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The SAFE Act returns to the Ohio Statehouse

The bill is the new version of House Bill 454 which sparked plenty of controversy before stalling out in the last session.

COLUMBUS, Ohio — Flanked by supporters and signs, Ohio Rep. Gary Click, R-Vickery, once again introduced a bill that would ban gender-affirming care for minors in the state.

The bill is called the SAFE (Saving Adolescents from Experimentation) Act, and it was delivered to the clerk’s office on Wednesday. It has yet to be assigned a bill number.

“We’re making sure that transgender young people have the highest quality and standards of care, that they’re not taken advantage of in this process for profit and for propaganda,” Rep. Click said.

The bill is similar to House Bill 454, which faced a lot of controversy before failing to make it through the last session.

This time, the bill contains similar language, with a bit more added. The SAFE Act would, among other things:

  • Ban a physician from performing gender-affirming surgery on a minor or prescribing a “cross-sex hormone” or puberty-blocking drug.
  • Ban a physician from “conduct that aids or abets” in those practices, which is language Rep. Click referred to when asked if the bill would prevent doctors from referring patients out of state.
  • Ban a mental health professional from diagnosing or treating a minor for a gender-related condition without first obtaining parental consent and screening the minor for other conditions, including depression, anxiety, ADHD, autism, and physical or sexual abuse.
  • Require each mental health professional who diagnoses or treats a minor for a gender-related condition to report to the Ohio Department of Health each year the number of minors being treated, biological sex, age, and comorbidities.
  • Ban Medicaid from including coverage for gender-transition services.

“With me, we have 40 people on this bill who are ready to protect and to defend young people who are experiencing gender identity disorder and keep them from being abused by the medical professionals, so-called,” Rep. Click said.

At the Wednesday press conference, Rep. Click also invited a mother to speak. She talked about her transgender child wanting to transition at age 14 and struggling to find a therapist who would help in the way she wanted.

“I wasn’t asked about his mental health history or the goals of therapy,” she said “I was asked if I wanted a dead son or a living daughter.”

The mother said she is not opposed to someone living as transgender or receiving care as an adult. She said her reason for advocating for the bill was to protect children like her own.

“He was promised a magic solution to real problems,” she said. “His mental health was ignored in lieu of a quick fix that in reality fixes nothing on the inside, which is where the problem lives. When the euphoria of the drugs and the endorphins from surgery subside, they’re still the same person on the inside, with the same problems, only now they’re a shell of themselves, having cut off body parts in a desperate search to cut out the emotional turmoil that they’re going through.”

Also at the press conference was Scott Newgent, who identifies himself as a trans man and lesbian. He is from Texas and often travels to speak out against medical transitioning.

“I’m here today to put an end to the idea that medically transitioning children is about human rights,” he said. “It is not. It’s about money. The truth is that medical transition is experimental, dangerous, and it doesn’t cure anything.”

Both Newgent and Click said the impetus for the bill came from families and members of the LGBTQ community who have faced challenges while transitioning or regretted their transitions. But Rep. Click admitted during the press conference that the stories of those families came to him through the Center for Christian Virtue, which approached him about the bill last session.

“The mere introduction of these bills is harmful to transgender youth,” said Maria Bruno, public policy director for Equality Ohio, a LGBTQ advocacy and legal aid organization.

Bruno pointed out what she found to be concerning in the new bill’s language. The bill would prevent judges from awarding custody to a parent based on which parent supports a child’s transition. Bruno also took issue with the “aiding and abetting” portion of the bill.

Rep. Click was asked on Wednesday whether a doctor could refer a minor patient for treatment out of state, and he answered that that would be considered aiding and abetting.

“It’s incredibly harmful,” Bruno said of the bill. “It’s also just a really, really scary precedent to set that a doctor, a parent, and a child could all agree on the same course of treatment, and a politician says, no, that’s actually outlawed.”

Also important to note about the bill is that it would not prevent surgery for someone born with ambiguous or genitalia for both sexes. It also would require minors currently on gender-affirming medication to transition off them within six months.

The American Medical Association supports gender-affirming care.

Improving access to gender-affirming care is an important means of improving health outcomes for the transgender population. Receipt of gender-affirming care has been linked to dramatically reduced rates of suicide attempts, decreased rates of depression and anxiety, decreased substance use, improved HIV medication adherence and reduced rates of harmful self-prescribed hormone use.

The AMA supports public and private health insurance coverage for treatment of gender dysphoria and opposes the denial of health insurance based on sexual orientation or gender identity.

The American Academy of Pediatrics also has issued a statement urging support and care for transgender children and adolescents.

The AAP recommends taking a “gender-affirming,” nonjudgmental approach that helps children feel safe in a society that too often marginalizes or stigmatizes those seen as different. The gender-affirming model strengthens family resiliency and takes the emphasis off heightened concerns over gender while allowing children the freedom to focus on academics, relationship-building and other typical developmental tasks.

Additional AAP recommendations include:

Providing youth with access to comprehensive gender-affirming and developmentally appropriate health care.

Providing family-based therapy and support be available to meet the needs of parents, caregivers and siblings of youth who identify as transgender.

Making sure that electronic health records, billing systems, patient-centered notification systems and clinical research are designed to respect the asserted gender identity of each patient while maintaining confidentiality.

Supporting insurance plans that offer coverage specific to the needs of youth who identify as transgender, including coverage for medical, psychological and, when appropriate, surgical interventions.

Advocacy by pediatricians within their communities, for policies and laws that seek to promote acceptance of all children without fear of harassment, exclusion or bullying because of gender expression.

Rep. Click, however, said he does not trust the AAP.

“The AAP does not represent all, they may be an association, and they may have thousands of members, but they do not represent the view of all of those pediatricians,” he said. “I’ve talked to pediatricians who totally oppose this, I’ve talked to several doctors who totally oppose this.”

Bruno admits it will be a challenge to fight the bill again this session, adding that the consequences could be dire, from doctors facing criminal charges to entire wings of hospitals being shut down.

“What we are seeing is a lot of interest groups and a lot of people who have political or religious views that conflict with someone else’s life, and they feel entitled to make big life decisions on behalf of other people,” she said. “And that’s just a concerning trend that we are seeing.”

The Ohio Children’s Hospital Association also released a statement on behalf of Nick Lashutka, president and CEO.

“As children’s hospitals, our job is to save, protect and enhance the lives of our patients in our care and their families. Based on proven research, we know that children receive the best quality care and best possible outcomes when the patient care team – including the family and clinicians – work together to make medical decisions. All treatment provided in our children’s hospitals has always required and will always require parental consent and support to optimize the health and wellbeing of our patients. 

We are experiencing a pediatric behavioral health crisis never seen before in our state or nation. If enacted, this legislation will restrict access to care at a time when families need mental health supports more than ever. 

We remain opposed to any legislation that inserts government between patients, their families, and medical professionals in decisions about what is best for their care.”

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