Alabama could become the next conservative state to prevent transgender girls from playing on female sports teams as the state House of Representatives on Thursday approved the legislation.

Representatives voted 74-19 for the bill that will require K-12 athletes to play on teams based on the biological sex listed on their birth certificates. The approval came after Republicans voted to end a filibuster. The bill now moves to the Alabama Senate.

More than a dozen states are considering restrictions on transgender athletes or gender-confirming health care for transgender minors. Mississippi Republican Gov. Tate Reeves last week signed a bill to ban transgender athletes from competing on girls or women’s sports teams. However, South Carolina lawmakers this week rejected a similar bill.

“It is unfair for biological males to compete against females in high school sports,” Republican Rep. Scott Stadthagen of Hartselle said as debate opened on the bill.

Alabama legislators who pushed the bill gave no evidence of any transgender athletes competing in state schools or universities. Democratic legislators questioned the need for the bill, saying the decision should be left to athletic associations and lawmakers shouldn’t get involved.

Democratic Rep. Napoleon Bracy of Prichard asked “what happened” to make the legislation a priority in the Alabama Legislature, noting that lawmakers could not point to instances in the state of transgender athletes dominating sports.

Rep. Mary Moore, a Democratic representative from Birmingham, expressed concern about the impact on transgender youth and said lawmakers were trying to insert themselves into these decisions.

“As a body, we are trying to practice medicine without a degree,” Moore said.

Supporters of the bills say transgender girls are born bigger and faster and have an unfair advantage in competition. Opponents say the bills are rooted in discrimination and fear and violate the federal law barring sex discrimination in education.