The Alabama Senate approved a bill to make it a felony to treat transgender youth with puberty-blockers, hormone therapy or surgery.
Senators voted 23-4 to approve the bill sponsored by Republican Sen. Shay Shelnutt of Trussville.
The bill moves to the Alabama House of Representatives.
Alabama is one of at least eight states where conservative lawmakers are pushing such measures, arguing such decisions should wait until adulthood.
Parents, trans youth and medical experts opposed to the bill argued it is dangerous. Opponents rallied outside the statehouse ahead of the vote.