As passed, House Bill 68 puts limits on how physicians can treat gender dysphoria. Physicians say there are three main avenues of treatment: counseling, hormone treatments, and gender-affirming surgery. HB 68 bans the latter two methods of treatment for Ohio minors and requires that counselors get permission from at least one parent or legal guardian before providing counseling on gender dysphoria.
The lawsuit was first filed on March 26, 2024 by the American Civil Liberties Union, the ACLU of Ohio, and the global law firm Goodwin on behalf of two families who said their transgender adolescents would be negatively impacted by HB 68.
The trial court backed the state legislature, but in March 2025, the Tenth District Court of Appeals found HB 68 to be unconstitutional. The state then brought the case before the Ohio Supreme Court, which recently heard oral arguments from both sides.
“Our position is that parents do not have an unlimited right to override the General Assembly’s contrary determination. It’s not a constitutional right,” said Solicitor General Mathura Sridharan, who represented the state of Ohio and its bid to keep HB 68 on the books and continue a statewide ban on gender-affirming care for minors.
Parents have discretion to govern the medical treatment of their children, she said, adding that parents have to abide by the state legislature’s guardrails.
“If we’re looking at it from the children’s side, there’s no deeply rooted right to get gender reassignment treatments. If we’re looking at it from the parents’ side, parents have discretion, certainly, to govern and direct the medical treatment of their children. But again, they do not have a constitutional right to override the General Assembly when it comes to determinations as to what is allowable health care in Ohio,” Sridharan said.
On the other side were attorneys representing two families seeking to be able to provide their transgender children, now teens, with gender-affirming care for the teens’ gender dysphoria.
Attorneys representing the families didn’t challenge bans involving surgery, but focused on medication treatment like puberty blocking medication and hormone treatments, particularly since those drugs are used for other medical conditions not related to gender dysphoria.
Puberty blockers can treat precocious or early-onset puberty, as well as endometriosis. Hormone replacement therapy can be used to treat conditions caused by hormone deficiencies or gynecological issues.
“When there is a conflict between the parent and the state, it is strict scrutiny that helps you find that limit,” said Jordan Bock, an attorney with Goodwin Procter LLP representing the families, referring to what the limit is when it comes to parents’ rights to make decisions about their children’s health care.
Sridharan and Bock also each made references to the Ohio Constitution’s Health Care Freedom Amendment, which was approved in 2011 and says, “No federal, state, or local law or rule shall prohibit the purchase or sale of health care or health insurance.”
In regard to that constitutional amendment, each side addressed questions of what is health care and who defines what health care is, with the state saying it’s the Ohio General Assembly that gets to decide what health care is in Ohio. Bock reiterated that strict scrutiny should be applied when determining if something is health care.
Sridharan also said gender-affirming care doesn’t qualify as health care, but Bock pointed out that the state did not previously challenge the lower courts’ findings that it is considered health care.
“If you were a voter looking at that language in the ballot box, how voters would have interpreted that text is to understand that the Health Care Freedom Amendment provides protection for treatments that are qualified as health care, and I think it’s critical in this case that the government did not challenge whether this treatment qualifies as health care,” Bock said.
Following those oral arguments, the case is awaiting a decision from the Ohio Supreme Court.
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