JEFFERSON CITY — Missouri Attorney General Andrew Bailey has joined a 24-state coalition calling on the Supreme Court of Ohio to reverse a lower court decision that struck down Ohio’s recently enacted ban on sex-change procedures for minors.
The coalition filed an amicus brief on May 16 urging the high court to review and uphold the "Saving Ohio Adolescents from Experimentation Act,” which prohibits the administration of puberty blockers, cross-sex hormones and sex-change surgeries to minors.
The 10th District Court of Appeals had previously invalidated the law, reasoning that the Ohio General Assembly could not override the prevailing guidelines of the World Professional Association for Transgender Health.
In its opinion, the court described WPATH as “the standard-bearer in gender-affirming care” and accepted its guidelines as “the prevailing standards of care for the treatment of individuals with gender dysphoria.”
However, in its petition to the Supreme Court, Ohio challenges the court’s deference to WPATH, asserting that the Constitution does not permit an unelected advocacy organization to dictate public health policy.
The coalition brief, filed by Bailey and other state attorneys general, argues that WPATH’s guidelines are not evidence-based and were crafted under the influence of political and legal advocacy rather than impartial scientific review.
The brief cites internal communications among WPATH contributors indicating that the guidelines were designed to bolster court arguments and influence public policy.
Authors of the guidelines, according to the court filings, acknowledged avoiding systematic evidence reviews because such reviews would not support their preferred treatment approaches.
The brief also notes that the guideline authors were required to be advocates for transitioning procedures even before the drafting process began. Multiple contributors also had financial or professional interests in the continuation of pediatric gender medicine, yet WPATH claimed no significant conflicts of interest existed in its authorship process.
One author, Dr. Marci Bowers, reportedly earned over a million dollars in 2023 performing gender-transition surgeries, yet testified it was “absurd” to consider this a conflict worth disclosing.
The amicus brief details how political actors, including the U.S. Assistant Secretary for Health, Admiral Rachel Levine, influenced the content of WPATH’s guidelines shortly before publication.
Levine expressed concern that specific age minimums for treatment could lead to restrictive legislation, according to the court document.
Following meetings with Levine and threats from the American Academy of Pediatrics to oppose the guidelines, WPATH removed all minimum age thresholds from its final Standards of Care version 8 (SOC-8), despite no new medical evidence prompting the change.
The Ohio Supreme Court is being urged to determine whether the state legislature retains the authority to regulate medical treatments for children or whether such decisions must align with standards developed by organizations like WPATH.
The coalition brief questions whether Ohio’s constitutional framework permits the delegation of regulatory power to interest groups whose members are themselves the subjects of the regulation.
Citing internal evidence reviews by Johns Hopkins researchers commissioned by WPATH, the brief underscores a significant lack of reliable data supporting pediatric gender interventions.
Dr. Karen Robinson, head of the evidence team, reported “little to no evidence” regarding the effectiveness of these treatments in children and adolescents. Robinson further noted WPATH's efforts to suppress publication of the evidence reviews to protect the organization’s policy goals.
In making their case, the states aligned with Ohio argue that legislatures must be free to reject guidelines that prioritize political advocacy over scientific rigor. They liken the issue to opioid regulation, asserting that just as a legislature could restrict opioid prescriptions for minors despite differing medical guidelines, so too should it be able to prohibit gender-transition procedures.
The Supreme Court filing frames the matter as one of democratic governance, asking whether policymaking authority lies with elected state legislators or unelected professionals within ideologically aligned associations.
As the brief notes, other countries such as the United Kingdom and Scotland have moved to restrict similar treatments, reflecting growing international concern about the long-term consequences of these irreversible procedures.
The coalition contends that Ohio's legislature acted within its constitutional rights to protect minors and that the judiciary should not enforce guidelines developed with political and legal aims in mind.
The states backing Ohio include Alabama, Alaska, Arkansas, Florida, Georgia, Idaho, Indiana, Iowa, Kansas, Kentucky, Louisiana, Mississippi, Montana, Nebraska, North Dakota, Oklahoma, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia and West Virginia.
Ohio Supreme Court case number: 2025-0472
