A devastating number of trans youth could lose access to affirming health care if bills introduced across the United States are signed into law, according to a new report.

The passage of trans youth health care bans could result in more than 54,000 trans kids between the ages of 13 and 17 no longer being able receive medical treatments intended to affirm their gender, per research from The Williams Institute at the University of California, Los Angeles. That number accounts for more than one-third—36 percent—of the estimated 150,000 trans youth in the U.S. between those age ranges.

The pro-LGBTQ2S+ think tank estimates that 10,000 trans kids live in Texas and Arkansas alone, two states that have already enforced restrictions on the types of medical care that can be offered to trans youth. Last April, Arkansas became the first state to pass a law banning medical providers from offering treatments like puberty blockers and hormone replacement therapy (HRT) to minors. In February, Texas Gov. Greg Abbott ordered the state’s child welfare services to investigate trans-affirming parents for “abuse.”

According to The Williams Institute’s data, 13 more states are considering cracking down on trans youth medical care this year. Alabama is a House vote away from sending its bill—which applies to young people up to the age of 19—to the desk of Republican Gov. Kay Ivey, who has already indicated she intends to sign it. Nearly identical bills have been introduced in North Carolina and Oklahoma.

If these three bills were signed into law, more than 4,000 trans youth would lose access to care, according to The Williams Institute’s projections.

In a statement accompanying the report, the study’s lead author, Kerith J. Conron, signaled that the revocation of medical treatments would have a devastating impact on the lives of trans youth. Conron, who serves as The Williams Institute’s research director, affirmed that a “growing body of research shows that gender-affirming care improves mental health and overall well-being of transgender people, including youth.

“Efforts that support transgender youth in living according to their gender identity are associated with better mental health,” he said.

Multiple research studies have testified to the positive impact of gender-affirming care on trans youth. A study published in February 2021 from University College London and the NHS Gender Identity Development Service found that puberty blockers, which delay the onset of puberty while young people consider more permanent interventions, improve mental health. A Trevor Project survey released later the same year found that access to HRT drastically lowered rates of suicidal ideation and depression.

Based on the prevailing body of research, numerous leading medical groups—including the American Medical Association (AMA), American Academy of Pediatrics (AAP) and the American Psychological Association—have released statements affirming that trans youth medical care is both safe and effective treatment for gender dysphoria in minors.

As U.S. lawmakers continued to push a record number of anti-trans bills despite overwhelming consensus from the medical community, the AMA directly criticized these efforts last year.

“Decisions about medical care belong within the sanctity of the patient-physician relationship,” the organization said in an April 2021 letter to the National Governors Association (NGA). “We believe it is inappropriate and harmful for any state to legislatively dictate that certain transition-related services are never appropriate and limit the range of options physicians and families may consider when making decisions for pediatric patients.”

At least 238 bills targeting LGBTQ2S+ rights have been introduced in the U.S. this year, according to NBC News. Two states, Iowa and South Dakota, have signed laws limiting participation of trans youth in school sports.