Courtesy of The Associated Press
On January 24, the Ohio Senate voted to ban gender-affirming healthcare for minors. This reverses Governor Mike DeWine’s (R-OH) veto of the measure less than a month prior. The ban will specifically prohibit hormone therapy and gender-affirming surgeries for minors and further restrict mental health care for transgender minors without parental consent. While Governor DeWine and others in opposition to the measure argue the state should not play a large role in this decision, those in favor of the ban claim children should not have the responsibility to make permanent gender-affirming decisions. Alliance Defending Freedom, a conservative Christian legal group, stated DeWine’s veto was a “betrayal” to the people of Ohio, underscoring the tension that exists surrounding the legislation.
Ohio’s ban follows a wave of over 23 states that have enacted similar laws prohibiting gender-affirming care. However, some of these bans have been overturned or are facing legal challenges. Following a ban on gender-affirming care, many parents of transgender youth are left without medical resources to support their children. While the grandfather clause allows for continued access to prescriptions and medical care already prescribed to minors, trans youth receiving treatment will be barred from seeking any changes in their current care.
While the ban is intended to prevent minors from receiving gender-affirming care, it will also have a significant effect on adults. The American Civil Liberties Union of Ohio has called the law a “de facto ban” on care for all trans people regardless of age due to the unfeasible requirements it presents for physicians and clinics. The legislation, which achieves similar GOP healthcare initiatives present in other bills, will punish physicians for continuing to provide care relating to gender-affirming change in youth. The group Equality Ohio said, “As drafted, the proposed rules fundamentally change how Ohio medical systems operate and disrupt care for existing patients, including adults.”
The ban will also block transgender girls and women from partaking in sports at all levels of primary, secondary, and higher education. This is yet another facet of the anti-transgender policy movement that has gained traction in recent years. The Biden administration is set to counteract this and other sports-related bans later this year on the basis of a violation of Title IX. The administration will seek to prevent many of the blanket ban laws from being enforced and instead offer guidelines as to what is and is not discriminatory. The Ohio ban is likely to be impacted by Biden’s initiatives.
Republicans have argued the legislation’s purpose is to prevent children from making unsafe medical decisions without their knowledge of the long-term effects. This is in alignment with many other widely accepted laws and regulations mandating parental consent and attendance for all healthcare needs. However, critics point out that conversations with trans patients about the permanency or possible side effects of gender-affirming care are commonplace. Medical groups such as the American Academy of Pediatrics have emphasized that trans care is safe and necessary for the health and well-being of trans youth.
Additionally, the Ohio ban has written exceptions for cases of intersex children, who often undergo permanent gender-assigning surgery and other treatments at young ages without full knowledge or consent. Intersex people account for 1.7% of the population, and many have reported feeling that they were forcefully given a gender they do not identify with or were surgically altered unnecessarily and without consent. This was the case of Sean Wall, who wrongly had his testicles removed. In an NPR interview, Wall stated, "You have these trans young people who are very confident in who they are…and they're being actively denied affirming health care. Whereas intersex children do not get to consent about the surgeries that they have." In 2013, the UN proposed an end to “genital-normalizing” surgeries. However, this movement has not gained similar attention in the United States despite its connection to gender-related healthcare.
Some argue that transgender youth laws are very politically significant. Others suggest transgender youth are a small percentage of the population, and there should not be as much political focus on gender-affirming care. Ohio medical professionals commented that, in reality, there are very few cases of gender-affirming surgery treatment for minors. Ohio Senate Majority Leader Nickie J. Antonio (D-OH) questioned the reason for continued attention on trans youth health care, arguing “the Legislature should be dealing with bigger issues such a[s] mental health and substance use disorders” instead. Moving forward, transgender youth and adults face increased medical uncertainty and are at risk for further oppressive legislation, with many feeling they must move out of their home states to protect their livelihoods.