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Transgender youth in North Carolina lost access Wednesday to the gender-affirming treatments many credit as live-saving after the Republican-controlled General Assembly overrode the Democratic governor’s veto of legislation banning such care.

GOP supermajorities in the House and Senate enacted – over Gov. Roy Cooper’s opposition – a bill barring medical professionals from providing hormone therapy, puberty-blocking drugs and surgical gender-transition procedures to anyone under 18, with limited medical exceptions.

The policy takes effect immediately, but minors who had begun treatment before Aug. 1 may continue receiving that care if their doctors deem it medically necessary and their parents consent.

North Carolina becomes the 22nd state to enact legislation restricting or banning gender-affirming medical care for trans minors. But most of those laws face legal challenges, and local LGBTQ+ right advocates have vowed to challenge the ban in court. Most of the laws elsewhere are facing lawsuits.

Democratic Sen. Lisa Grafstein, North Carolina’s only out LGBTQ+ state senator, said the gender-affirming care bill “may be the most heartbreaking bill in a truly heartbreaking session.”

Some LGBTQ+ rights advocates in the Senate gallery began yelling after Republican Lt. Gov. Mark Robinson, who was presiding, cut off Grafstein to let another lawmaker speak. Several people were then escorted out of the chamber by state capitol police.

Sen. Joyce Krawiec, a Forsyth County Republican and the primary sponsor of the gender-affirming care bill, said the state has a responsibility to protect children from receiving potentially irreversible procedures before they are old enough to make their own informed medical decisions.

The Senate voted 27-18 to complete the veto override approved earlier by the House.

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