In late December, Ohio Gov. Mike DeWine vetoed House Bill 68, a bill to ban gender-affirming care practices for minors.
This came as a surprise to many as DeWine has often found himself embracing social conservative positions throughout his long career. And indeed, DeWine framed his decision as a conservative one in his public statements on the veto, saying his decision is “about protecting human life” and rejecting the idea that “the government knows what is best medically for a child rather than the two people who love that child the most, the parents.”
In DeWine’s statements, he says repeatedly that it was the testimony of parents and people who received gender-affirming care that this care saved their lives that swayed him. That young people who felt trapped in bodies that weren’t theirs were able to find solace in this care that turned them away from the impulses of self-destruction that gender dysphoria can spark.
What is gender-affirming care? According to the U.S. Department of Health and Human Services’s Office of Population Affairs, gender-affirming care comprises four general practices.
The most simple practice is social affirmation. This includes practices such as adopting gender-affirming hairstyles, clothing, name, gender pronouns, and use of gender-appropriate restrooms and other facilities. These signal to someone experiencing gender dysphoria that they are being socially accepted for their gender expression.
Another is puberty blockers. According to a review of gender-affirming care published in the Annual Review of Medicine last year, these are hormones that can pause pubertal development, prevent otherwise permanent development of secondary sex characteristics that are not aligned with a person’s affirmed gender identity, and allow time for further gender exploration.
Next is hormone therapy: testosterone therapy for biological females and estrogen therapy for biological males. This sort of therapy can help development of gender-affirming characteristics and is partially reversible.
The final is gender-affirming surgery. This includes operations to change chest shape, genitals, or reproductive organs to affirm gender.
DeWine’s focus seems to be on puberty blockers and hormone therapies. He says explicitly in his public statements that he does not support gender-affirming surgery for minors. But the bill went further than that, prohibiting physicians from “prescribing a cross-sex hormone or puberty blocking drug to a minor” according to analysis of the bill by the Ohio Legislative Service Commission.
The best evidence available tells us transgender and gender diverse youth have higher risk for mood disorders, anxiety, depression, suicidal ideation, and suicide attempts. It also tells us that these youth tend to have better mental health and well-being outcomes later in life if they receive gender-affirming care earlier rather than later.
We should acknowledge that we are still gathering data on this sort of treatment. But the early data is promising. Short- and medium-term studies have found higher sense of well-being, resolution of gender dysphoria, and even lower rates of suicidal ideation.
Like any type of treatment, there are side effects to consider. Some early evidence of impacts to bone density, growth, blood pressure, neurocognitive development, and fertility need to be taken seriously.
Overall, it seems that in this case Governor DeWine listened to the current scientific consensus: gender-affirming care can save lives, and for that reason is a viable option for families that care about the mental health and safety of their children.
This commentary first appeared in the Ohio Capital Journal.