JEFFERSON CITY, Mo. – Legislation to restrict gender-affirming care for minors and require transgender athletes from playing on the team aligned with the sex on their birth certificate is headed to Governor Mike Parson’s desk.

Missouri is joining more than a dozen states in restricting or banning access to puberty blockers, cross-sex hormones, or gender-affirming surgery. Senate Bill 49 would also affect Medicaid patients due to the state prohibiting any funds from covering gender-affirming care in Missouri, and surgery will no longer be available to inmates and prisoners.

Minutes after the House approved to restrict gender-affirming care, representatives took up another bill aimed at the transgender community, by requiring transgender athletes from playing on the team that matches the sex on their birth certificate from kindergarten through college, both at public and private schools. Any school district that does not follow this law could jeopardize its funding.

“Missouri government has shown their number one priority this legislative session was to attack the trans community. It’s an all-out war,” Robert Fischer with PROMO Missouri, an LGBTQ advocacy organization, said. “A lot of what gender affirming care is, especially at the beginning, is social transition. It means you’re calling a child by their preferred name; you’re using their correct pronouns; you’re letting them dress as they want. Things that are incredibly reversible. Surgeries are not happening in Missouri for minors. Plain and simple.”

Following Wednesday’s votes in the House, one lawmaker is thinking twice about his political party.

“I’m not questioning me being a gay Republican, I’m questioning if I’m a Republican,” Rep. Chris Sander, R-Lone Jack, said.

It’s been the headline throughout session, and now the controversial topic is in the governor’s hands. Two weeks ago, the governor put pressure on lawmakers by saying they must pass the legislation or be prepared to come back for a special session.

“This is not against transgender people,” Rep. Wendy Hausman, R-St. Peters, said. “This is just to make sure that children do not make decisions that could affect the rest of their lives.”

Sander, an openly gay representative, said he was silenced by leadership during the House’s debate.

“I was holding a piece of paper in my hand like this on the floor all morning and didn’t get recognized,” Sander said. “Neither one of them would let me talk and I said if you don’t let me talk on the floor, I’m going to talk to the media.”

Under the legislation, doctors would be prohibited from performing surgeries and prescribing puberty blockers or hormone treatments to minors, but there would be an exemption to patients currently undergoing care by letting them continue with treatment once the law goes into effect.

“When you have kids being surgically and or chemically altered for life for no good reason, yes, it is time for the government to get involved and say this is wrong,” Rep. Brad Hudson, R-Cape Fair, who carried the legislation in the House, said. “We are simply trying to protect children.”

Hudson said on the floor the legislation would not penalize parents or families, but only physicians. Doctors who violate the law by treating patients could be subject to professional discipline and civil liability.

“When a trans kiddo is getting healthcare, we say gender-affirming care and that is not necessarily a surgery or a medication, that could be years with a therapist, making sure this kid doesn’t want to hurt themselves or take their own life,” House Minority Leader Crystal Quade, D-Springfield, said.

During a long debate in the Senate back in March, members came up with a compromise allowing the ban on puberty blockers and cross-sex hormones to expire in four years. The ban on gender-affirming surgeries is permanent.

Senate Bill 39 requires transgender athletes to compete on sports teams with their sex assigned at birth. The Missouri State High School Activities Association (MSHSAA) said there are eight trans student athletes who been approved through their policy, four competing at the junior high level and four at the senior high level.

“This bill is the epitome of bullying the most vulnerable kids in our state,” Rep. Peter Merideth, D-St. Louis, said. “A very small group of kids that are just trying to play sports.”

Rep. Ian Mackey, D-St. Louis, an openly gay member, said he has been fearing the day this legislation came up for a vote.

“When I say that I’m hurt as a member of the LGBT community, not nearly to the extent that these little kids are,” Mackey said. “I don’t care whether you meant to harm me or not, I’m still harmed, and these kids are still harmed.”

In a statement after the legislation passed Wednesday, Sen. Greg Razer, D-Kansas City, said, “This is a sad day for the LGBTQ community.”

“Laws made from hate and passed in fear will not make Missouri a safer, stronger state. This is a sad day for the LGBTQ community. We are all hurting, but we will persevere, just as we have at every point in our journey when government has acted on the wrong side of history. We will keep moving forward, and no law can stop that.

“The question is, when will Republicans prioritize moving Missouri forward? Targeting people because they are different will not grow our workforce, or improve our schools, or protect families and communities from deadly gun violence. Our state has real problems, but so long as encouraging hate and rewarding fear are the guiding principles of the Republican Party, Missourians will suffer.”

Wednesday’s votes come after a St. Louis County judge last week blocked Attorney General Andrew Bailey’s emergency rule restricting gender-affirming care for Missourians of all ages from going into effect. A court day is set for July.

Bailey has also launched an investigation into St. Louis’ Washington University Transgender Center after a whistleblower alleged doctors were prescribing hormones too quickly and without enough mental health services. He has since expanded his investigation to any clinic offering pediatric gender-affirming care in the state.

If the legislation is signed by the governor, the limits would go into effect at the end of August.

In a tweet Wednesday afternoon, Parson said, “We appreciate the General Assembly taking action today to pass protections for minors and women’s sports. We look forward to this legislation arriving to our Office soon.”

PROMO, Missouri’s LGBTQ advocacy organization, said after the passage,

“Today is an incredibly devastating day for transgender Missourians, for families raising transgender youth, BIPOC and trans women of color who will only see an increase in violence against them, and rural trans Missourians who have less resources available to them. Missouri’s state government is waging an all-out war on transgender Missourians.

“The lives of transgender people in our state — and in our country — have not only been prioritized as political pawns for elected leaders to advance their careers, but the rhetoric around who transgender Missourians truly are has become chalk-full of disgusting lies and dangerous misunderstandings.

“Since the beginning of the legislative session, our voices were not listened to and our stories were not taken seriously as public hearings were cut short, bill authors and sponsors left the room, and conversations fell on deaf ears. It continued today when Republican Rep. Chris Sander and other Democrat Representatives were unable to speak in opposition. ‘I’m not questioning being gay, I’m questioning being a Republican,’ said Rep. Chris Sander.

“As advocates, parents, and Missourians who value personal freedom and inclusion, we will continue to fight every day until every single transgender Missourian is able to live openly and honestly, and thrive within our state.”

Bishop Johnston with the Catholic Diocese of Kansas City-St. Jospeh gave a statement to FOX4 about the legislation. “Our human condition is frail, and we are all in need of acceptance, compassion, patience, and understanding. That said, children and youth need careful protection when they are vulnerable to procedures that have irreversible, life-altering implications. We must also acknowledge that our young people today are witnesses to a radical new paradigm which proposes that we are each free to define our own reality, that our bodies are more or less like a blank canvas to express what the mind determines. This has profound implications for marriage, family, and society. When everyone defines their own reality, it is impossible to find common ground, harmony, and peace.”

Yalmesie Rodriguez, president and CEO of Planned Parenthood of the St. Louis Region and Southwest Missouri, says patients now looking to continue care elsewhere can visit Planned Parenthood’s Fairview Heights clinic.

“This anti-science ideological crusade is straight out of the anti-abortion playbook – sham investigations, character assassination hit pieces and inflammatory disinformation to impose cruel insurmountable bans on lifesaving care and continue legislating our freedoms out of existence,” Rodriguez said.

Heritage Action, a conservative grassroots organization with two million grassroots activists, including thousands of Missourians, released the following statement:

“Children experiencing gender confusion are being subjected to experimental surgeries and cross-sex hormones that remove or alter healthy body parts, and the safety of female athletes is being threatened when they are forced to compete against men in sports. The Missouri General Assembly voted to defend women and children from radical gender ideology by passing SB 49 and SB 39. These bills would both protect children from harm by preventing physicians from performing experimental surgeries and administering cross-sex hormones and defend female athletes from being forced to compete against male athletes in sports designated for women and girls. The Left’s denial of the biological realities of gender is detrimental to women and children across the United States. Heritage Action commends the Missouri General Assembly for passing SB 49 and SB 39 and protecting the safety and opportunities of children and female athletes. We look forward to this essential legislation arriving on Governor Parson’s desk, and we urge him to sign to defend women and children across the Show-Me State.”