JEFFERSON CITY, Mo. (AP) — Transgender minors in Missouri no longer will have access to puberty blockers, hormones or gender-affirming surgery under legislation passed by the Republican-led legislature Wednesday.

The ban also affects some adults — Medicaid health care won’t cover any gender-affirming care in the state, and surgery will no longer be available to prisoners and inmates.

Gov. Mike Parson is expected to sign it — he threatened to keep lawmakers working beyond the normal end of their session if they didn't approve the ban. Once signed, it would take effect Aug. 28 and expire in August 2027. The ban includes exceptions for minors already getting such treatments.

Missouri's ban comes amid a national push by conservatives to put restrictions on transgender and non-binary people that has become, alongside abortion, a major theme running through legislative sessions across the country in 2023.

Missouri's legislative leaders vowed to stop minors from accessing puberty blockers, hormones and surgeries. And Missouri's Republican attorney general, Andrew Bailey, took up the charge after Parson appointed him to fill the vacant position in January.

In response, the Kansas City Council was considering a resolution Wednesday to make Missouri's largest city a sanctuary for people seeking such medical care.

Bailey, now campaigning to keep the job in 2024, launched an investigation in February into St. Louis' Washington University Transgender Center following a former staffer's complaints that doctors were prescribing hormones too quickly and without enough mental health wraparound services. An internal Washington University review found no malpractice.

Bailey has since expanded his investigation to any clinic offering pediatric gender-affirming care in Missouri, and demanded records from a St. Louis Planned Parenthood where doctors provide such health care.

In April, Bailey took the novel step of imposing restrictions on adults as well as children under Missouri's consumer-protection law. A judge temporarily blocked the limits from taking effect as she considers a legal challenge.

Under Bailey's rules, before gender-affirming medical treatments can be provided by physicians, people would have to demonstrate that they experienced an “intense pattern” of documented gender dysphoria for three years. They'd also need at least 15 hourly sessions with a therapist over at least 18 months. Patients would have to be screened for autism and “social media addiction,” and any psychiatric symptoms from mental health issues would have to be treated and resolved.

Bailey's rule says some patients could maintain their prescriptions as long as they promptly receive the required assessments.