COLUMBIA, S.C. (AP) — In Missouri, a House committee on Wednesday was debating a slate of anti-transgender legislation, even though Republican legislative leaders have said LGBTQ+-related bills are not a top priority this session. Lawmakers last year passed a partial ban on gender-affirming health care treatments for minors and limits on what sports teams student athletes can join based on the sex they were assigned at birth.

New measures would regulate public school bathroom use and define male and female in state laws as being based on a person’s sex assigned at birth.

Another proposal would apply the ban on gender-affirming health care to all minors and repeal its 2027 expiration date.

Republican Missouri Rep. Brad Hudson, who proposed last year's ban, said there should have never been a “sunset” in the first place.

Democratic Missouri Rep. David Tyson Smith said legislation aimed at transgender people is a campaign tactic to attract Republican votes. Smith said it’s “time we turn the page.”

“For this to dominate the airwaves over and over again, it’s too much,” Smith said.

The bills are among dozens this year in red states designed to restrict medical care for transgender youth — and in some cases, adults — or to govern the pronouns students can use at school, which sports teams they can play on, and the bathrooms they can use, along with efforts to restrict drag performances and some books and school curriculums.

At least 22 states have enacted laws restricting or banning gender-affirming medical care for transgender minors, and many of those states face lawsuits. Courts have issued mixed rulings. Enforcement is blocked in three states and enforcement is allowed in seven others. The Ohio Senate later this month is expected to override Republican Gov. Mike DeWine’s veto of that state’s ban.

Major medical groups, including the American Medical Association and the American Academy of Pediatrics, oppose the bans and have endorsed such care, saying it’s safe when administered properly.The Republican-led South Carolina House overwhelmingly approved a ban on gender-affirming care for transgender minors on Wednesday, while a Missouri legislative committee discussed a slew of like-minded proposals.

The measures' consideration in the two GOP strongholds highlights the continued interest among conservative lawmakers in targeting issues that impact LGBTQ+ people after a wave of high-profile bills last year. The South Carolina proposal will soon head to the state Senate, where the chair of the Medical Affairs Committee has said it would have his attention.

South Carolina is one of the few Southern states without a ban on gender-affirming care for minors. The bill its Republican-dominated House approved would bar health professionals from performing gender-transition surgeries, prescribing puberty-blocking drugs and overseeing hormone treatments for patients under 18 years old. People under 26 could not use Medicaid to cover the costs for such care, and school employees could not withhold knowledge of a student’s transgender identity from their legal guardians.

Doctors and parents told lawmakers last week that such treatment can be lifesaving, allowing young transgender people to live more fulfilling lives. They emphasized that people younger than 18 do not receive gender-transition surgeries in South Carolina and hormone treatments begin only after extensive consultation with health professionals.

Research has shown that transgender youth and adults are prone to stress, depression and suicidal behavior when forced to live as the sex they were assigned at birth.

But Republican South Carolina Rep. John McCravy, a co-sponsor of the bill, said Wednesday that “unpublished evidence” shows puberty blockers increase self-harm and decried the banned treatments as irreversible. He described transgender children as “mentally disturbed youth” in need of protection from “mutilation" — a narrative that expert panels in the nation’s major medical associations have said is false.

Democrats tried to cut the provision blocking Medicaid coverage for children and young adults seeking gender-confirming treatments. They accused Republicans of political fearmongering and said the bill will mean further ostracization for transgender youth if it becomes law.

Democratic South Carolina Rep. Marvin Pendarvis said Republicans should stick to their stated goal of protecting children and should not also limit adults' health care access.

“Is it really about protecting minors or is it about attacking a group of people that you don’t agree with their lifestyle?” Pendarvis asked.

Republican South Carolina Rep. RJ May, the vice chair of the state's ultra-conservative Freedom Caucus, compared public funding for any transition surgeries — regardless of the patient's age — to public funding for “lifestyles” like drug addiction.

Some other Republicans failed to add more definite penalties. The bill allows medical licensing boards to discipline health care professionals who provide the banned treatments. It does not expose medical providers to criminal liability as in Florida or civil liability as in Georgia.