The majority-Republican South Carolina General Assembly has passed a bill to ban sex-change surgeries and treatments on minors. 

Titled the “Help Not Harm” bill, the measure prohibits health providers from performing sex-change surgeries or hormonal treatments on minors and bans public funding of transgender procedures through Medicaid and other government health plans.

The bill also bars public school officials from withholding information from parents regarding their children’s perception of their gender. 

The measure received final approval in a 67-26 vote by the South Carolina House on Thursday. This comes after the law was passed by the Senate with additional amendments in an overwhelming 27-8 vote on May 2. 

It is set to take effect immediately upon being signed by Gov. Henry McMaster, who has previously signaled his support. 

The bill states that “a physician, mental health provider, or other health care professional shall not knowingly provide gender transition procedures to a person under 18 years of age.” 

Providers violating this law by performing sex-change surgeries on minors are considered to have inflicted “great bodily injury upon a child” and are subject to criminal prosecution and could face up to 20 years in prison. 

The bill clarifies that health providers treating “appropriate medical services to a person for precocious puberty, prostate cancer, breast cancer, endometriosis, or other procedure unrelated to gender transition, or to a person who was born with a medically verifiable disorder of sexual development” are not subject to any penalties under this law. 

Regarding public schools, the law says that no school official may knowingly withhold information related to a minor’s belief that he or she is a member of the opposite sex nor may officials knowingly “encourage or coerce a minor” to withhold such information from his or her parents. The bill also requires school officials to “immediately” notify parents in writing if their child expresses a belief that he or she is of the opposite sex.

This comes shortly after the 4th Circuit Court of Appeals, which includes South Carolina within its jurisdiction, ruled on April 29 that state Medicaid programs and government-run insurance plans must cover transgender treatments.

It is unclear how this ruling will impact the Medicaid portion of the newly passed South Carolina law. 

South Carolina joins 24 other states that have banned or restricted sex-change procedures on minors.