Ohio’s ban on gender-affirming care for minors, enacted as the Saving Adolescents from Experimentation (SAFE) Act in House Bill 68, bars physicians from performing gender reassignment surgery or prescribing hormones or puberty blockers to anyone under eighteen for the purpose of gender transition.1Ohio Legislative Service Commission. Ohio Revised Code 3129.02 – Physician Prohibitions The law took effect April 24, 2024, after the General Assembly overrode Governor Mike DeWine’s veto.2Ohio Legislature. House Bill 68 – 135th General Assembly It is being enforced statewide as of early 2026 while the Ohio Supreme Court considers a constitutional challenge.
What Is Banned
Ohio Revised Code Chapter 3129 covers three things a physician cannot knowingly do for a minor: perform gender reassignment surgery, prescribe cross-sex hormones or puberty-blocking drugs for gender transition, or help someone else do either.1Ohio Legislative Service Commission. Ohio Revised Code 3129.02 – Physician Prohibitions
The surgical prohibition reaches both genital and non-genital procedures done for transition purposes, including chest surgery, facial feminization, and voice surgery. “Cross-sex hormones” means testosterone, estrogen, or progesterone given in amounts greater than the body would naturally produce for someone of the minor’s age and sex. “Puberty-blocking drugs” covers GnRH analogs and other synthetic drugs that suppress normal puberty.3Ohio Legislative Service Commission. Ohio Revised Code 3129.01 – Definitions
Parental consent does not change the analysis. A physician’s clinical judgment that treatment is appropriate does not either. The prohibition is categorical for minors seeking care for gender transition.
Who the Ban Does Not Cover
The law applies only to people under eighteen. Adults in Ohio can still receive hormone therapy and surgical care from providers who offer it; Ohio State’s Wexner Medical Center, for example, continues to treat patients nineteen and older.1Ohio Legislative Service Commission. Ohio Revised Code 3129.02 – Physician Prohibitions
A physician may also treat a minor born with a disorder of sex development where biological sex characteristics are medically ambiguous, or a minor with a diagnosis confirmed through genetic or biochemical testing showing atypical sex chromosome structure or hormone production. And a physician may treat any infection, injury, disease, or condition caused or worsened by prior gender transition services, regardless of whether that earlier care was legal.4Ohio Legislative Service Commission. Ohio Revised Code 3129.04 – Permissible Medical Treatment A minor who develops complications from a procedure performed out of state or before the law took effect can still receive follow-up care in Ohio.
If Your Child Was Already in Treatment
Section 3129.02(B) sets out a narrow path to continue hormones or puberty blockers that were already prescribed. Three things must be true. The minor must have been a continuous Ohio resident since April 24, 2024. The physician must have started the treatment course before that date. And the physician must determine, and document in the medical record, that stopping the medication would cause harm.1Ohio Legislative Service Commission. Ohio Revised Code 3129.02 – Physician Prohibitions
This continuation rule covers medication only, not surgery. It does not apply to minors who move to Ohio after April 24, 2024, and it does not apply to a minor whose treatment was being managed by a provider in another state. New patients cannot start hormones or puberty blockers for gender transition under any circumstances.
Mental Health Care Rules
Before a mental health professional can diagnose or treat a minor for a gender-related condition, Ohio requires written consent from at least one parent, legal custodian, or guardian. That requirement overrides Ohio’s general mental health consent rules.5Ohio Legislative Service Commission. Ohio Revised Code 3129.03 – Mental Health Care
The mental health professional must screen for conditions that could be influencing the minor’s experience of gender, including depression, anxiety, ADHD, and autism spectrum disorder, and must separately screen for physical, sexual, mental, and emotional abuse and other trauma. The screening is not a one-time intake step; it has to occur during the course of diagnosis and treatment.5Ohio Legislative Service Commission. Ohio Revised Code 3129.03 – Mental Health Care
Separately, Ohio Department of Health administrative rules bar hospitals and other health care facilities from providing hormones or puberty blockers to a minor for a gender-related condition until the minor has completed comprehensive mental health counseling and evaluation lasting at least six months.6Ohio Department of Health. Notice of Public Rules Hearing That facility-level requirement operates independently of the statutory ban.
Medicaid Coverage
Ohio Medicaid will not pay for gender transition services for minors. Section 3129.06 writes that exclusion directly into statute.7Ohio Legislative Service Commission. Ohio Revised Code 3129.06 – Medicaid Medicaid will still cover treatment for disorders of sex development under Section 3129.04, mental health services for gender-related conditions, and medical services that do not qualify as gender transition services. A minor can receive therapy and counseling through Medicaid; what the program will not pay for is medical and surgical transition care.
Penalties for Providers
A physician or mental health professional who violates Sections 3129.02, 3129.03, or 3129.06 commits what the statute calls “unprofessional conduct.” That triggers disciplinary authority at the provider’s licensing board, which for physicians is the State Medical Board of Ohio. Sanctions can run from formal reprimand to suspension or revocation of the license.8Ohio Legislative Service Commission. Ohio Revised Code 3129.05 – Enforcement
The Ohio Attorney General also has independent authority to bring enforcement actions to compel compliance with Sections 3129.02 and 3129.03. The statute preserves any private cause of action already available under Ohio common law, so a family does not have to wait for a licensing board or the Attorney General to act.8Ohio Legislative Service Commission. Ohio Revised Code 3129.05 – Enforcement A provider who violates the law can face discipline, a state enforcement action, and private litigation at the same time.
Where the Court Case Stands
In March 2025, the Tenth District Court of Appeals found that the ban on prescribing puberty blockers and hormones for gender transition, Section 3129.02(A)(2), was unconstitutional on its face and ordered the trial court to permanently enjoin enforcement of that provision.9Supreme Court of Ohio. Moe v Yost, 2025-Ohio-914 The state sought review, and in April 2025 the Ohio Supreme Court stayed the appellate ruling. That stay put the full ban back into effect.
As of early 2026, the Ohio Supreme Court has accepted the case and the law remains enforceable statewide. A final ruling from that court could change the landscape, but until it does, every provision of Chapter 3129 applies.