Submitted by Jesse Hill Court summary in Maw vs. Yost On behalf of the plaintiff. 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 health care for transgender children.

The court heard oral arguments in the case late last month. Maw vs. Yost. Two transgender youth and their parents claim that Ohio’s ban on gender-affirming care for minors violates the state constitution. In early 2024, the Ohio General Assembly overrode the veto of Ohio’s Republican governor and passed House Bill 68, which prohibits health care providers from prescribing puberty blockers and hormone therapy to transgender children. “If I were to sign House Bill 68, if House Bill 68 were to become law, we would be saying that the state of Ohio knows better what is medically best for a child than the two people who love that child most, their parents,” Gov. Mike DeWine said of his veto. He added that the law also goes against “the medical judgment of the treating team of physicians and medical professionals.”

During oral arguments, the Ohio Supreme Court justices seemed interested in the law’s impact on parental rights, asking just seconds after the state attorney’s argument, “Is the state’s position that parents have no rights in this matter?”

Indeed, the lawsuit’s claims echo DeWine’s concerns. Plaintiffs argue that the ban violates parents’ fundamental right to make medical decisions for their children, which is enshrined in the state’s equivalent of the Due Process Clause. They also argue that the ban violates the right to buy and sell medical care under the Ohio Constitution’s Medical Freedom Amendment. The amendment was added to the Ohio Constitution in 2011 and was promoted by some advocates as a repudiation of the federal Affordable Care Act’s individual mandate for health insurance. But its language is much broader than that, and the amendment specifically declares that “no federal, state, or local law or regulation shall prohibit the purchase or sale of medical care or health insurance.”

A trial court ruled in August 2024 that the medical ban on transgender children is constitutional and enforceable. The Intermediate Court of Appeals reversed, ruling in March 2025 that the law violated both the Medical Freedom Amendment and a parent’s right to substantive due process. The state appealed.

During oral arguments, state attorneys told the high court that the question was whether parents had a fundamental right to “gender reassignment treatment” for their children. She argued that according to the “history and tradition” test outlined in a 1997 U.S. Supreme Court case: Washington vs Glucksbergthere was no such fundamental right. In fact, the state would completely reject the doctrine of substantive due process, which allows courts to protect rights they deem fundamental, even if those rights are not explicitly mentioned in the text of the Constitution. The state also argued that whatever rights parents have, they do not include the right to override decisions of Congress regarding this particular form of health care choice, do not have a long enough history, and therefore cannot constitute a fundamental right. The state therefore argued that since no fundamental rights were at stake, the ban should be subject only to rational basis review, the lowest constitutional level of review.

By contrast, the plaintiffs argued that the state defined fundamental rights at too specific a level that the law should be subject to strict scrutiny (the strictest form of judicial review) and would fail under the more general right of parents to make decisions about their children’s health care.

Regarding the plaintiffs’ medical freedom claims, the state’s lawyers argued that the 2011 reforms were only intended to protect medical care. transaction It was free from government regulation and did not undermine the government’s long-standing traditional authority to regulate medical procedures. Lawyers for the state also expressed concern that the text of the amendment, if taken literally, could be interpreted broadly enough to override virtually all medical regulations, including those targeting controlled substances like opioids.

In response, plaintiffs’ attorneys argued that their interpretation of the Medical Freedom Amendment does not invalidate all opioid regulations. Opioids have legitimate medical uses and, unlike gender-affirming care for minors, are not subject to a blanket ban in Ohio, the lawyers pointed out. Thus, a ban on gender-affirming care for minors completely prohibits access to accepted medical care, whereas regulation of opioids does not. Judge Pat DeWine (son of Gov. Mike DeWine) pressed the plaintiffs on whether Congress or the courts have the power to define health care. Plaintiffs’ lawyers argued that defining medical care is a judicial function, no different from courts defining what constitutes speech under the First Amendment or investigation under the Fourth Amendment.

The state also argued that another provision of the Medical Freedom Amendment, which maintains the validity of “laws intended to deter fraud or punish wrongdoing in the health care industry,” gave Congress the power to define gender-affirming care for minors as “fraud.” However, as the plaintiffs pointed out, this provision targeted illegal activities such as fraud and medical malpractice. Additionally, the plaintiffs said that if the bill were interpreted as delegating power to the Legislature to make all forms of medical care off-limits simply by calling it “fraudulent,” the constitutional amendment itself would be invalidated.

Moewhich determines whether minors in Ohio receive gender-affirming care, ties into national discussions and trends beyond gender-affirming care. First, throughout their arguments, state attorneys openly flouted science and expert consensus. For example, she claimed that the World Association of Transgender Health Professionals, which developed guidelines for gender-affirming care of minors, was “waging an ideological war” and painted medical professionals in the field as politically driven rather than scientifically. In contrast, the plaintiffs accepted the lower court’s findings based on the evidence. Similar debates over the politicization of science are currently unfolding in many areas, including abortion rights and vaccines.

Second, the case raises questions about the scope of medical freedom under state constitutions, including provisions like Ohio’s. Following passage of the Affordable Care Act, five other states (Alabama, Arizona, Florida, Oklahoma, and Wyoming) enacted similar amendments. The Wyoming Supreme Court recently ruled that the state’s Medical Freedom Amendment protects the right to abortion. In this decision, the Wyoming court clearly ruled that abortion is medical care, directly contradicting the argument that courts should leave it up to Congress to determine what does and does not qualify as “medical care.” The debate about the meaning of health care and the respective powers of legislatures and courts to define and regulate it is likely to continue.

Finally, Moe It highlights the increasingly important role of state courts and state constitutions in efforts to expand transgender rights. Last year, the U.S. Supreme Court upheld a Tennessee law banning gender-affirming care for minors. USA vs. Scumettiargues that the ban does not violate the Equal Protection Clause of the U.S. Constitution because it does not discriminate on the basis of sex or gender. Rather, the court said it made the distinction solely based on age and “medical use.” However, this did not affect the Ohio case. Moe Plaintiffs relied on state constitutions rather than the United States Constitution. Moreover, even though Ohio courts tended to link the meaning of the state constitution to federal interpretation, the U.S. Supreme Court did not consider that point. I shrieked. The question is whether this ban violates parents’ fundamental right to control their children’s medical care, and there is no federal law equivalent to the Medical Freedom Amendment. Regardless of the Ohio Supreme Court’s final decision, it will not be the last state high court to consider whether the state constitution provides broader protections for transgender people than the U.S. Constitution.

Recommended quote: Jesse Hill Ohio Supreme Court hears arguments in transgender lawsuitSᴛᴀᴛᴇ Cᴏᴜʀᴛ Rᴇᴘᴏʀᴛ (March 31, 2026), https://statecourtreport.org/our-work/analysis-opinion/ohio-supreme-court-hears-arguments-trans-rights-case