Former President Donald Trump recently compared gender and pronoun education to “child abuse.”

Florida Governor Ron DeSantis accused his critics of “sexualizing kindergarten children.”

And South Dakota Gov. Kristi Noem debuted an ad boasting, “Only girls play girls’ sports in South Dakota.”

Republicans across the country are focusing their efforts in the run-up to the midterm elections on enacting new restrictions on the LGBTQ community, particularly transgender children. They have passed legislation prohibiting the teaching of queer people in schools, prohibiting gender-affirming care for children under the age of 18, and prohibiting transgender children from participating in youth sports.

Many of the efforts are aimed at transgender children, who make up a small percentage of all children in the United States, and LGBTQ advocates and health care professionals have warned that the bills Republicans are pushing will further marginalize transgender children, who already face higher rates of depression, anxiety, and suicide.

The GOP-led efforts are gaining traction by uniting a group of religious conservatives, parents who want control over classroom curriculum, and families worried that their daughters will be disadvantaged in athletics. Now, a movement that began in red states is spreading to battlegrounds, with more prominent national figures — and more moderate audiences — joining in.

“This isn’t a cultural issue,” said one Republican strategist. “This is a parent revolution,” says the author.

According to the pro-LGBTQ Human Rights Campaign, more than 300 anti-LGBTQ bills are already pending in state legislatures by 2022. At least six states have made it illegal for transgender women and girls to compete on gender-specific sports teams. This year, Arizona, Alabama, and Texas all passed laws prohibiting doctors from providing gender-affirming care to minors, with Alabama making it a felony for doctors to do so. Others are considering restrictions on teaching LGBTQ topics in schools, following Florida’s lead, which passed a bill dubbed “Don’t Say Gay” by critics.

“I think this year is a really big wakeup call,” Cathryn Oakley, state legislative director and senior counsel for the Human Rights Campaign, said, adding that allies must step up their fight against these efforts.

This is a watershed moment for conservative culture warriors.

The Supreme Court’s decision in Obergefell v. Hodges, which legalized gay marriage in 2015, was a crushing defeat for many Republicans. They were taken aback by how quickly the culture had shifted in favor of gay marriage, and they were left scrambling for answers. They see this as an opportunity to gain support for more restrictions on LGBTQ Americans. According to CNN, conservative organizations have provided state lawmakers with suggested legislative text and fueled outside spending groups.

In an interview with CNN, Terry Schilling, president of the right-wing American Principles Project, said, “I feel like the whole gay marriage debate was a sham.”

“When we debated gay marriage as a country, opponents claimed that it would lead to the sexualization of children. It’s not going to end just because there are two consenting adults in a loving relationship “According to Schilling. “In essence, we’ve progressed from Obergefell and gay marriage to sex changes for gay minors, hormone treatments, and puberty blockers.”

Despite the GOP talking points, LGBTQ advocates and medical providers have noted that most gender-affirming care for kids involves changing their clothing, pronouns, preferred bathrooms and perhaps using puberty blockers, which are reversible. Surgery is rarely ever performed on children.

According to available data, Republicans are also targeting a small number of children, not all of whom seek medical help. According to the Williams Institute, which studies public policy, sexual orientation, and gender identity law, there were approximately 150,000 transgender youths aged 13 to 17 in 2017.

Gender-affirming care is appropriate for young people and can even be life-saving in some cases, according to major health care organizations ranging from the American Medical Association to the American Psychiatric Association to the American Academy of Pediatrics.