/transhealth (the first two sections mainly concern UK healthcare, but the third section has a lot of information about specific meds that is country-independent, and links to other reliable sources).
I take the point that the availability of such information does not guarantee that everyone who is self-medding will be taking the right dose. But neither do established healthcare systems, even in more trans-friendly states; too many doctors are just plain incompetent, frankly. And too many are transphobic or misled about risks and will intentionally under-dose you.
Hormones are considerably safer than a wide variety of other medical drugs. They're safer than some common over-the-counter drugs like acetaminophen: the latter's effective dose is very much closer to its potentially harmful dose than is the case for estradiol, progesterone, or testosterone.
At most, an inappropriate hormone dose can affect long-term risks of certain conditions such as breast cancer or VTE, but the actual extent of risks from that are often overemphasized as a gatekeeping tactic, as explained in my presentation linked above. I have never heard a report of anyone dying from any acute condition primarily caused by hormone usage. Unless the hormones are exacerbating some other condition like a hormone-sensitive cancer or a thyroid condition, that's implausible at doses that anyone is likely to take.
In fact, you are probably more likely to die or become long-term disabled from being forced to attend excessive gatekeeping appointments with doctors who don't take adequate infection-control precautions and getting acute or long COVID as a result, than you are to suffer those effects from self-medding.
I do not recommend DIY (meaning home-compounding from raw ingredients), for reasons I go over in the presentation. Grey-market is the way to go for most people who can't get hormones from an established health system. Yes many people cannot afford that, and that's the primary difficulty.
So let's not exaggerate self-medding risks; it's just not helpful. As you say, many trans people will have to consider that option now, and they are best served by accurate information, not scare stories about hypothetical deaths or infection.
Self-medicating can be done safely, and a whole lot of trans people have done it historically.
I just hope everyone who needs or chooses that route has access to good information and supplies, and ideally a good support system, especially with injections. The risks are a lot higher than with ingestion or transdermal delivery.
My biggest concern is for the people who don’t have good information or support. Needle reuse isn’t great, and needle sharing is downright dangerous.
And HRC just sent out an email yesterday praising this fool
These people hate regulations until it works out in their favor to hurt the people they consider the enemy. This whole country gets scarier for us by the minute.