ANNAPOLIS, Md. (AP) — Gender-affirming treatment in Maryland would be protected from criminal and civil actions brought by other states under a measure approved Tuesday by the state Senate.

The Democrat-controlled Senate voted 33-13 for the measure that would provide the same legal protection offered by the state for abortions. It now goes to the House, where a similar bill has been introduced.

The measure protects medical records of patients in Maryland from criminal, civil and administrative actions relating to gender-affirming care, if records were sought in investigations started in another state.

For example, a judge would not be able to order someone in Maryland to provide testimony or produce documents in a case where prosecution or investigations are pending in another state. Maryland enacted a law to protect information relating to abortion procedures last year, in response to other states that banned or restricted abortions.

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“This legislation simply adds gender-affirming treatment to what is already in statute as legally protected health care, legally protected health care that we placed into statute last year to ensure that women that need abortions can have privacy in their own medical records from being transferred out of state or being accessed by out of state entities,” said Sen. Clarence Lam, a Democrat who is a physician at Johns Hopkins.

Republicans who opposed the bill argued the measure would expand access to gender-affirming care to youths who could decide to have treatments that could have a permanent effect on them when they are at a vulnerable period in their lives. Sen. Justin Ready, a Carroll County Republican, urged senators to “stop this sprint down this road.”

“Let’s take some time, because all over the world people are starting to question whether we have the right approach on these issues,” Ready said.

But Lam said protections are needed for adults that come to Maryland for treatment. He noted that Florida currently has a law on the books that limits gender-affirming care for adults.

“So this bill is not simply about minors or just simply about adults,” Lam said. “It’s about all patients that may need gender-affirming treatment.”

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Lam also said the Maryland legislation doesn’t change the need for parental consent with children.

“This changes nothing about how care is provided to minors,” Lam said.

Under the legislation, gender–affirming care would mean any medically necessary treatment consistent with current clinical standards of care prescribed by a licensed health care provider for the treatment related to someone’s gender identity.

Treatment would include hormone therapy, hormone and puberty blockers, hair alteration for the purposes of altering secondary sex characteristics and surgical site preparation, as well as alterations to voice, voice therapy and voice lessons. It also would include surgical alterations and laser treatment for scars from gender–affirming treatment.

In June, Gov. Wes Moore signed an executive order to protect people who receive or provide gender-affirming care in Maryland from attempts at legal or disciplinary action by other states. The legislation passed by the Senate would put such protections into state law.