By Joshua Arnold

Ohio Governor Mike DeWine’s (R) Friday veto of a bill to protect children from the harmful effects of gender transition procedures has conservatives everywhere scratching their heads. Although the governor tried to explain himself, his remarks did not leave his hearers any better informed. His comments sounded conservative at first blush, but in reality, they echoed the narratives promoted by the Left and, on this issue specifically, their allies in children’s hospitals.

In fact, in webinars and podcasts conducted over the past several years, the very children’s hospitals DeWine met with before vetoing the Ohio SAFE Act undermined — nay, debunked — the grounds on which he based his decision. Let’s review two of his arguments.

1. Parents

In his Friday speech, DeWine repeatedly emphasized parents’ role in making medical decisions for their children. “These are gut-wrenching decisions,” he said, “that should be made by parents and should be informed by teams of doctors who are advising them. These are parents who have watched their child suffer — sometimes for years — and who have real concerns that their child may not survive to reach adulthood.” DeWine later added, “We have to make a decision, and I just felt that there’s no one better than the parents to make those decisions. You want those decisions to be informed.”

But parents aren’t always informed by children’s hospitals in Ohio, according to remarks by Lee Ann Conard, director of the Living with Change Center at the Cincinnati Children’s Hospital Medical Center during a webinar reviewed by The Washington Stand, apparently held in the spring of 2022.

An expert at talking with people, Conard was describing how physicians should navigate a conversation with a minor suffering from gender dysphoria, and she arrived at the hypothetical case, “What if the kid says, ‘No, my caregiver doesn’t know?’” (Incidentally, viewing parents merely as caregivers might be part of the problem here.) Conard answered: 

“Then the next question — after we’ve done our safety screening and everything — the next question is, ‘Are you ready to tell them?’ And some kids aren’t ready to tell the parent, and we shouldn’t out them. There may be reasons. There may be comments the parents have made about transgender people that make the child feel not safe about telling them. So, again, that’s where we talk about resources available to the teen.”

Conard later added, “We can refer a child for therapy without the parent knowing that the kid told us they’re transgender, if they’re having significant anxiety and depression.”

This attitude is consistent with incidents that have occurred from California to Michigan to Florida, in which health care professionals or school counselors have conspired with children to keep their transgender identity a secret from their parents, even to the detriment of the child’s well-being. Even in cases where the parents are aware, they have been bullied or manipulated into approving treatments based on woefully inadequate information. 

2. Surgery

DeWine also downplayed the urgent need for the SAFE Act by arguing that no Ohio hospitals conduct gender transition surgeries on minors. By their dramatic, obviously irreversible nature, gender transition surgeries on minors occupy an outsized position in SAFE Act debates. “I adamantly agree with the General Assembly that no surgery of this kind should ever be performed on those under the age of 18,” said DeWine. But he added, “I think that’s frankly a fallacy that’s out there, that [the gender transition treatment regimen] goes right to surgery. It just doesn’t. All the children’s hospitals, you know, say, ‘We don’t do surgeries.’”

They all say that, but is it true?

In a June 2021 podcast published by Nationwide Children’s Hospital in Columbus, Dr. Scott Leibowitz described the procedures he and his colleagues use. “We in the THRIVE program [Nationwide’s transgender center] follow the World Professional Association of Transgender Health [WPATH] guidelines,” he said. “We are currently revising those guidelines to be the 8th Edition.” While previous editions of the WPATH guidelines said minors could undergo various gender transition surgeries between 15 and 18 years of age, the 8th Edition removed all age guidelines.

“There are different medical interventions at different points in development that we use, starting with less irreversible — so, more reversible — going up to more irreversible, depending on emotional maturity and age,” Leibowitz explained. He walked through the process, explaining the use of puberty blockers, then “more irreversible treatments, which include the gender-affirming hormone treatments, such as testosterone or estrogen … and then surgery.” He added that “the surgery that is most likely to be recommended for a person who’s still a minor would be a ‘top surgery,’ or a ‘chest masculinization’ surgery for a transgender boy.”

Leibowitz elaborated on this point, going into detail on both the factors the THRIVE program considers in recommending a minor for this type of surgery and the reasons why such a surgery might be performed on a minor.

Here are the factors he gave: “The decisions on surgery are largely based on the emotional maturity of the young person, how long that they’ve been experiencing their own gender dysphoria, [and] how impaired their life is as a result of not obtaining surgery.” One factor I don’t see on that list: whether or not the young person is legally an adult and therefore able to consent.

And here are the reasons for surgery: “for a boy [he means a girl] who’s been living as a boy” for years, “the presence of chest anatomy that’s consistent with being a girl [— if only there were a word for that! —] can be extremely difficult. It limits them from participating in swimming or taking their shirt off in the summer and just feeling overall uncomfort [sic] with themselves or even have to bind every single day.” To be clear, the surgery being discussed is a double mastectomy. The reasons given for this inessential amputation are recreation, general comfort, and convenience.

If DeWine is correct that Nationwide and other children’s hospitals in Ohio do not perform gender transition surgeries on minors, one would expect Leibowitz to mention that fact somewhere in his minutes-long, detailed discussion on the topic — especially after saying that they do provide gender transition hormones. Yet he never mentioned this.

Conclusion

The charitable interpretation for DeWine’s empty arguments is that he was hoodwinked by hospital representatives who misrepresented the issue to him with more cleverness than conscience. A more cynical — but not necessarily less correct — interpretation is that DeWine’s decision was connected to the political donations he received from Ohio children’s hospitals.

One thing is clear: when presented with the same basic controversy, virtually no conservative has reached DeWine’s conclusion. This commonsense legislation passed both chambers of the Ohio legislature with a veto-proof majority, and it enjoys the support of other Ohio conservatives elected to both statewide office and Congress, not to mention conservatives across the nation.

Joshua Arnold is a senior writer at The Washington Stand.