Judges could consider parents' objections to medical treatments such as puberty blockers when modifying or deciding custody agreements for transgender children, under a measure approved Monday by a Senate committee.

The bill (SB 254) also would make it a felony for doctors or other health-care professionals to order puberty blockers, hormone treatment or surgery for transgender minors.

And it would require transgender adults to provide written consent to receive gender-affirming prescriptions and surgery and require in-person exams before such treatments could be ordered. Also under the bill, physicians would be the only health-care providers allowed to order "sex-reassignment prescriptions or procedures."

The bill, approved by the Senate Health Policy Committee, comes as Republican lawmakers throughout the country have filed more than 300 pieces of legislation seeking to restrict gender-affirming care or curb drag performances.

Gov. Ron DeSantis, who cruised to reelection in November and is viewed as a top contender in the 2024 GOP race for president, has made the issue one of his top priorities, frequently blasting what he calls "gender mutilation."

Chloe Cole, a "de-transitioner" who had a double mastectomy at age 16 and advocates against gender-affirming care for children, was seated next to First Lady Casey DeSantis during DeSantis' State of the State speech last week. The governor called Cole out by name during the address, saying "the people of Florida and the Legislature should heed your advice and provide protections against these procedures."

The Senate bill is part of a series of proposals targeting transgender people during the 60-day legislative session that began last week.

Senate bill sponsor Clay Yarborough, R-Jacksonville, told the committee that the measure is aimed at making Florida children safer.

He said he filed the bill "because I believe as lawmakers we have to draw the line" about "drastic, life-altering" procedures for children.

"Parents have the right and responsibility to raise their children as they see fit, and government intervention should be a last resort," Yarborough said.

Part of the bill would allow a judge to "vacate, stay, or modify a child custody determination of a court of another state to protect the child from the risk of being subjected to the provision of sex-reassignment prescriptions or procedures."

"One parent should not be able to unilaterally attempt to change the sex of their child," Yarborough told the panel.

The committee rejected several attempts by Democrats to water down the bill, including an effort to allow doctors to use telehealth to order prescriptions for trans adults. It voted 8-3 along party lines to approve the measure, after more than an hour of emotionally charged public testimony.

Denise Barber, a Northwest Florida resident who said her 43-year-old son and 15-year-old granddaughter are trans, urged the committee to reject Yarborough's plan.

"The language in this bill is scary. It is horrific," Barber said, referring to her son and granddaughter. "I am scared to death for them. And wondering if it is time for me to leave my home state, where I have lived all my life."

Major medical associations in the United States maintain that gender-affirming care is safe, medically necessary and, often, a life-saving intervention for trans youths, who are at higher risk of taking their own lives.

"If you pass this bill, many of us will die. We deserve to live as long as all of you. We are humans, too. Why are you so afraid of me, Mr. Yarborough?" Lola Smith, who described themself as a 12-year-old nonbinary person, told the committee.

Other speakers objected that trans kids' families are being excluded from DeSantis' and Republican leaders' support for parents' rights.

"It's painfully ironic that parental rights are supposed to be protected in our state for parents, while those rights are explicitly denied for parents like myself," Melinda Stanwood said.

The Senate proposal would codify into state law recently approved rules by the Florida Board of Medicine and Florida Board of Osteopathic Medicine preventing doctors from providing puberty blockers, hormone therapy or surgery for minors. The DeSantis administration asked the boards to sign off on the rules.

But the Senate proposal and a similar House bill go further than the rules. The Senate plan could lead to criminal charges for a person who "willfully or actively participates in a violation," while the House measure would require that doctors who violate the prohibitions lose their licenses.

In addition, the state Agency for Health Care Administration last year approved a rule prohibiting Medicaid reimbursements for puberty blockers, hormone therapy and surgery for transgender youths and adults. The rule is being challenged in federal court.

The Senate measure also would require hospitals and ambulatory surgery centers to provide annual "attestation" that they do not provide gender-affirming care to minors or offer referrals for such services.

The bill is an "extreme overreach," argued Senate Minority Leader Lauren Book, a Plantation Democrat who serves on the committee.

"We all want to protect kids. Let's be very, very clear about one thing. I have spent my life protecting kids," Book, a survivor of childhood sexual abuse, said. "The parents and adults who are here with these children today want to protect kids. It may not look the way you think it should, but we all want to protect kids. … We have a responsibility to allow parents the right to protect their kids the way that they see fit."

Dara Kam reports for the News Service of Florida.

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