The Supreme Court of Ohio heard oral arguments on March 24 in a lawsuit that will determine whether transgender Ohioans under age 19 have the right to receive gender-affirming health.
The case dates to 2024, when the ACLU filed a lawsuit on behalf two 12-year-old transgender girls and their parents challenging the “SAFE Act,” an Ohio law banning all types of gender-affirming health care for transgender minors.
In April 2024, a common pleas judge put the measure on hold with a temporary restraining order after the American Civil Liberties Union (ACLU) of Ohio filed a lawsuit on behalf of two transgender girls–Madeline Moe and Grace Goe–at risk of losing access to healthcare under the bill.
Republican Ohio Attorney General Dave Yost filed an emergency motion to block the temporary restraining order.
Ultimately, the court granted Yost’s request to pause that decision – reinstating a blanket ban on health care for transgender youth – including certain types of talk therapy and mental health resources – until justices hear the case.
Six months later, a panel of judges in Ohio’s Tenth District Court of Appeals declared the ban unconstitutional. The appellate court sent the case back to the trial court and imposed a permanent injunction on HB 68’s ban on the use of puberty blockers and hormones ‘for the purpose of assisting the minor individual with gender transition.’”
Now the ban’s fate rests with the state’s highest court.
At least four of the Court’s seven justices have indicated support for the ban. The Court is not expected to issue a decision for weeks – perhaps even months.
Arguing the case
During oral arguments, attorney Mathura J. Sridharan represented the State of Ohio, the Ohio Attorney General’s Office and the State Medical Board of Ohio.
Justice Jennifer Brunner pressed Sridharan regarding a lack of medical evidence to support banning gender-affirming health care for minors. In response, Sridharan claimed that minors who receive gender-affirming health care “write away their fertility [and] their sexual responsiveness for life.”
In reality, many people who receive hormone replacement therapies and gender-affirming health care before age 19 have biological children as adults. Transgender adults also typically report a wide range of sexual function and satisfaction after receiving gender-affirming care.
While some types of gender-affirming surgeries can impact long-term fertility, it is exceedingly rare for transgender people under age 18 to receive gender-affirming surgeries.
Instead, transgender minors typically pursue a “social transition,” often changing their names, pronouns or gender presentations via cosmetics like clothing, hair and makeup while under the care of a licensed medical and mental health care team.
Before conservation lawmakers passed the ban, some minors also accessed puberty-blocking medications and hormone replacement therapies.
Parents’ rights
Attorney Jordan Brock represented plaintiffs Madeline Moe and Grace Goe before Ohio’s seven Supreme Court justices.
“The impact of HB 68 is that there is no longer any evidence-based treatment for minors with gender dysphoria in Ohio,” Brock told the Court.
“Before treatment, Grace Goe questioned whether dying would allow her to return as a girl – and Madeline Moe told her parents that she wished she could die and just be reborn,” Brock said. “But after being able to live as girls, they ‘thrived’ because they were ‘free to live in the world as who they are.’”
“That does not mean the decision where to pursue treatment is an easy one, and it does not mean there is a right answer in any particular case,” Brock added. “But it is the parents’ right to decide, given the girls’ own circumstances, whether treatment is appropriate.”
Political influence in medical policy
Gender-affirming health care is considered lifesaving health care by every major medical association in the world – apart from the American Society of Plastic Surgery (ASPS).
The ASPS – which represents about 11,000 plastic surgeons worldwide – recently rescinded its support for gender-affirming surgical procedures for transgender people under the age of 19. The group operates the political action committee (PAC) PlastyPAC, which has skewed conservative since at least 2021 – donating tens of thousands of dollars to Republican political candidates.
On March 22, the American Medical Association (AMA) released a statement clarifying its support for gender affirming-health care for transgender minors, following reports suggesting the group had changed its stance.
Anti-transgender legislation
The Ohio ban on gender-affirming health care for minors is part of an unprecedented jump in anti-transgender legislation across the United States, increasingly limiting transgender Americans’ access to housing, health care, employment, education and public life.
Conservative Christian pastor Rep. Gary Click first proposed the bill in 2022.
Since then, anti-transgender legislation has skyrocketed.
In Ohio, anti-LGBTQ+ hate groups have been the primary drivers of anti-transgender legislation, recruiting political detransitioners to testify across the country in an effort to limit access to health care for transgender Americans.
Columbus-based anti-LGBTQ+ hate group the Center for Christian Virtue (CCV) provided extensive public testimony in favor of the bill, along with representatives from the Alliance Defending Freedom (ADF) and the Family Research Council (FRC) – both of which are also categorized as anti-LGBTQ+ hate groups by the Southern Poverty Law Center.
Gender affirming health care is still legal for cisgender minors, who may also require access to hormone-replacement therapies or hormone-blocking drugs for reasons unrelated to gender affirmation.
During oral arguments, Sridharan discussed political detransitioner Chloe Cole, who has testified before state legislatures across the country about her personal regret around receiving gender-affirming care as a teen.
Cole is part of a small contingent of people who discuss their personal experiences with “detransition” before lawmakers, in some cases earning speaking fees for their appearances..
Realistically, transgender Americans report very low rates of regret around receiving gender-affirming health care. Between 1.3% and 2% of transgender people report dissatisfaction or regret over seeking gender-affirming health care in their lifetimes.
In comparison, a 2025 study found that roughly 50% of Americans who received total knee replacement surgeries reported mild, moderate or severe regret around the procedure.
Click has repeatedly called gender-affirming health care “experimental.” However, historians estimate the concept and practice of gender-affirming care coincides with the dawn of modern medicine in the mid-19th century.
Gender-affirming health care is not new
Evidence suggests that gender-affirming health care has been practiced by doctors and health care professionals since the dawn of modern medicine.
However, most documentation of gender-affirming practices and research began in the 1920s.
The most extensive library of medical and sociological research and documentation on sexual orientation, gender identity and gender-affirming medical practices belonged to renowned sexologist Dr. Magnus Hirschfeld.
When Nazi youth burned the library in 1933, they destroyed most of the modern history of gender-affirming health care. 🔥
IGNITE ACTION
- If you are a young LGBTQ+ person in crisis, please contact the Trevor Project: 866-4-U-Trevor.
- If you are an transgender adult in need of immediate help, contact the National Trans Lifeline: 877-565-8860
- To learn more about Jake Newsome’s work as a public historian, or to purchase his book, “Pink Triangle Legacies: Coming Out in the Shadow of the Holocaust,” click here.
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