RALEIGH, N.C. (AP) — North Carolina has joined a growing list of states considering bans on gender-affirming medical procedures for transgender minors.

bill filed late Wednesday in the state House would ban hormone treatments and surgeries for anyone younger than 18 and make it illegal for medical professionals to help a minor “present or appear in a manner that is inconsistent with the minor’s sex.”

Doctors would be prohibited from surgically removing any healthy or “nondiseased” body part or tissue. Those who violate the proposed restriction could lose their license and would face a penalty of up to $1,000 for each violation.

The bill includes exceptions for children who were born with ambiguous sex characteristics.

Similar legislation introduced last session did not advance.

North Carolina Republicans grew their margins in the November elections but fell one seat short of a veto-proof supermajority in the General Assembly. Democratic Gov. Roy Cooper said after the election that he would continue advocating for trans residents.

The proposal comes amid a nationwide wave of legislation targeting trans youth, their parents and gender-affirming medical providers. At least 88 bills seeking to restrict gender-affirming care for minors or young adults have been introduced across 26 states, with Utah becoming the first state last month to enact a ban in 2023.