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.

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.”

On January 6, 2021, far-right groups like the Proud Boys and Oath Keepers rioted at the U.S. Capitol to prevent Joe Biden from becoming president. Their members didn’t act alone, often relying on funders and others who supported their violent efforts.

This compelled The Hill to question how many U.S. residents actually support political violence. According to academics from institutions like John Hopkins, Stanford, Cornell, and the Universities of California and Chicago, the number could range anywhere from 3 to 20 percent of the U.S. adult population, signifying between 7 to 51 million people.

For comparison, the population of New York City is around 8.6 million and the population of California is 39.6 million. So, put another way, the U.S. has enough supporters of political violence to nearly fill New York City or to just under two Californias.

This may seem like a theoretical exercise. After all, if that many people actually supported political violence, why aren’t we seeing revolt in the streets or daily attacks on political leaders?

But, as the Army’s Counterinsurgency Manual points out, supporters of political violence offer all sorts of assistance which can aid the growth of violent insurgency movements.

“Active popular support often has the greatest impact on the insurgency’s long-term effectiveness,” the manual says. “Popular support results in safe havens, freedom of movement, logistic support, financial support, intelligence, and new personnel.… As the insurgent group gains in support, its capabilities grow.”

However, recent studies suggest that voters often misbelieve that members of their opposing political viewpoint approve of violence more than they do. This makes people more inclined to support using violence against them. Conversely, if someone is shown data to prove that their opponents don’t favor using political violence, their own support of political violence lowers.

Also, studies suggest that one’s own support of political violence also decreases the more serious the offense. So while some voters might support property damage or theft against an opposing political party, their appetite for violence decreases with more serious offenses, like death threats or actual physical assault.