House Bill (HB) 68, a bill prohibiting gender affirming care for minors, had a third hearing in the House Public Health Policy Committee on May 24. It is the Ohio Academy of Family Physicians’ (OAFP) policy to oppose any laws and regulations that interrupt or interfere in the confidential relationship between a patient and their physician. As HB 68 would interfere in the patient-physician relationship, the OAFP opposes this bill, and opposed a similar bill in the previous general assembly.
OAFP Board Member Mark McLoney, MD, presented opposition testimony on behalf of the OAFP for the consideration of the committee. The text of the testimony appears below:
Chairman Lipps, Vice Chairman Stewart, Ranking Member Liston, and members of the Ohio House Public Health Policy Committee, my name is Dr. Mark Allen McLoney. I am a board member of the OAFP, a second-generation family physician, and a provider of LGBT care in a northeast Ohio clinic. Thank you for the opportunity to provide testimony in opposition in HB 68 on behalf of myself and the OAFP.
As I said, I am a second-generation family physician. My father was a family physician who had a practice in my hometown. In addition to living in Ohio all my life, I am a First Family of Ohio member, meaning I can trace my family back to their settlement in Ohio before it became a state.
I first obtained my master’s degree in human genetics. Then, following four years of medical school, and a three year residency in family medicine, I began practicing medicine in the Cleveland area and have continued for 30 years.
When I graduated medical school in 1989, I took an oath to serve my patients to the best of my ability. We did not take the Hippocratic oath, but the Oath of Maimonides which includes the following lines:
May the love for my art actuate me at all times; may neither avarice nor miserliness, nor thirst for glory or for a great reputation engage my mind; for the enemies of truth and philanthropy could easily deceive me and make me forgetful of my lofty aim of doing good to Thy children.
Grant me the strength, time, and opportunity always to correct what I have acquired, always to extend its domain; for knowledge is immense and the spirit of man can extend indefinitely to enrich itself daily with new requirements. Today he can discover his errors of yesterday and tomorrow he can obtain a new light on what he thinks himself sure of today.
I take my oath VERY seriously.
I, along with the OAFP, strongly oppose any legislation that infringes, or has the potential to infringe on the clinical practice of medicine, that interferes with the patient-physician relationship, or that nullifies the professional judgment of physicians by requiring that certain procedures or treatments be delayed without regard to medical condition.
Legislation like HB 68 mandates certain physician behavior without regard to the patient’s best interest, shows indifference for the patient-physician relationship, and disregards standard of care/evidence-based medicine.
Family physicians often serve as the initial point of contact for patients’ health concerns. Doctors in this specialty are trained to provide comprehensive healthcare for patients regardless of condition, to consider the impact of health on families, to understand social determinants of health, and to assist our patients in navigating the healthcare system including other specialty care. HB 68 would not only criminalize best practice medical care for youth that is backed by the American Academy of Family Physicians, the American Medical Association, the American Academy of Pediatrics, the American Association of Clinical Endocrinology, and every other leading medial authority; it takes away the rights of parents to direct the upbringing and physical and mental health of their children.
Who is best placed to decide how to address the health and safety of individual children? Patients and their families along with their licensed healthcare professional are in the best position to determine what is best for each patient.
HB 68 would codify non-scientific standards into individualized clinical decision-making and could prevent the provision of appropriate and potentially lifesaving care.
Thank you for the opportunity to speak against this bill which will set a dangerous precedent in depriving children of individualized care, deprive parents of their right to determine what is best for their own children, and deprive doctors of their ability to practice evidence-based medicine grounded in their professional judgment.
- Prohibit a physician from knowingly performing gender reassignment surgery on a minor.
- Prohibit a physician from knowingly prescribing a cross-sex hormone or puberty blocking drug to a minor for the purpose of assisting with gender transition.
- Prohibit a physician from aiding or abetting those prohibited practices.
- Prohibit a mental health professional from diagnosing or treating a minor for a gender related condition without first obtaining parental consent and screening for other comorbidities, abuse, and traumas.
- Establish penalties for physicians and mental health professionals who engage in conduct the bill prohibits.
- Prohibit Medicaid coverage of gender transition services for minors, among additional restrictions.
The full bill text and analysis of HB 68 can be accessed on the Ohio legislature’s website.
This is another example of how the OAFP, AAFP, AMA, AAP, AACE, and “every other leading media authority “ has lost touch with reality and likely a large number of their constituents (and former constituents who are no longer members because of this).
“ The science” tells me that humans with genotype including a Y chromosome and by nature having gonadal tissue that is testicular are males and those whose genotype is absent a Y chromosome and have naturally gonadal tissue that is ovarian are females. In my 40+ years as a family physician, I have never “assigned gender at birth” but rather objectively identified the sex of the newborn based on phenotype. If there was question, we would do further investigation with ultrasound or genotype (I don’t recall resorting to gonadal histology ever, but that would be another option).
As individuals mature, I understand that some have gender dysphoria and wish to be the sex other that which they are by nature. I also understand that the evolution in thinking was to first argue that gender and sex are not synonymous and it is possible for an individual to be of male sex but of female gender (or vice versa) because gender can be fluid and subjective, unlike sex. I would refer to such individuals as effeminate males or masculine females. I would argue that gender affirming therapy would be therapy to help these individuals to cope with and thrive as such.
However, somehow (and I suspect largely due to activist organizations lawsuits or threats of lawsuits) the evolution of the “transgender” ideology then took the leap of declaring “my gender is my sex,” and unfortunately there were sufficient advocates of this ideology (including those making large profits from it) that we have now redefined “gender affirming care” as hormonal and operative therapies that are attempts at sex change.
The Europeans, who were ahead of the U.S.A. in this advocacy, are backing away from it because they are seeing increasingly the harm that is being done by these “therapies.”
Please, please, OAFP, back away from this lunacy!
Also, if you have any real concern regarding parental rights, start a campaign to defeat the proposed Reproductive Freedom amendment to the Ohio Constitution, which if passed, will put Ohio among the states of which we are now hearing horror stories of the state taking children from their parents for trying to influence their minor child’s “reproductive freedom” in any manner contrary to the will of the minor/dependent “individual.”
So, a person who suffers from testosterone insensitivity syndrome, who appears outwardly female, is truly a male?
A baby with congenital adrenal hyperplasia may have an enlarged clitoris that resembles male genitalia so the baby is assigned as male at birth although they have XX chromosomes.
In your 40+years of practice, who has the right to determine their own health? The patient, or the state.
As an Ob/Gyn who has practiced in Ohio for the past 30 years and a committee member who listened to the testimony that Dr. McLoney and others provided at the state house I was very impressed with the passion and knowledge that these physicians have with providing the best care possible to a group that is being marginalized and attacked to further a political agenda. Gender affirming care and reproductive care belong in the exam room not in the state house. As Dr McLoney said the standard we should all adhere to is do no harm and by banning gender affirming care we will cause significant harm. LGBTQ youth who are supported and given care have less mental health issues and suicidal ideation than those who are not. As the numbers show when it comes to reproductive care states that have restricted abortion and contraception care have higher maternal and infant mortality rates than those who don’t. Physicians should be able to practice evidence based medicine without fearing criminal penalties. Politics do not belong in the exam room.
Ohio politicians are so afraid of the majority support for reproductive rights that they have voted in a special election in August. This is Issue 1 which would “elevate the ability to change the constitution”. The real question is why would anyone vote for less rights than they have now? Issue 1 would increase the percentage of voters needed to pass amendments to the constitution from a simple majority to 60%. This is what minority rule would look like. Right now the only recourse citizens have is a constitutional amendment. Constitutional amendments can only address one issue at a time and as we all know physicians cannot provide care to minors without consent. The language is simple and doesn’t address gender affirming care or parental rights.
In conclusion, learn the facts and Vote No in August and Yes in November.
Dr. McLoney is literally saving lives every day. I am proud to call him a colleague.
Thank you to the OAFP and Dr. McLoney for this powerful and important testimony.
Gender affirming care can literally save lives. Lawmakers have absolutely no business telling doctors how to practice evidence-based medicine. I’m glad to see the OAFP taking a stance on this issue.