Earlier this year, a Hamilton County, Ohio, court granted custody of a teen who is transgender to his grandparents after his parents refused to allow him to undergo hormone therapy. The case has resulted in a bill proposed to the Ohio house, which has sparked controversy in recent weeks. Lawmakers may vote on House Bill 658, presented by Reps. Tom Brinkman (R) and Paul Zeltwanger (R), in the fall. Coming at a time when discriminatory legislation is on the rise, the bill has the potential to emotionally, physically, and financially harm all youth, not only those who are trans or gender nonconforming.

A two-pronged measure, HB 658, if enacted, would impact guardianship and medical decisions. It would not allow a judge to use a parent’s decision to deny their child treatment for gender issues, including counseling, as a “basis for determining custody of the child,” as happened in the Ohio case. In an article from April, Maria Polletta of the Arizona Republic wrote that “[c]lashes over how to support children exploring their gender identities have revived custody fights in at least ten states,” a burgeoning issue that, according to LGBTQI advocates: “most U.S. family courts are poorly equipped to handle.”

Creating a Culture of Informants

Advocates also worry the bill in Ohio would turn trusted adults into informants. HB 658 would legally compel some adult authority figures to report any minor who they think shows signs of gender conflict. It would require a member of a state entity—a group that includes any “agent, employee, contractor, or volunteer for a public children services agency, private child placing agency, court, or school district”—to inform parents in writing if a child exhibits signs of gender dysphoria. If such “agents” of a state institution, including public school staff and volunteers, provide “gender dysphoria treatment,” they can be charged with a fourth-degree felony, with penalties of six to 18 months in prison.

But the bill does not specify signs of gender conflict. It defines gender dysphoria as “the condition of feeling one’s emotional and psychological identity as male or female to be opposite to one’s biological sex,” but the bill also requires adult authority figures to notify parents if a child “otherwise demonstrates a desire to be treated in a manner opposite of the child’s biological sex.”

This is vague language, up for interpretation, that could empower adults to report and police children who don’t fit those adults’ gender norms, whether the young people are trans or not.

Trans and gender-nonconforming/gender-nonbinary youth already face hostility from family and friends. They experience high rates of housing discrimination and living without housing. According to Melissa Alexander, co-chair of TransOhio, suicide rates among trans youth are soaring.

In February, a wrestling coach in Wilmington, Ohio, outed a trans teen to his classmates. The teen faced subsequent bullying by peers and disregard for his gender identity by the coach. His mother, Sheila Progue-Kabacher spoke out during a school board meeting about the implications of outing young people like her child: “Not only did Coach Tolliver announce to the entire team that Aiden is transgender, he publicly humiliated him in front of his classmates with privileged, medical information he had no business sharing.”

The breach of trust with an authority figure like a coach could be especially devastating for children who are trans because “[r]elationships with trusted professionals/adults are a core factor in trauma recovery and overall wellness for youth,” according to Erin Upchurch, the executive director of the Kaleidoscope Youth Center in Columbus, Ohio, the only LGBTQ center for young people and allies in Ohio. “These relationships offer safety and belonging; both necessary aspects of both development and overall thriving.”

For Alexander, of TransOhio, trusted medical staff helped her. In an interview with Rewire.News, Alexander said: “I can speak from my experience, even as an adult, it was important to find someone I could trust to discuss everything which was going on in my life during the periods leading up to and during transition and coming out. The issue is even more important for LGBTQ youth … this confidence and trust cannot be breached.”

Alexander said HB 658 could essentially turn school teachers and staff into snitches, legally required to “out” children who had previously “felt [teachers] were a safe person to discuss their gender identity issues with …. Such actions are hurtful and will lead to more issues.”

Medical Impact

Alexander also said the bill could potentially block information about treatment from trans and gender-nonconforming/gender-nonbinary youth, without a parent’s knowledge. This includes information about puberty blockers, medications that can effectively pause puberty.

“Counseling and hormonal intervention is standard methodology in the community and has been for some time now. The practice has been shown to improve the lives of transgender youth, and the hormonal intervention only seeks to delay the onset of puberty in the child until they can fully understand their [gender identity] and decide on further action,” Alexander said.

A relatively recent medical development, puberty blockers could allow for an easier physical transition if the time comes for an individual to decide to transition physically. But if the bill passes, that information would be harder for minors to access.

“The methods are safe and proven,” Alexander said. “This bill seeks to prevent youth from access to this necessary treatment.”

Currently, Ohio law generally leaves medical decisions regarding minors in the hands of parents.

An Australian court recently ruled that trans youth would no longer need the permission of courts to access hormone therapy; advocates noted that delaying gender affirming hormones can cause further harm to an already marginalized population. In the long term, restrictions to medical information and options for trans youth could later cost them thousands of dollars in gender reassignment surgeries.

Furthermore, if the proposed bill in Ohio passes, and trans youth wish to fight for access to medical information and treatment related to gender, this could lead some minors to long, costly legal battles seeking emancipation.

HB 658 could even result in medical staff being culpable if they affirm a minor’s understanding of legitimate forms of hormone therapy. Section 2131.149 of the bill states that any person or entity involved in talking to a minor or a minor’s parents would not be required to “engage in affirmative acts, or speech, or to affirm any particular viewpoint.”

This would essentially mean any minor questioning their gender may not get the support they need from a health-care provider who refuses to discuss their gender identity with them.

Upchurch, of the Kaleidoscope Youth Center, called the bill “discriminatory; [it] is not about protecting parent’s rights, and will not support or protect youth. HB 658 goes against all established best practices as they relate to mental health and wellness and therapeutic care. The impact of this bill is discrimination and further marginalization of the most vulnerable members of our community.”