Legislation that would criminalize gender transition treatments for minors, such as surgery and hormone supply, and punish providers with up to ten years in federal prison was approved by a divided House on Wednesday.

On a vote of 216 to 211, the bill—which civil rights organizations claimed was among the most extreme anti-trans legislation ever considered by Congress—was approved nearly entirely along party lines.

It is unlikely to be taken up by the Senate, where it would require a bipartisan alliance to move forward. However, the ultraconservative Republican majority and President Trump’s priorities were reflected in its discussion and passage in the House.

Republican Representative Marjorie Taylor Greene of Georgia pushed it through the House after she demanded earlier this month that Speaker Mike Johnson bring her bill to the floor in exchange for her backing of the defense policy measure she was otherwise threatening to sabotage.

According to Greene, the legislation fulfilled one of Trump’s major campaign pledges, and Congress must take action to formalize his executive order banning gender-affirming medical procedures.

“Most Americans agree that kids just need to grow up before they do anything radical, like a mastectomy on a 15-year-old girl,” she said on Wednesday on the House floor, pointing at a poster board of a child who had undergone such a surgery.

Greene has recently gained odd new respect from some Democrats for disagreeing with the president on a number of issues. She abruptly announced last month that she was leaving Congress one year before the end of her term.

“If a child believes they’re a unicorn, do adults take their word for it as well?” Greene said, adding that in electing Trump in 2024, the American people voted to end gender transition treatments.

Republican Representative Barry Moore of Alabama claimed that Democrats were indoctrinating children by falsely framing gender-affirming procedures as necessary.

“It is not lifesaving care,” he said. “It is child abuse.”

In response, Democrats claimed that proponents of the bill were attempting to replace medicine with ideology by focusing on a small and vulnerable group of trans youth. They claimed that by threatening parents with jail time, the law violated their rights and gave politicians the authority to make extremely private decisions for families.

“Does anyone believe that the Freedom Caucus and President Trump love America’s children more than their parents do?” said Representative Jamie Raskin, Democrat of Maryland.

California Democratic Rep. Mark Takano said the surgeries on minors that Greene described were extremely rare.

What the bill would really do, he said, is ban “safe and effective medications for an entire group of people.”

Takano said that the bill would not make children safe and that it would “interfere with parental choice and open private medical data up to investigation.”

A second anti-trans bill, also supported by Greene, that would prohibit Medicaid coverage of gender-affirming care for trans youth is scheduled to be voted on by the House later this week.

The first openly transgender lawmaker to serve in Congress, Rep. Sarah McBride, a Democrat from Delaware, claimed before Wednesday’s vote that Republicans were “obsessed” with transgender people and were concentrating on a “misunderstood and vulnerable 1 percent of the population” rather than taking any action to safeguard Americans’ health care.

“They think more about trans people than trans people think about trans people,” McBride said, speaking to reporters on the steps of the Capitol. “They are consumed with this and they are extreme on it.”

Three Democrats and four Republicans voted across party lines. Democrats Henry Cuellar and Vicente Gonzalez, both from Texas, and Don Davis of North Carolina voted for the measure.

Republicans Gabe Evans of Colorado, Brian Fitzpatrick of Pennsylvania, Mike Lawler of New York, and Mike Kennedy of Utah voted against it.