The Alabama state senate passed a bill that would make it a felony for doctors to provide gender confirmation treatments to transgender people under the age of 19, including puberty blockers.

The Vulnerable Child Compassion and Protection Act was introduced by Alabama Sen. Shay Shelnutt (R) and it would make it a Class C felony for doctors to prescribe hormone therapy or puberty blockers to transgender youth in the state and punishable with up to ten years in prison.

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The bill passed the state senate by a vote of 22-3, sending it to the state house. There are currently 77 Republicans and 28 Democrats in the Alabama House of Representatives, and a House committee has already approved similar legislation.

The bill would also ban gender confirmation surgery for minors, even though Shelnutt admitted that he didn’t know of any minors are actually getting gender confirmation surgery in his state.

“I just don’t think and others don’t think that kids should be given experimental drugs or surgeries that could have irreversible consequences for the rest of their life,” he said.

Puberty blockers are meant to delay puberty so that transgender youth have more time to assess their options before the body undergoes permanent changes, and getting puberty blockers has been linked to a lifelong drop in suicidality among transgender people who wanted them.

“Kids are not fully developed until later in life,” Shelnutt said. “I think we can all agree that kids aren’t capable of making certain decisions until certain ages. And so, we want to just stop these procedures from happening in Alabama.”

The American Academy of Pediatrics issued a policy statement in 2018 that affirmed the use of puberty blockers as part of a care model for young people with gender dysphoria.

“Pubertal suppression creates an opportunity to reduce the distress that may occur with the development of secondary sexual characteristics and allow for gender-affirming care, including mental health support for the adolescent and the family,” the statement said.

“It reduces the need for later surgery because physical changes that are otherwise irreversible (protrusion of the Adam’s apple, male pattern baldness, voice change, breast growth, etc) are prevented.”

Alabama Sen. Vivian Davis Figures (D) opposed the bill because she said that the decision should be left to children and their parents, not the government.

“We call on the House to treat trans children and their families with more empathy than the state senate and reject this bill as the harmful, divisive legislation it is,” said Mia Raven of the Yellowhammer Fund, a women’s advocacy group in Alabama.

If the bill passes the Alabama House of Representatives, it will be sent to Gov. Kay Ivey (R). At least ten other states are considering similar legislation.