Will Ohio Strike Down Its Draconian Gender-Affirming Care Ban?

The fate of gender-affirming care for transgender youth in Ohio will soon rest in one person’s hands. For the past week, Franklin County Judge Michael Holbrook has heard a case challenging a recent state law that includes a ban on the use of puberty blockers and hormones for trans youth. Now, it’s up to him to decide whether to turn a temporary block on the law into a permanent one—which would make Ohio just the third state to do so as a growing body of anti-trans laws moves through the courts.

From his chambers on the fifth floor of a downtown Columbus courthouse, the judge has heard pleas from the parents of trans children whose lives have been saved by gender-affirming care, physicians from the state’s children’s hospitals, and national experts in trans care. He’s also heard the state’s sharp defense of its law, featuring what is being framed as the “expert” testimony of nationally prominent anti-trans activists who made dubious claims about the efficacy and risks of puberty blockers, hormones, and other gender-affirming medical treatment.

Ohio’s sweeping law, dubbed the “Saving Adolescents from Experimentation” or “SAFE” Act, doesn’t just block the use of puberty blockers and hormones in trans youth (while allowing such medical interventions for cisgender children who may need them for precocious puberty or polycystic ovary syndrome). Passed by a GOP supermajority in January over Republican Gov. Mike DeWine’s veto, it also prohibits trans girls and women from playing women’s sports, including college athletics. The ACLU of Ohio is challenging the entire law as a violation of the state’s single-subject rule for legislation, which requires that bills must pertain to one topic. The state says that topic is “addressing gender transition in children,” but the trial mainly focused on what the families of two trans girls have argued is the discriminatory, life-threatening impact of the ban on gender-affirming care.

“She laid down and wept in my bed. She is carrying looming anxiety and deep sadness surrounding this law.”

Ohio is among the 25 states with laws on the books restricting gender-affirming care, according to the Kaiser Family Foundation, and 39 percent of trans youth live in states with such policies. While most bans have been challenged—and several temporarily blocked, like Ohio’s—the vast majority remain in effect. Only policies in Florida and Arkansas have been permanently enjoined, while the US Supreme Court has agreed to hear a case this coming term about the constitutionality of trans care bans.

On Monday, the mother of a 12-year-old trans girl testified that when her daughter began publicly identifying as a girl, her anxiety “melted away.” The daughter, going by the alias “Grace Goe,” has received gender-affirming mental health care for seven years and hopes to medically suppress puberty at its onset. The prospect of not being able to access that medical care has caused immense distress for Goe and her family. “She laid down and wept in my bed,” her mother said of Goe learning of the ban. “She is carrying looming anxiety and deep sadness surrounding this law.”

The state of Ohio showcased its line of experts, including Jamie Reed, a self-identified “whistleblower,” whose claims about a Missouri gender clinic have been widely disputed by families of the clinic’s current and former patients. Another Ohio witness was James Cantor, a Canadian sex researcher who has testified in support of gender-affirming care bans in trials across the country.

Cantor, a PhD who has never diagnosed a child with gender dysphoria or served on a child’s gender-affirming care team, claimed US studies on gender-affirming care are “sloppy” and that such care causes “sterility in children.” While hormones are known to cause temporary infertility, the long-term effects are unknown—which is why the World Professional Association for Transgender Health (WPATH), the leading professional organization for gender-affirming care providers, recommends providers and patients extensively discuss fertility impacts and options before initiating such treatments. (Some forms of gender-affirming surgery do cause permanent infertility, but for years the Ohio Children’s Hospital Association has assured lawmakers it is not being offered to trans youth in Ohio.)

And as my colleague Madison Pauly revealed last year, it’s not medical professionals or swaths of people who have stopped gender-affirming care proposing these bans to state legislators; many are conservative Christian organizations that believe transness is something to be “cured.”

As the trial wraps up on Friday, it bears repeating what actual experts testified: Dr. Sarah Corathers, an endocrinologist at Cincinnati Children’s Hospital who has served on care teams for about 300 trans youth over the past decade, said she’s seen patients’ quality of life improve under her care. “When medically indicated, gender-affirming medical treatment is safe, effective, and well-established,” she said. Dr. Jack Turban, the director of the University of California, San Francisco’s Gender Psychiatry program, explained the widely accepted protocols clinicians in Ohio and elsewhere use for offering such care to trans youth, including using a multidisciplinary team of providers, offering comprehensive mental health support, and making every decision in concert with the trans child and their parents. He noted that every major medical organization opposes bans on gender-affirming care.