Arizona has become the latest U.S. state to pass legislation limiting medical care for trans youth after its legislature approved a bill condemned by LGBTQ2S+ advocates. It was just one of several anti-trans bills across the country that received final approval on Thursday amid an unprecedented wave of political attacks on the trans community.

The Arizona House greenlit Senate Bill 1138, which claims to outlaw “irreversible gender reassignment surgery to any individual who is under 18 years of age.” Such procedures are seldom recommended for trans minors, although they can be performed in rare instances. Yet supporters of the bill, which passed by a 31-26 vote, likened affirming surgical interventions to mutilation.

“This is mutilation of children,” said Arizona Rep. John Kavanagh (R-23rd District) in comments reported by the Arizona Daily Star. “It is irreversible, it is horrific.”

The scope of SB 1138 was significantly reduced from its original draft, which banned all forms of gender-affirming care for trans minors, including puberty blockers and hormone replacement therapy (HRT). A sweeping youth medical care ban was voted down by the Senate Health and Human Services Committee last month following testimony from trans young people, who said that the bill would be extremely detrimental to their well-being.

The narrowed version of SB 1138 is currently headed to the desk of Gov. Doug Ducey after having already passed the Arizona Senate last month. Ducey, a Republican, has not stated whether he intends to sign the bill into law.

“It is not the job of legislators to make healthcare decisions for the families who this legislation will directly impact.”

Even a limited medical care ban was met with widespread condemnation from LGBTQ2S+ advocates in Arizona. In a prepared statement shared with Xtra, Bridget Sharpe, Arizona state director for the Human Rights Campaign (HRC), says that it is “simply not the job of legislators to make healthcare decisions for the families who this legislation will directly impact.”

“Transgender kids do not deserve to be the targets of dehumanizing attacks that invalidate their identity,” she states. “For transgender young folks for whom this care this medically necessary, this bill could have serious, life-threatening consequences.”

Carla Thomas, the mother of a trans daughter, tells Xtra that she is “still in shock that this is actually happening.”

“I’m in denial that we have to depend on the governor of Arizona to veto these vicious, dehumanizing, discriminatory bills, that are invading my parental rights and my child’s privacy,” says Thomas, who co-founded the Equality Squad, a local LGBTQ2S+ advocacy group, to lobby against anti-trans legislation. “Transgender children have a right to feel protected in their own homes, schools and doctor’s offices.”

Should Ducey sign SB 1138 into law, Arizona will join Arkansas and Tennessee in restricting certain forms of trans youth medical care. Last April, Arkansas became the only state in U.S. history to enact a sweeping ban on surgery and medications, like hormones and puberty blockers, for trans youth after state lawmakers overrode the veto of Republican Gov. Asa Hutchinson. The legislation, known as House Bill 1570, was later blocked by a federal court.

Tennessee’s bill, by contrast, is extremely finite in its purview. The text of SB 126 solely bans puberty blockers for “prepubertal minors,” a treatment that is almost never recommended for trans youth before they reach puberty.

The medical care bill wasn’t the only anti-trans measure approved by the Arizona Legislature on Thursday, however. Senate lawmakers also passed SB 1165, which bans trans female student athletes from participating on school sports teams in alignment with their gender identity. The legislation applies solely to students competing at the middle school, high school and collegiate levels.

“Arizona has unfortunately joined the long list of states that have made bullying and discriminating against trans students a priority this legislative session.”

In a statement, the American Civil Liberties Union (ACLU) of Arizona said that SB 1165 seeks to “solve problems that do not exist.” Just 16 trans athletes in the state have applied for waivers to play on the sports team that matches their lived gender since 2017, according to the Arizona Interscholastic Association.

“Arizona has unfortunately joined the long list of states that have made bullying and discriminating against trans students a priority this legislative session,” concluded Darrell Hill, policy director of Arizona’s ACLU.

Eleven U.S. states have passed laws to curb the participation of trans student athletes in school athletics, but governors have been divided on the issue during a legislative session that has seen more than 130 bills singling out the trans community. While Iowa and South Dakota signed trans sports bans into law earlier this year, similar bills in Utah and Indiana were met with gubernatorial vetoes this week. (Utah’s anti-trans sports law is likely to be overridden by its GOP-majority legislature.)

The issue of trans participation in sports is only going to grow more contentious as two additional states passed athletics bans on Thursday alone: Kentucky and Oklahoma.

Both bills await consideration from their respective governors after passing both of their Houses and Senates by wide margins.

Oklahoma Gov. Kevin Stitt is expected to sign SB 2 into law following numerous controversies over his views on LGBTQ2S+ equality. The Republican leader has denied the existence of non-binary people and issued an executive order in November calling on the Oklahoma Department of Health to stop issuing corrected birth certificates with an “X” gender marker for individuals who identify as neither male nor female. Last year, Stitt also signed a law banning LGBTQ2S+ diversity training for college students.

While Kentucky’s Democrat governor, Andy Beshear, is likely to oppose his state’s trans sports ban, a veto could easily be overridden by lawmakers. Republicans control 76 percent of seats in the legislature, enough for a veto-proof supermajority.

LGBTQ2S+ advocates in both states urged politicians not to move forward with proposals aimed at trans students. Chris Hartman, director of Kentucky’s Fairness Campaign, says in a statement provided to Xtra that all young people “deserve the opportunity to participate on sports teams that help them stay active, bring them joy and fulfillment, and teach them about teamwork, discipline and sportsmanship.”

“Transgender kids want the same things all children do—to play with their friends, get a good education and pursue their passions, including sports,” he says.

Nicole McAfee, executive director of Freedom Oklahoma, adds that LGBTQ2S+ Oklahomans are “exhausted” and “angry” following the legislative attacks on their community. In the past week, lawmakers have also advanced bills that would make good on Stitt’s call to ban non-binary gender markers on official documents and expand the state’s legal definition of “obscene materials” to include “deviate sexual conduct,” such as acts of same-sex intercourse.

“It’s unacceptable,” McAfee says in a press release provided to Xtra. “Trans girls are girls. Non-binary Oklahomans exist. Having representation of gender and sexual diversity available to young folks is not obscene, but efforts to not only censor it but criminalize it certainly are.”