Iowa Gov. Kim Reynolds (R) on Wednesday signed into law two bills that will restrict the rights of transgender young people in the state.

One of them, Senate File 538, prohibits doctors from providing gender-affirming health care, including puberty blockers, hormones and surgeries, to transgender minors. The other, Senate File 482, bars transgender students from using school restrooms or locker rooms that are consistent with their gender identity.

Both laws are effective immediately, although health care providers who are already administering gender-affirming health care to minor patients will have 180 days before they are forced to end treatment.

Reynolds has not issued a comment or statement on either measure but said during a press conference on Tuesday that she backed the legislature’s proposal to ban gender-affirming health care for youths, citing a need for research studying the long-term effects of certain medications and procedures.

“We need to just pause; we need to understand what these emerging therapies actually may potentially do to our kids,” Reynolds said. “My heart goes out to them. I’m a parent, I’m a grandmother, I know how difficult this is. This is an extremely uncomfortable position for me to be in. I don’t like it. But I have to do what I believe right now is in the best interest of the kids.”

Including Iowa, 10 states since 2021 have enacted laws or policies that bar transgender minors from receiving gender-affirming health care. Georgia Gov. Brian Kemp, also a Republican, signed legislation banning most gender-affirming care for youth under 18 on Thursday.

Reynold’s approval of the state’s new restrictions on school restrooms and changing rooms comes almost seven years to the day since North Carolina passed the nation’s first so-called bathroom bill in 2016. The law was repealed in 2017 by Democratic Gov. Roy Cooper, after the NCAA said it would not consider North Carolina to host any championship events through 2022 if the law was not overturned.

Arkansas Gov. Sarah Huckabee Sanders (R) signed similar legislation into law on Tuesday.

Under the new Iowa law, transgender students in both public and private elementary and secondary schools are unable to use multiperson restrooms or locker rooms that align with their gender identity, and students must obtain written consent from a parent or guardian in order to use single-occupancy facilities at school.

LGBTQ groups on Wednesday pushed back against Reynold’s signature on either bill, arguing that the measure will do more harm than good.

“Banning gender-affirming care not only goes against the medical consensus of every major health organization but jeopardizes the health and wellbeing of young transgender Iowans,” Cathryn Oakley, state legislative director and senior counsel of the Human Rights Campaign, an LGBTQ advocacy group, said Wednesday

“Transgender youth already face alarming rates of discrimination, harassment and violence, and this new law only exacerbates the challenges they face,” Oakley said. “It is unconscionable that the Iowa legislature and Governor Reynolds are willing to play politics with the lives of trans youth in this way.”

Mark Stringer, the executive director of the American Civil Liberties Union of Iowa, called Reynolds’s approval of the bills “simply wrong” and said the legislation will have “devastating consequences” for transgender children and families throughout Iowa.

“Parents of transgender children are doing their level best to keep their kids alive,” Stringer said Wednesday in a statement, referencing disproportionately high rates of anxiety, depression and suicidality among transgender youth.

“These parents deserve every tool at their disposal to create a future for their children. That should include the option of gender-affirming care, which is endorsed by every major medical association,” he said.

Stringer said the organization is aware of several families that are preparing to move out of Iowa or are making arrangements for their transgender teenagers to move to live in a state where access to gender-affirming health care is still legally available for minors.

Stringer said the bathroom bill signed Wednesday by Reynolds is similarly cruel.

“It’s a bill born out of a deep misunderstanding of what it means to be a student and transgender and out of ill-placed fears,” he said. “Unfortunately, politicians can pass laws that hurt kids and never look back, but it’s transgender kids who have to live with increasing hostility against them from the government, including even monitoring where they go to the bathroom at school.”