South Dakota became the first of more than a dozen states to take action on pending legislation that would restrict access to treatment for transgender youth.

The state’s Republican-dominated House on Wednesday voted 46-23 in favor of House Bill 1057, which will make it a misdemeanor for physicians to provide puberty blockers or offer gender-confirming surgery to trans patients under 16 years old.

The bill, which could be sent to the state’s Senate for a committee hearing as early as next week, carries a maximum penalty of one year in jail and a fine of up to $2,000. It will also codify a narrow definition of sex as “the biological state of being female or male, based on sex organs, chromosomes, and endogenous hormone profiles.”

Rep. Fred Deutsch (R), the bill’s primary sponsor, tweeted his approval late Wednesday.

After some of the heaviest lobbying I have seen in years, South Dakota‘s bill to protect gender confused children passes 46 to 23 pic.twitter.com/Q1K85KEuJ8 — Rep. Fred Deutsch (@FredDeutsch) January 30, 2020

Earlier this week, Deutsch sparked outrage when he described gender confirmation surgeries as “crimes against humanity,” likening such procedures to Nazi medical experiments conducted on Jews during World War II.

“You know, I’m the son of a Holocaust survivor. I’ve had family members killed in Auschwitz,” he said in a Jan. 22 interview with Tony Perkins, the president of the anti-LGBTQ Family Research Council. “I’ve seen the pictures of the bizarre medical experiments. I don’t want that to happen to our kids. And that’s what’s going on right now.”

Deutsch doubled down on that sentiment in an interview published Monday, telling the Sioux Falls Argus Leader, “I’ve been to a whole bunch of Holocaust museums all over the world ... It’s just a simple reflection that the pictures seem similar to me.”

Later that day, however, he backtracked somewhat, telling CNN and other outlets that the statement was “regrettable.” Since then, he’s described HB 1057 as a “bill of compassion.”

Gov. Kristi Noem, a Republican, has thus far declined to offer full support or disapproval of HB 1057, saying last week that she had “a few concerns” about it.

“When you take public policy and try to fill parenting gaps with more government, you have to be very careful about the precedent you’re setting,” Noem told the Associated Press.

The bill has been staunchly opposed by state Democrats, who view it as vast government overreach, as well as LGBTQ rights advocates nationwide.

Among them is the American Civil Liberties Union’s Chase Strangio, who said the organization plans to mount a legal challenge should HB 1057 be signed into law.

To trans youth in South Dakota and beyond: We know you know who you are. You don’t need to be protected from your own agency but from the powerful adults who claim to know what is best for you and your bodies. We will fight with you against these horrible bills. #NoHB1057 — Chase Strangio (@chasestrangio) January 30, 2020

In a Wednesday email to HuffPost, Human Rights Campaign President Alphonso David blasted Deutsch and other South Dakota lawmakers for “spreading misinformation and using vicious, harmful rhetoric” with regard to trans youth with the bill.

Dr. Alexis Chavez, who is The Trevor Project’s medical director, felt similarly, telling HuffPost that the bill “poses a grave threat to transgender and nonbinary youth.”

“This bill actively contradicts evidence-based medical recommendations and restricts parents’ ability to support their child with best-practice care, which has been shown to decrease suicide risk,” she said. “Medical decisions should be made between doctors and their families — politicians have no role in this intensely personal process.”

Last week, Strangio spoke out against bills in more than a dozen states that would directly impact the transgender community. Colorado, Florida, Missouri and Oklahoma are among those mulling legislation mirroring HB 1057.

Others, like Arizona, Georgia and New Hampshire, have proposed measures that would bar trans athletes from participating on teams that align with their gender identity.