The Virginia Board of Health decided Thursday to move forward with a review of rules for abortion clinics, the latest step in a lengthy process that could roll back controversial regulations finalized last year.

The move was a victory for Gov. Terry McAuliffe (D), who campaigned on a promise to reverse the rules, which regulate abortion clinics as if they were hospitals by dictating such details as hallway widths and the number of parking spots. Opponents of the regulations say they were intended to block access to abortion by closing down clinics that do not meet the requirements.

“These clinics provide essential preventive care and cancer screenings to many women and families and unfortunately were facing closure due to onerous regulations that were the result of politics being inserted into the regulatory process,” McAuliffe said in a statement.

However, groups opposed to abortion did not necessarily see Thursday’s action as a defeat; they said the review approved by the health board leaves open the possibility that restrictions on clinics could be strengthened. The restrictions, they said, are meant to protect women’s health and safety.

“We don’t know what will happen at the end of this process. This is simply a reopening and reviewing of the standards,” Victoria Cobb, president of the Family Foundation of Virginia, told reporters after the meeting.

Abortion has long been a contentious issue in the state, but those opposed to the procedure have prevailed in many public-policy decisions, for instance pushing through measures to require parental consent for girls and ultrasounds for women seeking abortions.

McAuliffe’s recent advocacy for abortion rights reflects a dramatic cultural shift in the state. He talked about the issue regularly on the campaign trail, appealing in part to the influx of liberal voters into the Northern Virginia suburbs that helped fuel last year’s sweep of all three statewide offices.

Still, the antiabortion contingent remains strong in Virginia. On Thursday, activists on both sides began lining up in a suburban Richmond office park before 6 a.m. to make their position known to the health board. Some of them — including E.W. Jackson, the GOP’s 2013 nominee for lieutenant governor — went so far as to call attention to the state’s health commissioner, Marissa Levine, because she is transgender.

“This is the transgender commissioner of health appointed by Gov. [McAuliffe],” Jackson, a minister from Chesapeake, wrote in a tweet that also featured a picture of Levine. “Formerly a married MAN (Mark) with children, now Marissa. Needless to say — very pro-abortion.”

After the board of health meeting, Jackson said he merely intended to draw a connection between what he considers to be causes of the left.

“I do see a close relationship between the whole LGBT movement and the whole pro-abortion movement,” he said, adding: “I do not believe in personal attacks.”

Others were more harsh about Levine. In a letter distributed to the crowd, Donald N. Blake, president of the Virginia Christian Alliance, accused Levine of being unfit for her post.

“There are serious issues with Dr. Levine, both enforcing Virginia Law, and in his (or her) personal struggle with ‘his’ gender identity. When a man looks in the mirror and sees a woman, he has serious issues. Dr. Levine should find a job in the private sector; not in a state position requiring public faith and trust,” Blake wrote.

A McAuliffe spokesman said Blake’s attack had no place in the commonwealth.

“Governor McAuliffe, Dr. Levine and this entire administration are working hard to build a new Virginia economy where every family can live healthy and productive lives. Bigoted attacks on dedicated public servants do nothing to advance those goals and should have no place in our public discourse,” the governor’s spokesman, Brian Coy, said in a statement.

The health board voted 13­ to 2 Thursday to launch the examination of a broad scope of rules, including several that go beyond the building codes that have stoked the most heated debate. The board will also review parental consent, medical testing and lab services, anesthesia services and emergency services as well as the administration, storage and dispensing of drugs.

Before the board votes on the final rules, the public will have a chance to comment. Health department staff have six months to draft proposed amendments.

The latest battle over abortion began in early 2011, when the General Assembly voted for, and then-Gov. Robert F. McDonnell (R) signed, legislation that categorized as hospitals those facilities that perform five or more abortions each month.

As a result, the health department imposed temporary building standards on all clinics; the health board finalized those standards last year. After the initial legislation passed, one clinic stopped offering abortion services; two others closed last year.

Of the remaining 18 clinics, 13 have sought temporary waivers from the current rules. Twelve of those have been granted waivers, and one request is still under administrative review. Five clinics have said they can comply with the new standards as written.

McAuliffe set the stage for this week’s action in May, when he urged Levine and the health board to review the regulations.

Before Levine was appointed health commissioner, she served as chief deputy commissioner for public health at the Department of Health. She previously directed local health departments in two districts in the commonwealth.

Levine, a family physician, has a masters of public health from the Johns Hopkins Bloomberg School of Public Health, received her medical degree from the Albert Einstein College of Medicine and completed her family practice residency at the University of Virginia, according to a biography provided by the state.