Ohio Supreme Court Hears Arguments in Trans Rights Case

Jessie Hill filed an amicus brief in Moe v. Yost on behalf of the plaintiffs. She is the Judge Ben C. Green Professor of Law and director of the Reproductive Rights Law Initiative at Case Western Reserve University.

The Ohio Supreme Court is considering a case that touches on two hot-button issues: parental rights and access to medical care for transgender children.

The court heard oral arguments late last month in the case, Moe v. Yost. Two trans youth and their parents assert that Ohio’s ban on gender-affirming care for minors violates the state constitution. In early 2024, the Ohio legislature passed House Bill 68 — which forbids medical providers from prescribing puberty blockers and hormone therapy to trans kids — over the veto of Ohio’s Republican governor. “Were I to sign House Bill 68, or were House Bill 68 to become law, Ohio would be saying that the state, that the government knows better what is medically best for a child than the two people who love that child the most: their parents," Gov. Mike DeWine said of his veto. The law also acts “against the medical judgement of the treating physician and the treating team of medical experts,” he added. 

At the oral argument, the Ohio Supreme Court justices seemed interested in the parental rights implications of the law, asking just seconds into the state attorney’s argument whether “it is the state’s position that parents have no rights in this.”

Indeed, the claims in the case echo DeWine’s concerns. The plaintiffs argue that the ban violates parents’ fundamental rights to make medical decisions for their children, enshrined in the state equivalent of the Due Process Clause. They also say the ban violates the right to purchase and sell health care under the Ohio Constitution’s Health Care Freedom Amendment. The amendment was added to the Ohio Constitution in 2011, having been promoted by some of its proponents as a rejection of the federal Affordable Care Act’s individual mandate to buy health insurance. But its language is much broader than that: The amendment categorically declares that “no federal, state, or local law or rule shall prohibit the purchase or sale of health care or health insurance.”

The trial court ruled in August 2024 that the ban on medical care for trans children was constitutional and could be enforced. An intermediate appellate court reversed, ruling in March 2025 that the law violated both the Health Care Freedom Amendment and the parent’s right to substantive due process. The state appealed.

During the oral arguments, the state’s attorney told the high court that the question was whether parents possessed a fundamental right to access “gender reassignment treatment” for their children. She asserted that according to the “history and tradition” test described in the 1997 U.S. Supreme Court case Washington v. Glucksberg, there was no such fundamental right. Indeed, the state would altogether reject the doctrine of substantive due process, which allows courts to protect rights they deem fundamental, even if those rights are not mentioned explicitly in the text of the constitution. The state also argued that whatever rights parents might have, those did not include the right to override the determination of the legislature with respect to choosing this particular form of medical care, which lacks a sufficiently long pedigree and therefore cannot constitute a fundamental right. Thus, the state argued, since no fundamental right is at stake, the ban should be subject to only rational basis review — the lowest level of scrutiny in constitutional law.

The plaintiffs, by contrast, argued that the state was defining the fundamental right at too high a level of specificity, and that under the more general right of parents to make health care decisions for their children, the law should be subject to strict scrutiny — the most stringent form of judicial review — which it would fail.

Regarding the plaintiffs’ health care freedom claim, that state’s attorney insisted that the 2011 amendment was aimed only at protecting health care transactions from government regulation and that it did not undermine the government’s longstanding and traditional authority to regulate health care procedures. The state’s attorney also leaned into the concern that, if taken literally, the amendment’s language could be read so broadly as to nullify virtually all health care regulations — even those aimed at controlled substances like opioids.

In response, the plaintiffs’ attorney insisted that the plaintiffs’ interpretation of the Health Care Freedom Amendment would not invalidate all regulation of opioids. Opioids have legitimate medical uses and are not subject to a total ban in Ohio, the attorney pointed out, unlike gender-affirming care for minors. Therefore, the ban on gender-affirming care for minors outright prohibits access to an accepted medical treatment, whereas regulating opioids does not. Justice Pat DeWine — who is Gov. Mike DeWine’s son — pressed the plaintiffs on whether the power to define health care rests with the legislature or the courts. The plaintiffs’ attorney argued that defining health care is a judicial function, no different from courts defining what constitutes speech under the First Amendment or a search under the Fourth Amendment.

The state also argued that another provision of the Health Care Freedom Amendment, which preserves the validity of “laws calculated to deter fraud or punish wrongdoing in the health care industry,” granted the legislature the authority to define gender-affirming care for minors as “wrongdoing.” As the plaintiffs noted, however, this provision was aimed at misconduct such as fraud or malpractice. In addition, the plaintiffs said, to read it as a delegation of authority to the legislature to place any form of health care off-limits simply by calling it “wrongdoing” would make the constitutional amendment itself a nullity.

Moe, which will determine minors’ access to gender-affirming care in Ohio, connects to national debates and trends beyond gender-affirming care. First, throughout the argument, the state’s attorney was openly disdainful of science and of expert consensus. For example, she claimed that the World Professional Association for Transgender Health, which developed guidelines for gender-affirming care for minors, “was on an ideological warpath” and painted medical experts in this field as politically rather than scientifically driven. The plaintiffs, by contrast, embraced the lower court’s evidence-driven findings. Similar debates over the politicization of science are currently playing out in numerous domains, such as abortion rights and vaccines.

Second, this case raises questions about the scope of health care freedom under state constitutions that contain provisions like Ohio’s. Similar amendments were enacted in five other states — Alabama, Arizona, Florida, Oklahoma, and Wyoming — in the wake of the passage of the Affordable Care Act. The Wyoming Supreme Court recently ruled that the state’s health care freedom amendment protected abortion rights. In so ruling, the Wyoming court unequivocally held that abortion is health care — cutting against arguments that courts should leave determinations of what does or does not constitute “health care” to legislatures. Debates about the meaning of health care, and the respective power of legislatures and courts to define and regulate it, are likely to continue.

Finally, Moe highlights the increasingly prominent role of state courts and state constitutions in efforts to expand trans rights. Last year, the U.S. Supreme Court upheld a Tennessee law banning gender-affirming care for minors in U.S. v. Skrmetti, holding that the ban did not violate the Equal Protection Clause of the U.S. Constitution because it did not discriminate based on sex or gender; rather, the Court said, it drew distinctions based only on age and “medical use.” This did not impact the Ohio litigation, however, because the Moe plaintiffs relied on the state constitution, not the U.S. Constitution. Moreover, even if Ohio courts were inclined to tie the meaning of the state constitution to federal interpretations, the U.S. Supreme Court did not consider in Skrmetti whether the ban violated parents’ fundamental rights to control their children’s medical treatment, and there is no federal equivalent of the Health Care Freedom Amendment. Regardless of the Ohio Supreme Court’s ultimate decision, it will not be the last state high court to consider whether its state constitution protections trans people more broadly than the U.S. Constitution.

Suggested Citation: Jessie Hill, Ohio Supreme Court Hears Arguments in Trans Rights Case, Sᴛᴀᴛᴇ Cᴏᴜʀᴛ Rᴇᴘᴏʀᴛ (Mar. 31, 2026), https://statecourtreport.org/our-work/analysis-opinion/ohio-supreme-court-hears-arguments-trans-rights-case