An Ohio county judge upheld the state’s law banning transgender surgeries and hormone therapies for minors on Wednesday, months after the state legislature enacted the law despite a veto from Republican Gov. Mike DeWine.

Franklin County Judge Michael Holbrook issued the ruling in Moe v. Yost, stating the law reasonably limits parents’ rights regarding their children’s medical care due to the state’s interest in regulating medical treatments. The law bans transgender surgeries and hormone therapies for minors unless already undergoing treatment and deemed risky to stop by a doctor. It also restricts certain forms of gender counseling and prohibits biological males from participating in girls’ and women’s sports.

Holbrook emphasized Ohio’s legitimate interest in protecting minors’ health and noted that transition surgeries for underdeveloped minors carry significant risks and permanent outcomes. He mentioned that some countries are reversing their stance on gender-affirming care for minors due to inconsistent results and potential side effects.

Republican Attorney General Dave Yost praised the ruling, stating it protects children from making irreversible medical decisions. The American Civil Liberties Union of Ohio, which helped file the lawsuit, announced it would appeal the ruling immediately.

Ohio joins several states with laws preventing minors from undergoing transgender procedures, with similar legal disputes occurring nationwide. The Supreme Court is set to review a similar case from Tennessee, which the Biden administration argues violates the Equal Protection Clause of the 14th Amendment.