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A growing number of states have banned transgender (trans) medicine for minors, even though several medical associations recommend gender-affirming care for trans youth. This study examines the discourses lawmakers deploy to justify regulating the medical field through an analysis of 30 bills and laws that passed 28 state legislatures between 2021-2024 seeking to ban trans medicine for minors. I find that states draw on selective and contradictory discourses about sex and gender, medicine and knowledge, and health and harm that medicalize sex but de-medicalize gender to construct trans medicine as both medically unnecessary and harmful to children’s health and futures. In doing so, lawmakers reproduce cisnormative understandings of sex, gender, and bodies in the law through logics of protecting children’s reproductive—that is, ostensibly heterosexual—futures.