In the coming year, nine states will introduce legislation to block transgender youth from seeking gender-affirming care, The Hill reports.

The states include Missouri, Montana, New Hampshire, Oklahoma, South Carolina, Tennessee, Texas, Utah, and Virginia. Over 20 bills have been introduced in these states in an attempt to block the life-saving medical care.

Many of the bills would prohibit medical providers from providing puberty blockers, hormone therapy, or gender-affirming surgeries to minors under the age of 18. Gender-affirming surgeries are typically not performed on minors.

Medical professionals who provide gender-affirming care say that puberty blockers have been used for decades on trans children and children with certain cancers with neither harmful nor permanent side effects. Puberty blockers give trans kids time to explore their identities before the permanent effects of puberty occur.

Some of the bills would block taxpayer and healthcare funds from going to any organization that provides gender-affirming care. Others would revoke the medical licenses of professionals who provide such care or would report any parent or guardian who allows their minor child to receive such care to their state’s social services department for “child abuse.”

Arizona, Alabama, and Arkansas have already passed laws trying to restrict medical care for transgender youth, though some of the laws have been blocked by courts. State officials in Texas and Oklahoma have also tried to restrict such care, even though their legislatures haven’t passed laws forbidding it, the Movement Advancement Project reported.

The bills are just part of a national Republican-led campaign to demonize transgender people, LGBTQ allies, and gender-affirming medical professionals as “grooming” and “indoctrinating” children into “gender confusion” so that they can “mutilate” children’s bodies for profit. Such rhetoric has led to death threats and harassment of medical professionals, teachers, and other community members who support the LGBTQ community.

Such laws go against the best practices of trans-related pediatrics outlined by the American Academy of Pediatrics, the American Medical Association, and the American Psychological Association. The organizations find that gender-affirming medical care is medically necessary and reduces suicide and depression among trans youth.

Numerous studies have shown that a lack of societal acceptance and access to gender-affirming care can contribute to high rates of suicide among trans youth.

When two Republicans lost Georgia’s special runoff senate elections in January 2021, state Republicans in the General Assembly re-wrote voting laws to restrict absentee ballots and give voters fewer days to vote in future runoff elections.

However, after Republicans lost yet another runoff election for Georgia’s Senate seat — with Herschel Walker losing to his Democratic competitor, Rev. Raphael Warnock, earlier this month — state Republicans want to re-re-write the rules, hopeful of a more favorable outcome.

Georgia’s Secretary of State Brad Raffensperger (R), the official who oversees the state’s voting procedures, said he plans on giving three proposals to lawmakers when they return to the General Assembly in January.

“[The proposals] include forcing large counties to open more early-voting locations (in an attempt to reduce the hours-long lines some voters waited in) … lowering the threshold candidates must achieve to avoid a runoff from 50 percent to 45 percent; and instituting a ranked-choice instant-runoff system that would not require voters to come back to the polls again after the general election,” The New York Times reported.

To be clear, it’s unclear whether these changes would’ve helped Walker win. But they stand in contrast to the changes state Republicans made to voting laws following their failed January 2021 Senate runoff ambitions.

The changes after that time severely restricted the types of people eligible to receive an absentee ballot. While 24 percent of the January 2021 vote came via mail-in absentee ballots, the rule changes resulted in 5 percent of mail-in votes coming in for the January 2022 runoff.

Republicans also lowered the number of in-person early voting days to five (though the rule change allowed counties to add extra days.) The Times found that 28 of Georgia’s 159 counties opted to add extra in-person early voting days — 17 of the counties that did largely backed Warnock while 11 backed his challenger.

Before the recent run-off election, Raffensperger also tried to enforce a state law forbidding in-person early voting on the Saturday after Thanksgiving. However, Warnock successfully sued to prevent the law from going into effect.

Overall, the changes may have “backfired,” Republicans told The Times, actually encouraging Democratic voters to come out in greater numbers.

While Republicans point to the large turnout of runoff voters as “proof” that their changes didn’t discourage voting, Warnock’s campaign criticized the changes, saying that such restrictions shouldn’t make it harder for people to vote in the first place.

Andy Campbell, a senior editor at The Huffington Post who is the author of the book We Are Proud Boys: How a Right-Wing Street Gang Ushered in a New Era of American Extremism has said that The Proud Boys and other far-right vigilante groups will likely commit violence during the next two upcoming elections.

In a recent interview, Campell noted the Proud Boys were founded by right-wing commentator Gavin McInnes to fight in ways that other straight-laced Republicans wouldn’t.

Campbell also noted former President Donald Trump’s ominous command for the Proud Boys to “stand back and stand by” during his final September 2020 debate against now-President Joe Biden.

Several Proud Boys members are currently on trial for sedition for their involvement in the January 6, 2021 insurrection at the U.S. Capitol.

“I think we might learn some bombshells about their connection to Trump’s inner circle,” Campbell said. “And the fact that several top-level Proud Boys have already agreed to testify against their own means we may learn a lot.”

Trump also recently said that the nation would face “problems … the likes of which perhaps we’ve never seen” if he is indicted for taking classified documents after leaving office. His comment was widely seen as a call for his followers to commit violence if he’s ever criminally charged.

“I think Trump knows that everybody is going to react violently to this,” Campbell said. “The pipeline between the rhetoric and the violence in the street is so short now. How many hours was it between the time he was complaining about the FBI going through Mar-a-Lago and somebody showing up with a gun to an FBI field office? He knows he has people waiting to mobilize.”

Campbell added, “There will absolutely be Proud Boys violence in 2024 and I think in the 2022 election, too,” noting that Arizona Republicans have called for vigilante justice around ballot boxes.

“I think they are absolutely going to show up in force for Trump’s election regardless of what happens. I think we have to realize that the violence has trickled out to everyday Americans. It’s not just extremist groups anymore. Trump pointing to the back and calling the press the enemy, Trump glorifying Jan. 6 rioters,… that has come full circle.”

He concluded, “I think the spirit of January 6 is still here. All of the groups involved are still here, and everyday Americans have joined them… It’s going to be scary.”