A bill introduced in May by two Republican legislators in Ohio aims to tighten parental control over transgender children and teens who seek mental health and medical care — even if the kids suffer as a result.

Ohio House Bill 658 would turn school employees, psychologists, and social workers into spies of a sort; the legislation mandates that they disclose to parents if a minor approaches them with questions about gender identity or seeks mental health care for gender dysphoria. And if they don’t inform the child’s parents — regardless of concern for the safety or wellbeing of the child — they would face felony charges.

“No government agent or entity shall purposely or knowingly authorize or provide gender dysphoria treatment for a child without the written, informed consent of each of the child's parents and the child's guardian or custodian, as required in section 2131.144 of the Revised Code,” says the text of HB 658. “A violation of this section is gender dysphoria treatment without parental consent, a felony of the fourth degree.”

Rep. Thomas Brinkman, the legislation’s primary sponsor, told Ohio’s WKSU that the bill was inspired by a single court case, in which a Cincinnati juvenile court judge gave custody of a 17-year-old trans boy over to his grandparents because his parents refused to support his gender identity and tried to place him in conversion therapy.

But Erin Upchurch, executive director of the Kaleidoscope Youth Center in Columbus, says the LGBTQ+ youth that access Kaleidoscope’s services could be harmed by the prospective law.

“Every medical and psychological association agrees that transition-related care is medically necessary,” says Upchurch. “Making sure that this stays between doctors and patients and isn’t a one-size-fits-all situation is really important.”

Kaleidoscope, home to the Ohio GSA Network of student “Gender and Sexuality Alliance” clubs, serves LGBTQ+ youth between the ages of 12 and 20. 80 percent of those kids cite isolation and loneliness as the primary reason for visiting the center.

Upchurch, who has a 20-year background in social work, says that 49 percent of the LGBTQ+ youth that come to Kaleidoscope identify as transgender or nonbinary. Many of them already struggle for acceptance at home. While the custody case that inspired HB 658 was unusually extreme, Upchurch says that every parent or guardian has a different level of comfort when it comes to their child’s gender issues.

“There’s a middle ground, where maybe [the parents] support pronoun use or affirming names but they don’t support medical care. There’s a spectrum, and most of our families fall sort of in the middle,” says Upchurch.

Being alienated from family members can make an already difficult situation much worse for trans youth in Ohio. The state has no laws protecting trans people from discrimination, and in a July 2017 video produced by the ACLU of Ohio, trans adults from the state shared their experiences of housing and employment discrimination. And the national lansdscape is similar: according to the 2015 U.S. Transgender Survey, 19 percent of trans adults report having been fired, denied a promotion, or not being hired for a job because of their gender identity or expression.

The GOP legislation would likely have the most impact on school staff and caregivers. In Ohio, as in most U.S. states, the consent of a parent is already required in order for a minor to start hormone treatments or have gender-affirmation surgery. And the state already mandates that both parents, regardless of relationship, be notified of a name and gender change on identity documents. Even if there is no known father, for example, the child’s mother has to prove that they sent a notification in the mail to the person they think might be the father before the child’s name or gender can be legally changed. Essentially, it’s already an arduous process for a minor to undergo gender transition in Ohio.