Arkansas is set to ban gender-transitioning procedures for children, including the use of cross-sex hormones, surgeries, and puberty-blocking drugs.

The Arkansas Senate voted 28-7 on Monday to pass House Bill 1570, known as the “To Create The Arkansas Save Adolescents From Experimentation (SAFE) Act.” The bill has not yet been signed by Gov. Asa Hutchinson (R), but he is expected to sign it into law.

The bill states that “A physician or other healthcare professional shall not provide gender transition procedures to any individual under eighteen (18) years of age,” and that “A physician, or other healthcare professional shall not refer any individual under eighteen (18) years of age to any healthcare professional for gender transition procedures.”

The SAFE Act describes gender transition procedures as cross-sex hormonal treatments, surgeries including mastectomies and vaginoplasties, and drugs that are prescribed with the intent of stopping or delaying puberty in a pre-pubescent child.

Further, the bill also bans the use of public funding of gender transition procedures of children under the age of 18. Insurance companies in Arkansas will not be required to cover gender transition procedures, nor will they be allowed to cover the gender transition of a minor.

Chase Strangio, who is the deputy director for transgender justice for the American Civil Liberties Union (ACLU), referred to the SAFE Act as “the single most extreme anti-trans law to ever pass through a state legislature” and said that this legislation and similar bills are “potentially genocidal” for trans-identified people.

On its Twitter account, the ACLU claimed on Monday that “Arkansas has become the first state to ban health care for trans youth,” and that “our rights and lives are under attack.” While the legislation banned gender-transitioning for children, it did not apply to general health care procedures for youth identifying as transgender.

“This is one domino we cannot let fall,” the ACLU tweeted on Tuesday evening.

Last week, Arkansas became the second state to ban biological males who identify as female from competing on sports teams for women and girls.

“This law simply says that female athletes should not have to compete in a sport against a student of the male sex when the sport is designed for women’s competition,” Hutchinson said in a statement after signing the bill. “As I have stated previously, I agree with the intention of this law. This will help promote and maintain fairness in women’s sporting events.”

On Wednesday, President Biden tweeted on the International Transgender Day of Visibility, saying that “Transgender rights are human rights — and I’m calling on every American to join me in uplifting the worth and dignity of transgender Americans. Together, we can stamp out discrimination and deliver on our nation’s promise of freedom and equality for all.”