COLUMBUS, Ohio (WCMH) -- Several Ohio mayors say their cities lost points in a national report grading municipalities for LGBTQ+ equality because of the Statehouse's recent ban on gender-affirming care for transgender youth. While Akron, Cleveland, Columbus and Toledo each scored a perfect 100 by the Human Rights Campaign's Municipal Equality Index for 2024, the cities were docked points in the "transgender-inclusive healthcare benefits" category. The cities said in a joint statement, while they "are proud to offer trans-inclusive health care benefits to their employees," Ohio's ban on gender-affirming care for trans youth prevents young people from accessing those benefits. "While several Ohio cities were able to maintain strong scores thanks to local policies and services that empower and support LGBTQ+ residents, the harm of the state's anti-trans law goes beyond scorecards; it affects health care access, business attraction, tourism and reputation in cities throughout Ohio -- and worst of all -- it harms children and families who call Ohio cities home," the cities said. Voting rights amendment could be on Ohio ballots next election These mayors cited HRC's 2023 study that found 42.9% of LGBTQ+ adults in Ohio said they would move or try to move to a different state if Ohio were to pass or enact a ban on gender-affirming care. They also spoke against an "anti-trans" bill that passed the Statehouse this month to ban students from using school restrooms that don't align with their sex assigned at birth. "These laws and proposals serve no purpose other than to encourage hate and exclusion," Columbus Mayor Andrew Ginther said. "While our city does everything we can to empower and lift up all our youth, the state law prevents parents in our city from making health care decisions for and with their child." A Franklin County judge ruled in August that Ohio's contested law banning gender-affirming care for trans youth can go into effect after being on hold for several months. The ruling followed a five-day trial that took place in July after the ACLU filed a lawsuit against the measure in March on behalf of two families whose children are at risk of losing access to their healthcare.  The legal challenge came after the Statehouse voted to override Gov. Mike DeWine's veto of the legislation. DeWine decided to reject the bill after visiting several children's hospitals, arguing "parents should make these decisions and not the government." Poll: Trump’s favorability jumps post-election; plus, front-runners for 2028 Now, Cleveland Mayor Justin Bibb said Ohio's mayors "play a powerful role in protecting our LGBTQ+ communities, even in the face of discriminatory legislation and harmful rhetoric." "In Cleveland, we are focused on maintaining existing local protections, expanding youth mental health services, building a pipeline to housing for vulnerable populations and promoting inclusive health care, education and employment practices," Bibb said. "While I am pleased that Cleveland has maintained our 100-point MEI score, we know we have work to do, and that work is ongoing." HRC's index, which is a benchmarking tool examining the inclusivity of laws, policies and services for LGBTQ+ residents in more than 500 U.S. cities, also gave Cincinnati and Lakewood perfect scores of 100. While Dayton and Dublin achieved perfect scores in 2023's index, the cities both scored 96 this year. Nationwide, a record-breaking 130 cities scored a 100, 50% scored over 76, and 25% scored under 56. The report said the average score was 72, an increase from last year's average of 71, and six cities received a zero. County could be Ohio’s first to ban anti-LGBTQ+ conversion therapy Municipalities receiving a 100 are driven by leaders supporting direct services to people living with HIV, implementing a LGBTQ+ liaison to city executives, reporting hate crimes statistics to the FBI and passing ordinances like a ban on anti-LGBTQ+ conversion therapy. In Ohio, 12 localities have banned conversion therapy, including Akron, Cincinnati, Columbus, Dayton, Reynoldsburg and Toledo. "Toledo is proud to champion welcoming and inclusive policies that empower individuals and families to make their own choices," Toledo Mayor Wade Kapszukiewicz said. "Our consistently strong rankings in studies like these are a testament to that commitment."