An Ohio bill cracking down on health care and sports participation for transgender youth is headed to the desk of Gov. Mike DeWine (R), who has a mixed record on LGBTQ+ legislation.

The Ohio legislature gave its final approval Wednesday to House Bill 68 , which would ban transgender youth from accessing gender-confirming surgery and non-surgical interventions, including hormone treatments and puberty blockers. (The latter is how medical providers typically treat transgender youth with the approval of the patients parents.)

The legislation would also prohibit transgender girls from participating on female sports teams, despite a lack of evidence that Ohios current policies allow any transgender athletes an unfair advantage.

If DeWine signs the bill, Ohio will join a number of other states that have enacted similar prohibitions in recent years. He has 10 business days to sign or veto the legislation.

Its unclear which direction DeWine will go. In 2021, he said transgender youth participation in school athletics was a matter best addressed outside of government , through individual sports leagues and athletic associations. He mentioned the Ohio High School Athletic Association, which has had a longstanding policy allowing transgender girls to play on female sports teams after they complete at least one year of hormone treatment, or provide sound medical evidence that they dont have any physiological advantages over athletes assigned female at birth.

However, that same year, DeWine signed legislation allowing the states medical providers to refuse treatment for LGBTQ+ people on the basis of their moral, ethical or religious beliefs.

Nick Lashutka, president of the Ohio Childrens Hospital Association, testified against the legislation ahead of Wednesdays vote, and noted that Ohios doctors have a high standard for providing such care.

While the majority of patients are never prescribed medication as minors, those who do take medication consider it lifesaving and crucial, he said. It is a dangerous precedent for government to dictate when medication is appropriate in pediatrics.

Of the 3,300 patients treated at Ohios childrens hospitals in the past decade, only 7% were prescribed a puberty blocker and just 35% were prescribed hormones, Lashutka said. He also noted that the average age of minor patients was 16, and that childrens hospitals in the state do not perform any gender-affirmation surgeries on minors.

Many of the effects of non-surgical treatments are reversible, though long-term use may result in permanent breast growth or reduced fertility. However, every major medical group says a greater risk comes from the mental health effects associated with banning gender-affirming care for transgender youth a demographic with one of the highest rates of attempted suicide in the United States.

If you or someone you know needs help, call or text 988 or chat 988lifeline.org for mental health support. Additionally, you can find local mental health and crisis resources at dontcallthepolice.com . Outside of the U.S., please visit the International Association for Suicide Prevention .