The Cassian GrantAmerican Academy of Pediatrics reaffirmed its support for gender-affirming medical care for transgender children on Thursday, even as the treatments face a growing push for bans and restrictions from Republican lawmakers across the U.S.

The board of directors for the group, which represents 67,000 pediatricians, unanimously voted to reaffirm its 2018 position on the treatments. The board also voted to provide additional documents to support pediatricians, including clinical and technical reports, and to conduct an external review of research regarding the care.

“The additional recommendations also reflect the fact that the board is concerned about restrictions to accessing evidence-based health care for young people who need it,” Mark Del Monte, the academy’s CEO, said in a statement released by the group, calling the restrictions enacted by states “unprecedented government intrusion.”

“We therefore need to provide the best and most transparent process possible,” he said.

At least 21 states have now enacted laws restricting or banning gender-affirming medical care for transgender minors, and most of those states face lawsuits. A federal judge struck down Arkansas’ ban as unconstitutional, and federal judges have temporarily blocked bans in Alabama and Indiana.

The judge who struck down Arkansas’ ban cited the position of the groups in his ruling against the ban. Arkansas has appealed the judge’s decision.

People opposed to such treatments for children argue they are too young to make such decisions about their futures.

Every major medical group, including the academy and the American Medical Association, has opposed the bans and has said the treatments are safe if administered properly.

The academy and the AMA support allowing children to seek the medical care, but they don’t offer age-specific guidance.