RALEIGH, N.C. >> Transgender youth in North Carolina lost access Wednesday to the gender-affirming treatments many credit as live-saving after the Republican-controlled General Assembly overrode the Democratic governor’s veto of legislation banning such care.

GOP supermajorities in the House and Senate enacted — over Gov. Roy Cooper’s opposition — a bill barring medical professionals from providing hormone therapy, puberty-blocking drugs and surgical gender-transition procedures to anyone under 18, with limited medical exceptions.

The policy takes effect immediately, but minors who had begun treatment before Aug. 1 may continue receiving that care if their doctors deem it medically necessary and their parents consent.

North Carolina becomes the 22nd state to enact legislation restricting or banning gender-affirming medical care for trans minors. But most of those laws face legal challenges, and local LGBTQ+ right advocates have vowed to challenge the ban in court. Most of the laws elsewhere are facing lawsuits.

Democratic Sen. Lisa Grafstein, North Carolina’s only out LGBTQ+ state senator, said the gender-affirming care bill “may be the most heartbreaking bill in a truly heartbreaking session.”

Some LGBTQ+ rights advocates in the Senate gallery began yelling after Republican Lt. Gov. Mark Robinson, who was presiding, cut off Grafstein to let another lawmaker speak. Several people were then escorted out of the chamber by state capitol police.

Sen. Joyce Krawiec, a Forsyth County Republican and the primary sponsor of the gender-affirming care bill, said the state has a responsibility to protect children from receiving potentially irreversible procedures before they are old enough to make their own informed medical decisions.

The Senate voted 27-18 to complete the veto override approved earlier by the House.

THIS IS A BREAKING NEWS UPDATE. AP’s earlier story follows below.

RALEIGH, N.C. (AP) — North Carolina’s Senate and House voted minutes apart Wednesday to override Gov. Roy Cooper’s veto of a bill limiting LGBTQ+ instruction in the early grades, immediately making it law.

The law, which is expected to face a legal challenge, requires public school teachers in most circumstances to alert parents before they call a student by a different name or pronoun. It also bans instruction about gender identity and sexuality in K-4 classrooms, which critics have previously likened to a Florida law opponents call “Don’t Say Gay.”

The Senate voted 27-18 for the override, followed swiftly by a 72-47 decisive House vote. That came on an afternoon of intense activity in the state’s General Assembly.

Both chambers also voted to override Cooper’s veto of another bill banning transgender girls from playing on girls’ sports teams from middle and high school through college. That bill also immediately became law.

Earlier, a GOP supermajority in the North Carolina House voted Wednesday to override the Democratic governor’s veto of legislation to ban gender-affirming treatments for transgender minors, putting those youth just a vote away from losing access to that care.

The House vote was 73-46 to overturn Cooper’s veto of the bill that would bar medical professionals — with limited exceptions — from providing hormone therapy, puberty-blocking drugs and surgical gender-transition procedures to anyone under 18. Minors who began treatment before Aug. 1 could continue receiving that care under parental consent if their doctors deem it medically necessary.

Democratic state Rep. John Autry of Mecklenburg County, who has a transgender grandchild, choked up while debating the gender-affirming care bill on the House floor. “Just stop it,” he begged his Republican colleagues shortly before they voted to enact the law.

The House vote left North Carolina one vote away from becoming the latest state to ban gender-affirming health care for transgender youth.

The Senate has a similarly veto-proof GOP majority as the House. If Republicans in the Senate succeed as expected, they would make North Carolina the 22nd state to enact legislation restricting or banning gender-affirming medical care for trans minors. Many of those laws are facing court challenges and advocates have promised similar challenges in North Carolina.

Cooper blasted the votes in the Republican-controlled chambers, calling them “wrong priorities.”

“The legislature finally comes back to pass legislation that discriminates,” he said, adding it would have several negative impacts for North Carolina. “Yet they still won’t pass a budget when teachers, school bus drivers and Medicaid Expansion for thousands of working people getting kicked off their health plans every week are desperately needed.”″

Gender-affirming care is considered safe and medically necessary by the leading professional health associations, including the American Academy of Pediatrics, the American Medical Association and the Endocrine Society. While trans minors very rarely receive surgical interventions, they are commonly prescribed drugs to delay puberty and sometimes begin taking hormones before they reach adulthood.

Parents of transgender and nonbinary children, like Elizabeth Waugh of Orange County, said they have been considering whether to move their families out of North Carolina so their children will have unrestricted access to gender-affirming care.

Waugh’s nonbinary child did not begin receiving treatment before Aug. 1 and would need to travel elsewhere if they decide they want to start taking hormones.

“I have felt like I had a lump in my throat for months,” Waugh said Wednesday before the House vote. “Just talking to other families who are dealing with this, I mean, the pain that they are feeling, the suffering, the fear for their children — it’s devastating.”

Local LGBTQ+ rights advocates had braced in expectation of House and Senate override votes succeeding Wednesday, and vowed to challenge them in court.

The first override vote by the House came Wednesday on Cooper’s veto of a bill that would prohibit transgender girls from playing on girls’ middle school, high school and college sports teams. The House overrode that veto 74-45. The Senate later in the day cast the clinching override vote, enacting that measure into law.

A former Olympic swimmer, Rep. Marcia Morey, had spoken in House floor debate earlier about the repercussions of that bill on young athletes.

“This bill affects 10-, 11-, 12-year-olds who are just starting to learn about athletics, about competition, about sportsmanship,” Morey, a Durham County Democrat, said. “To some of these kids, it could be their lifeline to self-confidence.”

Critics have said limits on transgender girls’ participation in sports were discriminatory and have called it a measure disguised as a safety precaution that would unfairly pick on a small number of students.

But supporters of that bill such as Payton McNabb, a recent high school graduate from Murphy, argued that legislation is needed to protect the safety and well-being of young female athletes and to preserve scholarship opportunities for them.

“The veto of this bill was not only a veto on women’s rights, but a slap in the face to every female in the state,” said McNabb, who says she suffered a concussion and neck injury last year after a transgender athlete hit her in the head with a volleyball during a school match.

The GOP holds veto-proof majorities in both chambers for the first time since 2018, affording Republicans a clear path to consider certain LGBTQ+ restrictions that had not previously gained traction in North Carolina.