As the United States Supreme Court prepared its decision holding that states cannot categorically ban conversion therapy, the Ohio Supreme Court heard its own treatment ban case and seems likely to come to the opposite result. In Moe v. Yost, parents of transgender children who are barred from gender-affirming care by a recent state law banning the use of hormone treatments for minors, only for its use in gender-affirming care, challenged the law as violating their parental rights. In the case, the state and its conservative defenders advanced a strikingly narrow vision of parental rights that is at odds with both established precedent and the right’s embrace of parental rights absolutism in almost all other contexts. Like the U.S. Supreme Court’s decision, the discrepancy comes down to conservatives’ feelings about the LGBTQ+ community.
Ohio Solicitor General Mathura Sridharan argued that parental authority over medical treatment must be minutely particularized to specific categories of treatment and that, despite the state’s Healthcare Freedom Amendment (HCFA), legislators—not judges or medical experts—define what actually counts as healthcare protected by the constitution. From the same state that has asserted near-absolute parental rights when it comes to what constitutes child abuse and when parents can override children’s personal decisions, the case highlights the glaring inconsistency in how conservative powerbrokers define parental rights when it suits them.
Across Ohio’s political landscape, conservative lawmakers and allied groups have loudly touted the notion of parental sovereignty over children’s education, medical decisions, and cultural upbringing. Bills like HB 8, branded as the “Parents’ Bill of Rights,” assert that parents have a fundamental right to make decisions about their children’s care and that schools must notify parents about sexual content or even a student’s request for personal mental health counseling. Other measures have limited access to emergency mental health services for teens unless a parent consents, even if they are a contributing factor to the child’s mental distress. At the same time, they are eliminating options for trans children to escape abusive parents or vindicate their individual rights. These laws are framed as shields against government coercion and protection of the nuclear family’s autonomy.
Yet, when confronted in Moe with a concrete exercise of parental authority—to obtain medically recognized, evidence‑based treatment that even the state’s expert did not dispute is appropriate for at least some transgender youth—the state’s position flipped. Sridharan declined to recognize a broad parental right to direct healthcare for children. Instead, she urged the Court to define any such right so narrowly that it would exclude the contested care, effectively handing the legislature veto power over what families and their doctors can agree is in children’s best interests. The claim is essentially that politically elected officials possess greater legitimacy than treating physicians and families to make medical judgments about children.
Under the HCFA, the state constitution is supposed to protect individuals’ freedom to obtain or decline healthcare without undue interference. Yet during oral argument, the state repeatedly tried to cabin that freedom through questions of what counts as medical care and doubts that the courts should rely on “expert-driven, confusing standards of care” rather than politicians. The “significant dangers of relying on expert consensus” was a recurring theme of the state’s argument, with Sridharan characterizing the World Professional Association for Transgender Health as putting “politics before children,” coming to “politically-driven conclusions,” and being on an “ideological war path.” However, the state’s solution to the alleged political bias of the medical profession is to put actual politicians in charge.
The real world consequences of a state win in Moe on transgender children are stark. As the parents’ lawyer, Jordan Bock, pointed out, there is currently not a single evidence-based treatment for gender dysphoria available for minors in Ohio under the law at issue. Physicians and parents who have worked together for years to support a young person’s well‑being have had their decisions upended by a legislature that treats evidence‑based care as always subject to a veto by non-experts like bill sponsor Representative Gary Click, who is not a doctor at all but a Baptist pastor. The state’s insistence that “expert consensus” is suspect when defining rights but legislative judgment is unimpeachable is a wide-open door for legislators to impose their religious ideology on the entire state by overriding actual doctors’ definitions of medical care.
The state made much of the “known and unknown mental health risks” of gender-affirming care for minors, speculating that there could be long-term effects of which experts are currently unaware. What the state cast aside were the well-studied mental health risks of denying transgender youth gender-affirming care. Transgender youth die by suicide at twice the rate of their cisgender peers, which is strongly influenced by negative cultural attitudes and discrimination against the transgender community and a lack of support in far too many families. Gender-affirming care like puberty blockers and gender-affirming hormone treatment has been shown to reduce suicide risk in adolescents by up to 73 percent, and Ohio’s ban completely denies the state’s children this lifesaving treatment.
If the Ohio Supreme Court is serious about protecting parental rights under the state constitution, it must reject a cramped, politics‑driven definition and instead acknowledge that the authority to direct children’s medical care, especially done in concert with the affected children and following evidence-based advice, belongs first to families rather than politicians. Otherwise, the state’s embrace of parental rights will remain even more inconsistent, protecting some families in theory while denying others their most basic familial autonomy in practice. Of course, for families with the wrong politics—and supportive families ofLGBTQ+ children in particular it seems like—this may be the point.