MONTGOMERY, Ala. (AP) — Alabama lawmakers approved sweeping legislation Thursday to outlaw gender-affirming medications for transgender youths, as well as a separate measure setting rules about school bathrooms and prohibiting early classroom instruction on sexual and gender identity — a bill critics have dubbed “Don’t Say Gay.”

The bills now go to Republican Gov. Kay Ivey for her consideration as Alabama becomes the latest red state to seek legislation and policies aimed at trans young people. Ivey, who is running for reelection, has not indicated whether she will sign the measures.

The House of Representatives voted 66-28, largely along party lines, to grant final approval to legislation that would make it a felony for a doctor to prescribe puberty blockers, hormones or perform surgery to aid in the gender transition of anyone under age 19. Violations would be punishable by up to 10 years in prison.

Rep. Neil Rafferty, the only openly gay member of the Alabama Legislature, appeared to struggle to hold back his anger and maintain composure as lawmakers headed to the vote.

“This is wrong,” Rafferty said. “Y’all sit there and campaign on family being the foundation of our nation … but what this bill is doing is totally undermining that. It’s totally undermining family rights, health rights and access to health care.”

Republican Rep. Wes Allen of Troy, sponsor of the House version of the bill, argued during debate Thursday morning that transgender youth are not old enough to make decisions about gender-affirming medication.

“Their brains are not developed to make the decisions long term about what these medications and surgeries do to their body,” Allen said.

Rep. Chris England, who serves as chairman of the Alabama Democratic Party, said the measure targets already vulnerable children and essentially tells them they are not welcome in Alabama.

“You’re saying this is about children. It’s not. What it is about is scoring political points and using those children as collateral damage,” England said.

The bill would also require school counselors, nurses and others to tell parents if a child discloses they believe they are transgender.

A spokeswoman for Ivey did not immediately reply to a text message asking if the governor will sign the measure.

“I want the governor to know that she doesn’t have to sign this, she can veto it,” Jeff Walker, whose 15-year-old daughter, Harleigh, is transgender, said Thursday afternoon. “All you are doing is hurting Alabama families with these bills.”

Arkansas approved a similar law in 2021, but it was put on hold by the courts. Advocacy groups in Alabama have vowed to quickly challenge the measure if Ivey signs it into law.

In a written statement, Chase Strangio, deputy director for Trans Justice with the ACLU’s LGBTQ & HIV Project, called the Alabama measure “the most deadly, sweeping, and hostile law targeting transgender people in the country.”

White House spokeswoman Jen Psaki told reporters Thursday that the U.S. Department of Justice has warned states such laws and policies may violate the Constitution and federal law.

“Today’s vote in Alabama will only serve to harm kids,” she said.

Lawmakers approved separate legislation Thursday related to public school bathrooms and discussions of gender and sexual identity in early grades.

Senators voted 26-5 to approve legislation mandating that K-12 students can only use multiperson bathrooms and locker rooms that correspond with the gender on their original birth certificate, rather than their current gender identity. Republicans in the Senate also added language similar to a law in Florida that critics called the “Don’t Say Gay” measure.

The Alabama language would “prohibit classroom instruction or discussion on sexual orientation or gender identity” for students in kindergarten through the fifth grade. The Alabama proposal goes further than Florida’s law, which includes grades K-3.

“I do agree kids in kindergarten through fifth grade should not be introduced to sexual orientation and gender identity, and if they are it should could come from their parents,” said Republican Rep. Scott Stadthagen of Hartselle.

Stadthagen said he introduced the bathroom bill after hearing of schools being threatened with lawsuits when they offered to let students use faculty bathrooms. “The attorney says, no, they identify as this so this is the bathroom they are going to use, he said.

Rep. Napoleon Bracy, a Democrat from Prichard, called the sudden addition of the Florida-style language “totally political” as lawmakers head to primaries in May.

“We can’t continue to just be bullying and targeting people because of who they are,” Bracy said.