MONTGOMERY, Ala. (AP) — Alabama Gov. Kay Ivey enacted a sweeping law Friday that bans gender-affirming medication for transgender youth and includes criminal penalties for doctors who prescribe it.

Ivey also signed a bill into law that prohibits students from using school bathrooms that don’t align with their sex at birth.

Ivey signed the bills a day after the House and Senate passed both measures.

Alabama is among multiple states with Republican-controlled legislatures that have advanced bills not only to block medical treatment but to ban transgender children from using school restrooms or playing on sports teams that don’t correspond with their sex at birth. The Alabama medication bill is one of the most far-reaching: It would put doctors in prison for up to 10 years for prescribing puberty blockers or hormonal treatment to trans kids under 19.

“In one breathtakingly cruel and cowardly day, the Alabama legislature passed the single most anti-transgender legislative package in history,” said Cathryn Oakley, state legislative director and senior counsel for the Human Rights Campaign, a national advocacy group for the LGBTQ community.

Conservative lawmakers say the measures are needed to protect children and parental rights.

“We regulate all kinds of things that are harmful for minors — alcohol, cigarette smoke, vaping, tattoos — because their minds aren’t ready to make those decisions about things that can affect them long term,” said Rep. Wes Allen, the sponsor of the House version of the Alabama legislature. Allen cited public hearing testimony from a woman who said she regretted taking hormone therapy to try to transition to being male.

“With these powerful medications that have detrimental effects on their body long term, we just want to put a pause on it … give them a chance to develop and grow out of that,” Allen said.

But opponents say transgender health is being used as a deliberate political wedge issue to motivate a voting base — in the same way, they say bills about critical race theory have been employed. Critical race theory is a way of thinking about America’s history through the lens of racism. Numerous Republican-controlled legislatures have proposed bills to block its teaching in public schools.

The measures involving trans youth have prompted swift backlash from medical experts, Democratic President Joe Biden’s administration, the U.S. Department of Justice and the families of trans youth. Last month, the Justice Department sent a letter to all 50 state attorneys general, warning them that blocking transgender and nonbinary youth from receiving gender-affirming care could be an infringement of federal constitutional protections.

“My child is not a political tool. This is not a fair fight to pick on vulnerable children,” said Vanessa Finney Tate, the mother of a 13-year-old trans boy in Birmingham, Alabama, after testifying at a public legislative hearing on the bill that would block students from using bathrooms corresponding to their gender.

Medical groups including The American Academy of Pediatrics have publicly opposed efforts to outlaw gender-affirming care.

“Gender-affirming care benefits the health and psychological functioning of transgender and gender-diverse youth,” the Endocrine Society said in a statement. “When an individual’s gender identity is not respected and they cannot access medical care, it can result in higher psychological problem scores and can raise the person’s risk of committing suicide or other acts of self-harm.”

The organization notes that only reversible puberty blockers are recommended for younger adolescents, while older adolescents might qualify for hormone therapy.

Angus, a 16-year-old trans teen who requested that his last name not be used because of the bullying he has received in his north Alabama town, said he knew at puberty that the mirror reflected “a body that wasn’t my own.”

After coming out to his mother, he began slowly testing the waters: dressing as a man, changing his name. Only after years of talking to a team of doctors, was he able to recently get medications to stop his periods. The next step, which he is eager to start, would be a small dose of testosterone.

“I have been waiting for seven years to finally become a man, the man that I’ve always known I am,” Angus said.

He said bills to block such treatments are harming, not protecting trans youth.

“The government is saying, ‘Oh, parents are abusing their children by letting them transition,'” he said. “Actually, it’s more child abuse to not let them transition if they come out. What these bills really are doing is putting trans youth’s lives at risk because these suicide rates will spike exponentially. And a lot of families will lose their children.”

Similar bans are moving forward in other states.

In Texas, Republican Gov. Greg Abbott has ordered the state’s child welfare agency to investigate abuse reports of gender-confirming care for kids. And the law in Arkansas bans gender-affirming medications. That law has been blocked by a court, however.

Trans youth in many red states say they feel attacked, angry, betrayed and scared by the wave of legislation aimed at them.