Gov. Jim Justice (R-WV) signed a bill banning puberty blockers and transgender surgeries for minors.

The bill also bans hormone replacement therapy, according to the Associated Press. However, it is unique among other bills that ban hormone therapy, as it allows exceptions in extreme cases. A child may be prescribed puberty blockers or hormone therapy if they get parental consent and a diagnosis of severe gender dysphoria from two physicians specializing in the field, who must provide written testimony specifying that the treatment is needed to prevent self-harm.

KENTUCKY LEGISLATURE OVERRIDES DEMOCRATIC GOVERNOR'S VETO OF TRANSGENDER YOUTH BILL

“These kids struggle. They have incredible difficulties,” state Senate Majority Leader Tom Takubo (R), who added the exception provision, said on the Senate floor.

West Virginia now joins Alabama, Arkansas, Arizona, Georgia, Iowa, Kentucky, Mississippi, Tennessee, Utah, and South Dakota as states that have limited or banned procedures related to transgender youth. Judges have blocked the laws in Alabama and Arkansas.

Despite the exceptions, LGBT activists were still highly critical of the measure.

“Gov. Justice and the legislature are substituting their political priorities for the expert judgment of medical experts – the mainstream American medical community recommends the age-appropriate, best practice medical care that this law now prohibits," Cathryn Oakley, Human Rights Campaign’s state legislative director and senior counsel, said in a statement . "I want to be clear: these lawmakers are denying transgender and non-binary youth care that saves lives. Gov. Justice’s actions today are dangerous, discriminatory, and just another example of politicians in positions of power abusing their authority to cater to extreme elements of their base – harming the children of West Virginia in the process.”

However, the American College of Pediatricians, a conservative medical advocacy group, argues that such treatments are not only unproven but dangerous.

"There is not a single long-term study to demonstrate the safety or efficacy of puberty blockers, cross-sex hormones, and surgeries for transgender-believing youth," the group said. "This means that youth transition is experimental, and therefore, parents cannot provide informed consent, nor can minors provide assent for these interventions. Moreover, the best long-term evidence we have among adults shows that medical intervention fails to reduce suicide."

The group wrote that puberty blockers and hormone therapy may be the cause of health problems such as "osteoporosis, mood disorders, seizures, cognitive impairment, and when combined with cross-sex hormones, sterility. In addition to the harm from Lupron, cross-sex hormones put youth at an increased risk of heart attacks, stroke, diabetes, blood clots, and cancers across their lifespan."

Nevertheless, the HRC wrote, "Every credible medical organization — representing over 1.3 million doctors in the United States — calls for age-appropriate gender-affirming care for transgender and non-binary people."

The group cites approval from the American Academy of Pediatrics, the American Medical Association, and the American Psychiatric Association as supporting their claim.

However, in a paper published in the Journal of Sex & Marital Therapy, gender identity psychologist Dr. James Cantor wrote that the American Academy of Pediatrics, whose approval of transgender procedures is frequently cited by activists as expert opinion, misrepresented the findings of other experts on the subject.

"Remarkably, not only did the AAP statement fail to include any of the actual outcomes literature on such cases, but it also misrepresented the contents of its citations, which repeatedly said the very opposite of what AAP attributed to them," he wrote.