Lawsuit filed against Ohio trans care ban legislation

The American Civil Liberties Union, the ACLU of Ohio, and the law firm Goodwin filed a lawsuit Tuesday challenging House Bill 68, legislation in Ohio that bans gender-affirming medical care for transgender minors, and also bans transgender girls from taking part in girls' and women's sports.

Specifically, the complaint targets the medical care restrictions and asks the Franklin County Court of Common Pleas to strike down the controversial law - titled the SAFE Act, for Save Adolescents from Experimentation - before it's scheduled to take effect on April 24, 2024.

Physicians who provide gender-affirming care for trans youth would be "subject to discipline by the applicable professional licensing board" under the legislation. The law includes exceptions for such care for non-transgender youth, and also includes a grandfather clause that allows transgender people already receiving care to continue doing so.

The lawsuit was filed on behalf of two families who say their children are at risk of losing access to "critical, medically necessary" healthcare. They say the law violates four sections of the Ohio Constitution, including the Equal Protection clause, a provision that states that no bill shall contain more than one subject, and that no law or rule "shall prohibit the purchase or sale of Health Care or health insurance," as well as the Due Course of Law provision.

"These personal, private medical decisions should remain between families and doctors; they don't belong to politicians," said Freda Levenson, Legal Director at the ACLU of Ohio, in a statement regarding the lawsuit. "We will fight in court to ensure that trans youth and their parents can access critically important, lifesaving healthcare without government intrusion."

One of the children represented in the lawsuit, who was unidentified due to age, said that puberty blockers helped ease her "fear and anxiety about her body changing in ways inconsistent with her gender, which greatly improved her mental health and alleviated her gender dysphoria." If HB 68 goes into effect, her family says that not having access to estrogen hormone therapy when the time comes, "if that is what she wants and her parents agree," has raised concerns about her health, according to the lawsuit.

The Republican-controlled Ohio House and Senate in January overrode a veto of the bill by Republican Gov. Mike DeWine.

DeWine had expressed concerns about judicial challenges the state would face if the law passed. A law in Arkansas was ruled unconstitutional by a federal judge, and similar legislation in states including Texas and Georgia have been blocked while the cases are tried.

DeWine also expressed concern about the potential impact that banning transgender medical care could have on the small, vulnerable transgender population.

"Many parents have told me that their child would be dead today if they had not received the treatment they received from an Ohio children's hospital," DeWine said during remarks following his veto. "I have also been told, by those that are now grown adults, that but for this care, they would have taken their lives when they were teenagers."

Often because of gender-related discrimination and gender dysphoria, transgender youth are more likely to experience anxiety, depressed mood, and suicidal ideation and attempts, according to the Centers for Disease Control and Prevention. A recent study in the New England Journal of Medicine found that hormone therapy can improve the mental health of transgender adolescents and teenagers.

"These are gut-wrenching decisions that should be made by the parents and should be informed by teams of doctors who are advising them," said DeWine. "These are parents who have watched the child suffer sometimes for years and have real concerns that their child may not survive."

Republican Rep. Gary Click, a sponsor of HB 68, criticized the ACLU's lawsuit.

"Gender-affirming care is a slogan, not science," Click said Tuesday in response to the ACLU filing. "Sex changes for children and counseling without parental consent are not the types of civil rights embedded in our constitution. I have complete faith in Ohio Attorney General David Yost's ability to defend the SAFE Act."

ABC News spoke with physicians who perform gender-affirming care. They say patients, their physicians and their families work together to build an individualized approach to care, meaning not every patient will receive any or every type of gender-affirming medical care option. Parents are a part of the conversation, they say.

DeWine stated in his veto announcement that "none of [the families] that I talked to talked about surgery" or sex changes for people under 18. The ban enacted as part of HB 68 would impact reversible puberty blockers and less-reversible hormone therapy treatments.

"That's not where they were going in the discussion. And I think that's, frankly, a fallacy that's out there that, you know, this goes right to surgery," said DeWine. "It just doesn't. All the children's hospitals say that we don't do surgeries."

Other HB 68 supporters say there needs to be more research regarding gender-affirming care. Such research is not included in the bill.

"If you don't know if something you're doing is going to hurt someone 10, 15, 20 years down the road - or maybe even one year down the road - don't do it," GOP state Sen. Terry Johnson, who is a retired physician, said in a Dec. 13 debate on the bill. "The medical evidence is not there to support what we're doing in the country."

Critics of these restrictions say they will harm transgender youth, a small population that already disproportionately faces discrimination, violence, and bullying.

Gender-affirming care has been called safe and effective by more than 20 major national medical associations, including the American Academy of Pediatrics and the American Medical Association. The AMA has said such care can be medically necessary to improve the physical and mental health of transgender people.

Ohio is one of at least 23 states that have so far enacted legislation restricting gender-affirming health care for trans youth.