The Ohio Senate voted Wednesday to override Republican Gov. Mike DeWine’s veto of a bill that bans transition-related medical care for transgender minors and restricts trans athletes’ participation on school sports teams. 

After the Senate’s 23-9 vote, the bill will become law in 90 days. The Ohio House already voted 65-28, along party lines, to override DeWine’s veto earlier this month.

Ohio is now the 22nd state with a law that restricts minors’ access to puberty blockers and hormone therapy and the 24th with a law that bars trans girls and women from playing on women’s school sports teams. 

Health care providers who violate the law could face disciplinary action from their licensing board. The law also allows students in K-12 schools and colleges who believe they have been deprived of an athletic opportunity because of a trans student’s participation to sue their school, school district, interscholastic body or other related organization.

Dara Adkison, secretary of the board for the transgender advocacy group TransOhio, said  some trans people and their families have been “in crisis” before the vote. The group offers emergency funding and relocation assistance for families with trans kids who want to leave the state. Adkison, who uses they/them pronouns, said in a phone call Tuesday that they talked to 68 families and seven trans adults in the days leading up to the vote who requested emergency relocation funds and planned to leave the state due to the law and the political climate.

“Their government is forcing them to uproot their lives,” Adkison said. “They’re selling their homes, they’re changing jobs and careers and closing out all of their savings. They’re closing their businesses, they’re leaving their medical practices. The intense amount of personal and community trauma that is being inflicted by the government right now and putting these families through who just love their f—ing kids is so cruel.” 

Ahead of the vote Wednesday, state Sen. Kristina Roegner, one of the bill’s co-sponsors, said it’s impossible for someone to change their gender and that “there is no such thing as a gender spectrum.” 

“There is no such thing as gender-affirming care,” Roegner added. “You can’t affirm something that doesn’t exist.” 

Roegner said treatments for gender dysphoria, or the distress that results from a misalignment between someone’s sex assigned at birth and gender identity, “creates, as you can imagine, a permanent patient.” 

“This is quite a profit center for those hospitals pushing these procedures to teenagers, children,” Roegner said. “They’re not capable of making life-altering decisions.”

Protestors interrupted Roegner’s speech at one point, and the Senate temporarily cut the feed to the livestream. 

Major medical associations — including the American Medical Association, the American Academy of Pediatrics and the American Psychological Association — support minors’ access to gender-affirming care and oppose state bans. 

Ohio’s law makes an exception for minors who were already receiving gender-affirming care before the measure’s effective date. However, all minors and trans adults could face more barriers to such care due to a set of administrative rules that DeWine announced after he vetoed the bill last month. These rules require trans patients under 21 to receive at least six months of therapy before they can receive puberty blockers, hormone therapy or surgery. They also require a multidisciplinary team of physicians, such as an endocrinologist and psychiatrist, to be involved in a trans patient’s treatment plan, among other requirements.

When DeWine announced the rules this month, he said he was concerned about substandard clinics in the state that could be providing trans adults with hormone therapy “without the lead-in psychiatric care that we know is so very, very important.”

However, Adkison said Tuesday that there are no such clinics, and the rules are “bad and unnecessary bureaucracy.” 

“No one is getting pop-up gender-affirming care,” Adkison said. “We have months and yearslong waitlists for gender-affirming care in this state, and the concept that anyone can get it in a fly-by-night, pocketbook clinic is beyond preposterous. It’s insulting to the bureaucratic mess that those of us seeking gender-affirming care have to navigate through.” 

The Ohio Department of Health is taking public comments on the rules until Feb. 5, and the Department of Mental Health and Addiction Services until Jan. 26. If the rules take effect after that period, it would make Ohio the second state to restrict gender-affirming care for trans adults after Florida, which passed a law in May that requires trans adults to give consent for such care in person and with a physician present.