Ohio’s state budget puts intersex children in danger [COMMENTARY]

This piece originally appeared in The Ohio Capital Journal on 10/16/25 and appears here with permission.

By Courtney Felle

The latest two-year state budget could have devastating consequences for intersex children born in Ohio. When the law only recognizes two sexes, male and female, and defines them as “not changeable and… grounded in fundamental and incontrovertible reality” — what happens to intersex people like me? 

Reality is much messier than the budget’s new definition suggests.

Nearly 2% of people are born with sex traits that fall outside the male/female sex binary, with as many as 1 in every 1000 born with “ambiguous genitalia.”

Historically, strict adherence to a sex binary leaves intersex infants vulnerable to traumatic, irreversible medical attempts to conform the infant to a male or female body.

For decades throughout the 20th century to the present, when an infant was born with ambiguous genitalia, pediatric surgeons and specialists chose which sex they felt that the infant conformed with — then enforced that sex with cosmetic, sometimes sterilizing genital and gonadal surgeries. 

Many intersex people describe these surgeries as nonconsensual “intersex genital mutilation” (IGM) because they do not have direct health justifications and can often cause increased risk of urinary tract infections, osteoporosis, cancer, and other complications.

As children age into adults, they may experience loss of fertility, loss of sexual response, and significant trauma and mental health effects, impacting their future health care.

The Center for American Progress found that 3 in 5 intersex adults avoided seeking medical care due to past discrimination, and 9 in 10 intersex adults report poor physical and/or mental health, many from nonconsensual surgeries and their lifelong impacts. 

No federal or state law protects intersex infants against continued medical violence.

Because the new state budget forces infants to be identified only as either “male” or “female” on birth certificates, there may be increased pressure for parents to accept coercive sex ‘correction’ on their children. 

The state budget, which went into full effect on Sept. 30, 2025, does not make exceptions for intersex individuals.

Instead, it struggles to clearly and cohesively describe what “sex” means, defining “sex” as “the biological indication of male and female, including sex chromosomes, naturally occurring sex hormones, gonads, and nonambiguous internal and external genitalia present at birth.”

(As many biologists have noted, the exact language from the state budget, which is modeled on President Trump’s Jan. 25 Executive Order, also incorrectly describes fetal sexual differentiation and classifies every American as female.) 

However, those sex traits may conflict within intersex bodies.

For example, infants with Complete or Partial Androgen Insensitivity Syndrome may present with externally “female” genitalia, internally “male” gonads, XY chromosomes, and an inability to produce testosterone.

The state budget does not explain how it will classify infants with ambiguous genitalia and sex characteristics.

The ramifications for intersex people whose existence is not recognized under the law are still uncertain.

This is especially true in Ohio, which is seventh in the nation for the most children’s hospitals within the state.

Many of these clinics treat a disproportionate amount of intersex infants.

Shriners Children’s Hospital houses pediatric urologists who explicitly treat “sexual development disorders” and “hypospadias,” both intersex variations.

Nationwide Children’s Hospital has a specialty Turner Syndrome Clinic and “treats” other forms of intersex variations.

Up to 150 infants per year may be born in the state with ambiguous genitalia, and others may travel from surrounding states to specialty pediatric hospitals, all of whom are at increased risk for coercive procedures due to the state budget provisions.

For intersex teenagers and adults, the binary definition does not bode well either.

The law has the potential to restrict IDs and social services, including prohibiting funds to mental healthcare providers that “promote or affirm social gender transition.”

These regulations may disproportionately affect intersex individuals, who are more likely to be perceived as gender nonconforming (whether or not they are also transgender) and to experience mental health conditions. 

The full scope of the harm that the state budget will cause to intersex Ohioans has yet to be determined, but one thing is clear: It will cause harm. 🔥