An Ohio Court Strikes Down Ban on Gender-Affirming Care for Minors
Citing the state’s health care freedom amendment, the court ruled that Ohio’s restrictions on transgender youth care violate the state constitution.
Last month, an Ohio appellate court struck down portions of a state ban on gender-affirming care for transgender minors. The court ruled that Ohio’s prohibitions on hormone therapy and puberty-blocking medications violated the state constitution.
The case, Moe v. Yost, isn’t over — the state attorney general has filed an appeal to the Ohio Supreme Court — but the opinion is well worth a read. Most striking to me was how the court relied in part on Ohio’s “health-care freedom amendment,” a 2011 ballot initiative that was part of a conservative-led effort to limit the effect of the Affordable Care Act. Significantly, the amendment bars the state from prohibiting “the purchase or sale of health care or health insurance.”
State constitutions are full of provisions that don’t appear in the U.S. Constitution. They’re also relatively easy to amend, which means that the texts of state constitutions often tell a story of political and social movements over time. That’s certainly the case with health care freedom amendments, which appear in six state constitutions (including Ohio’s), as State Court Report contributor Julia Livingston has explained.
Proponents of these provisions were animated by opposition to federal mandates related to health insurance, but the constitutional rights they established also prioritize personal medical decision-making as a right. At the time, these amendments were largely a messaging tool to mobilize the public against the Affordable Care Act. While they didn’t have much legal traction at the time they were enacted, they could have big implications today for some of the most high-profile issues landing in state court.
With respect to gender-affirming care, the Ohio court concluded that the freedom to choose health care must mean more than just “the right to receive health care subject to the policy preferences of the General Assembly.” Rather, the amendment establishes a right to choose to receive health care when it “follows the widely accepted guidelines and treatment protocols of the professional medical community in the United States.” The kind of categorical ban at issue in Ohio violates that right, the court explained, because it completely bars treatments by qualified medical providers that are widely accepted by the professional medical community.
Health care freedom amendments have also been cropping up in the reproductive health care arena. Last year, a Wyoming trial court relied on the state constitution’s “right of health care” to block the state’s abortion ban. Concluding that the Wyoming Constitution establishes a fundamental right to make health care decisions and that abortion services are a form of health care, the court held that Wyoming’s ban was an “unreasonable and unnecessary restriction[] on the right of pregnant women to make their own health care decisions.” On April 16, the Wyoming Supreme Court will hear arguments in an appeal of that ruling.
State courts have turned to other state constitutional provisions to establish health care freedom rights as well, using analysis that can be applicable to both transgender health care and abortion rights. In a recent piece, Amy Myrick and Alexander Wilson of the Center for Reproductive Rights discuss recent Montana Supreme Court rulings that rely on a provision in the state constitution providing for the “right of individual privacy.” In the context of abortion rights, the Montana court has long held that the right to privacy encompasses the “right to make medical judgments affecting her or his bodily integrity and health in partnership with a chosen health care provider free from governmental interference.” In December, the court applied these principles to uphold a preliminary injunction blocking a state ban on gender-affirming care for minors.
It’s an important lesson, Myrick and Wilson argue, that “the same constitutional protections for personal autonomy and bodily integrity apply to diverse decisions that people make about their bodies, health, and lives.”
Alicia Bannon is the director of the Judiciary Program at the Brennan Center for Justice and editor in chief for State Court Report.
Suggested Citation: Alicia Bannon, An Ohio Court Strikes Down Ban on Gender-Affirming Care for Minors, Sᴛᴀᴛᴇ Cᴏᴜʀᴛ Rᴇᴘᴏʀᴛ (Apr. 11, 2025), https://statecourtreport.org/our-work/analysis-opinion/ohio-court-strikes-down-ban-gender-affirming-care-minors
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