Ohio governor signs executive order banning gender surgeries for minors

Ohio Gov. Mike DeWine announced an executive order Friday that will immediately ban transition-related surgeries for minors in the state, about a week after vetoing a bill that would have banned all gender-affirming care for minors, including puberty blockers and hormone therapy. 

“A week has gone by, and I still feel just as firmly as I did that day,” DeWine said at a news conference Friday, reaffirming his decision to veto the broader ban. “I believe the parents, not the government, should be making these crucial decisions for their children.”

DeWine’s executive order makes Ohio the second state to specifically ban transition-related surgeries for minors after Arizona passed such a law in 2022. 

Since 2021, more than 20 states have enacted broader transgender health care laws like the one DeWine vetoed last week. These measures restrict all gender-transition care for minors, including access to puberty blockers and hormone therapy. A judge struck down such a law in Arkansas in June, and judges have issued temporary blocks, either partial or full, against restrictions in Florida, Georgia, Montana, Idaho and Indiana.

Major medical associations — including the American Medical Association, the American Academy of Pediatrics and the American Psychological Association — support minors’ access to gender-affirming care and oppose state bans. 

Surgery for minors is rare and is generally not recommended under standards of care developed by the World Professional Association for Transgender Health, a nonprofit professional organization dedicated to transgender health care. In the rare cases minors do receive surgery, it is usually a double mastectomy, also known as top surgery. Genital surgery is never available to minors. 

Nick Lashutka, the president of the Ohio Children’s Hospital Association, previously testified in the state legislature that children’s hospitals in the state don’t perform any surgeries on minors as treatment for gender dysphoria, according to NBC affiliate WCMH of Columbus. 

At Friday’s news conference, in addition to announcing his new executive order, DeWine said he is concerned that there are “fly-by-night” clinics that provide transgender adults with hormone therapy “without the lead-in psychiatric care that we know is so very, very important.”

As a result, he announced a set of new administrative rules for both minors and adults seeking transition-related care that would be adopted and enforced by the Ohio Department of Health and Department of Mental Health and Addiction Services after a public comment period.

These rules would require that those receiving transition-related care have a multidisciplinary team of health providers; mandate that patients give informed consent before treatment and after having received information about the risks of gender-affirming care; and require that patients undergo a period of psychological counseling before receiving hormone therapy or other treatment for gender dysphoria, which is the distress that results from a misalignment between someone’s assigned sex at birth and their gender identity.

“An adult who goes in for this care will get this lead-up psychiatric care and the counseling that is absolutely the key, whether you’re dealing with an adult or whether you’re dealing with a child,” DeWine said. “The bill that I vetoed, that the legislature put forward, did not deal with that at all.”

The Ohio General Assembly, which is controlled by a Republican supermajority, could override the governor’s veto with a three-fifths majority vote. The Ohio House planned to return from its winter break early to vote on the override, the Ohio Capital Journal reported. However, it’s unclear if the House would have the votes necessary for an override if not all representatives are able to return for an early session, the Journal reported.