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Parental Approval Mandate for Diagnosing Gender-Related Conditions in Minors under Ohio House Bill 68

Client Alert

Effective August 6, 2024, mental health professionals cannot diagnose or treat a minor presenting with a gender-related condition without first obtaining consent from one of the minor's parents, a legal custodian, or a guardian. The law, established by Ohio House Bill 68 (HB 68) and recently upheld by a Franklin County Common Pleas Court judge, imposes stringent requirements on the process that must be followed in these cases.

This mandate applies to a wide range of professionals, including advanced practice registered nurses (APRNs) specializing in psychiatric-mental health, psychiatrists, psychologists, licensed social workers, counselors, and marriage and family therapists.

HB 68 defines a “gender-related condition” broadly to include any situation where an individual feels an incongruence between their gender identity and biological sex, with gender dysphoria being the most commonly recognized condition. Before addressing any gender-related condition, mental health professionals are required by law to first screen the minor for other comorbidities, including depression, anxiety, ADHD, and autism spectrum disorder. Additionally, professionals must assess the minor for signs of physical, sexual, mental, or emotional abuse, as well as other traumas that might be influencing the gender-related condition.

In other words, providers must account for the order of operations required by HB 68 (diagnosing gender conditions last) and parents/guardians need to fully consent to that plan of action. If providers do not take both steps, then they are considered to be engaging in “unprofessional conduct” that could subject them to discipline by their professional licensing board.

If you have any questions regarding HB 68 or would like assistance ensuring your policies and procedures comply with the new law or any of its provisions, please contact BMD Healthcare Member Daphne Kackloudis at dlkackloudis@bmdllc.com or Attorney Jordan Burdick at jaburdick@bmdllc.com.


Pre and Postnuptial Agreements | Necessary, Maybe, What Happened to Forever?

Both Florida and Ohio now allow clients to enter into a prenuptial or postnuptial agreement prior to marriage or after marriage (Ohio previously did not allow postnuptial agreements). Both documents have statutory guidelines that must be followed in terms of execution and financial disclosure.

DHS Ends All Employment Authorization Auto-Extensions

Effective October 30, 2025, DHS ends all automatic work authorization renewals. The 540-day extension applies only to renewals filed before this date, and there is no grace period for expired EADs filed on or after October 30. Employers must audit EADs, train staff, ensure I-9 compliance, and plan for work authorization gaps. Penalties for noncompliance can be severe.

CMS’s Rural Health Funding Announcement

CMS has announced a $50 billion Rural Health Transformation (RHT) Program to improve healthcare access, quality, and outcomes in rural communities. All states are eligible to apply for funding by November 5, 2025. Half of the funds will be distributed equally, with the remainder based on state-specific factors. The program supports evidence-based initiatives, workforce recruitment, and access to treatment services, with awards assessed annually

Expanding Access to Care: Ohio’s Effort to Modernize APRN Practice Through Ohio SB 258 and HB 508

Ohio is moving to expand access to healthcare through Senate Bill 258 and House Bill 508, which would modernize APRN practice by removing the outdated requirement for a physician contract. This change would allow nurse practitioners, nurse midwives, and clinical nurse specialists to provide care more efficiently, especially in underserved areas, while maintaining high-quality, cost-effective care.

Cleveland Joins the Pay Transparency Movement: What Employers Need to Know

Beginning October 27, 2025, all Cleveland employers with 15 or more employees will be prohibited from asking applicants about their pay history and will be required to include reasonable pay ranges in all job postings where the position will be performed, solicited, considered, or processed in Cleveland. The ordinance is intended to help close the gender wage gap and promote greater pay equity across the city.