AUSTIN, Texas (AP) — Texas would become the largest state to ban gender-affirming care for minors under a bill sent Wednesday night to Republican Gov. Greg Abbott, who has previously ordered child welfare officials to investigate such treatment as abuse.

The bill cleared the GOP-controlled Legislature after a final vote in the Senate over the objections of Democrats, who used parliamentary maneuvers in recent weeks to delay passage but could not derail it entirely.

Texas is now poised to join at least 17 other states that have enacted similar bans.

Abbott’s office did not return an email seeking comment Wednesday night. Last year, Abbott became the first governor to order the investigation of families who were receiving care. The investigations were later halted by a Texas judge.

Every major medical organization, including the American Medical Association, has opposed the bans and supported the medical care for minors when administered appropriately.

Texas is among a number of states where Republican lawmakers have given priority status this year to measures limiting the rights of transgender people. Earlier Wednesday, the Texas House also gave preliminary approval to a bill that puts restrictions on transgender college athletes.

Transgender rights activists have disrupted the Texas House with protests from the chamber gallery, which have led to state police forcing demonstrators to move outside the building.

Earlier this month, a Texas hospital’s care for transgender minors came under investigation by state Attorney General Ken Paxton, who said he was seeking evidence of alleged “potentially illegal activity” without elaborating.