Russian lawmakers unanimously passed a bill on Friday to ban gender-affirming surgeries for transgender people in the country. The Chairman of the Russian State Duma Viacheslav Volodin announced the bill’s passage on his Telegram channel, claiming the bill will protect Russian citizens and children.

The bill prohibits surgery and hormone therapy for transgender individuals as well as any gender changes on official Russian documentation. The bill also applies retroactively, barring any Russians who have already transitioned from adopting children. The bill also annuls transgender individuals’ marriages.

The only exceptions to the bill’s wide-reaching language apply in cases of medical interventions for congenital anomalies or children born intersex.

Speaking to the Associated Press ahead of the bill’s final reading, Executive Director of Russia’s Independent Psychiatric Association Lyubov Vinogradova said gender-affirming procedures “shouldn’t be banned entirely, because there are people for whom it is the only way to … to exist normally and find peace with themselves.”

The law’s passage through the Russian Duma reflects the escalating persecution of LGBTQ+ people within the country, despite international pressure to reverse course. In December, Russia enacted a sweeping law banning “LGBT propaganda,” including any and all positive displays of LGBT relationships and lifestyles for all age groups. In April, Russian authorities arrested two men and charged them with violating the law because the two released videos to YouTube and TikTok where they can be seen touching. 

The law also reflects a global rise in the persecution of transgender and LGBTQ+ people, including broad restrictions on gender-affirming care in the US and laws elsewhere, which criminalize LGBTQ+ people entirely.

The bill now goes to Russian President Vladimir Putin for final approval, at which time the law will come into effect.