Ohio’s SAFE Act Sparks Ethical Dilemma for Mental Health Professionals

Toledo, OHIO – Nearly a year after Ohio’s SAFE Act went into effect, banning gender-affirming care for minors, mental health professionals are still grappling with how to navigate the complex intersection of the law and their ethical responsibilities. The legislation, which prohibits mental health providers from diagnosing or treating minors with a gender-related condition without parental consent, has left many counselors and therapists uncertain about their professional obligations.

On Friday, the National Association of Social Workers (NASW) hosted a workshop aimed at helping mental health professionals better understand the implications of the SAFE Act. The session provided guidance on how to manage the legal requirements while maintaining the trust and safety of their patients, particularly those who are LGBTQ+.

For many providers, such as Allison Kuhr, a licensed professional clinical counselor who attended the workshop, the stakes are high. “Serving queer youth is one of my areas of expertise, so I need to know what I can do both professionally to create that important and trusting connection, but also be following the laws of my state,” said Kuhr.

The SAFE Act requires mental health providers to obtain parental consent before diagnosing or treating minors for any gender-related conditions. This stipulation has led to confusion over what qualifies as a “gender-related condition,” leaving mental health providers uncertain about what they can and cannot address in therapy sessions.

Kristen Bruce, a counselor who led the workshop, emphasized that the ambiguous language in the law has left providers in the dark. “We don’t necessarily know what that means,” said Bruce. “This training is really about helping us navigate the ethical issues and conflicts, helping us define for ourselves what we are going to consider diagnosing and treating as a gender-related condition.”

The workshop also explored practical strategies for mental health professionals to protect the safety and confidentiality of their patients. One such approach involves asking parents to sign consent forms in advance, which could help prevent the potential outing of children to their families later on.

Bruce, who works closely with at-risk youth, noted the delicate balance providers must strike between upholding ethical standards and complying with state laws. “If I am forcing outing on a patient who is not ready and who may not be safe, that puts me in the position of putting the client in harm’s way,” she said. “That would go against my professional ethics.”

Beth Powder, a professional who works in youth crisis services, expressed similar concerns. Powder, who serves a large number of LGBTQ+, transgender, and gender-nonconforming youth, explained that many of her clients struggle with mental health issues, including self-harm and suicidal thoughts. Forcing minors to disclose their gender identity to parents, she believes, could exacerbate these issues. “We strip away the biggest piece that we can do to keep these kids safe, which is to acknowledge them,” said Powder. “The SAFE Act gets in the way of our ability to do so.”

As Ohio’s SAFE Act continues to raise ethical and legal challenges, mental health professionals remain at a crossroads. The law, intended to limit access to gender-affirming care for minors, has unintentionally created a complicated dilemma for those tasked with supporting vulnerable youth through challenging and sometimes life-threatening struggles. With the ambiguity surrounding the law, providers are left to navigate a landscape where their professional ethics may clash with state mandates, putting them in difficult positions as they strive to do what’s best for their patients.