Alabama has become the first U.S. state to make it a felony to provide gender-affirming medical care to trans youth. A law went into effect Sunday that bans the use of puberty blockers and hormones, which can be lifesaving for trans children and teens. Doctors and others who are found in violation of the law could face up to 10 years in prison. The Alabama law is the latest in a series of escalating conservative attacks on LGBTQ people in the United States. “This is all happening in the same context that we’re seeing the criminalization of abortion care, that we’re continuing to see the massive suppression of votes across the country,” says ACLU attorney Chase Strangio, deputy director for trans justice with the organization’s LGBTQ & HIV Project. “All of these things are interconnected and creating chaos and fear among individuals, families and communities.”