Montana became the latest state to ban or limit gender-affirming medical care for transgender children on Friday when the Republican governor signed a law banning transgender legislator Zooey Zephyr for criticizing her colleagues.

Montana is one of at least 15 states with laws prohibiting such care, despite protests from the families of transgender youth, citing health officials’ claims that the care is essential.

Debate over Montana’s bill drew national attention after Republicans chastised Zephyr for saying they drank blood [their] hands for their support, which GOP members said they found offensive. House Speaker Matt Regier refused to let Zephyr speak on the House floor until she apologized. She doesn’t.

Zephyr denounced the bill signing, saying it is unconscionable to deprive Montanans of the care we need.

I know this is an unconstitutional bill. It is as cruel as it is unconstitutional. And it will end in court, Zephyr said. To trans youth, she added: There is an understandable tendency to desperation in these moments, but know that we are going to win, and until then we lean on the community, because we will have each other’s backs.

On Monday, Zephyr defiantly stood on the floor of the house with her microphone raised as protesters shouted, “Let her speak,” disrupting the house’s procedures for at least 30 minutes. Zephyr was subsequently banned from the House and its stand, voting on bills from a bench in the hallway outside the room on Thursday and Friday.

Lambda Legal, the American Civil Liberties Union and the Montana ACLU have announced they will file a lawsuit against the ban, which takes effect Oct. 1. 1, which kicks off a five-month clock during which Montana youth can try to find a way to get around the ban or get rid of hormone treatment.

This bill is an overly broad blanket ban that takes decisions that should be made by families and physicians and puts them in the hands of politicians, according to the Montana Chapter of the American Academy of Pediatrics.

Gov. Greg Gianforte signaled his willingness to sign the bill on April 17 when he offered amendments to make it clear that public funds could not be used to pay for hormone blockers, sex hormones or surgical procedures.

The bill protects Montana children from permanent, life-altering medical procedures until they are mature enough to make such serious decisions, Gianforte wrote in his letter accompanying the amendments.

Debate over the amendments led Zephyr to admonish supporters the next day. House Majority Leader Sue Vinton said Zephyr’s language was completely inappropriate, disrespectful and inappropriate.

The far-right Montana Freedom Caucus intentionally misused Zephyr by using masculine pronouns in a letter saying she should be censored. After Monday’s protest, the caucus said she should be further punished.

Under the new law, healthcare workers providing care prohibited by the measure could have their medical licenses suspended for at least a year. They can also be sued in the 25 years following a prohibited procedure if a patient suffers physical, psychological, emotional, or physiological harm. Doctors could not purchase malpractice insurance against such lawsuits. The law also prohibits public property and employees from being involved in such treatment.

During hour-long emotional committee hearings, opponents tested that hormone treatments, and in some cases surgery, are evidence-based care, supported by numerous medical associations, and could be life-saving for someone with gender dysphoria, the clinically significant distress or impairment caused by feeling that one’s gender identity does not correspond to one’s biological sex.

Parents of transgender children testified that the bill infringed on their parental rights to seek medical care for their children.

Opponents also noted that treatments such as puberty blockers and breast reduction would still be legal for minors who do not suffer from gender dysphoria, a difference they say is unconstitutional.

In the letter to lawmakers accompanying his proposed amendments, Gianforte said he had met transgender residents, understands their issues are real, and said Montanans struggling with gender identity deserve love, compassion and respect.

That’s not what trans-Montanans need from you, Zephyr said as the House considered his amendments. We need access to the medical care that saves our lives.