PIERRE (AP) – South Dakota Gov. Kristi Noem says she has “concerns” about a bill in the House that would make it illegal for physicians to administer gender-change treatments to children under 16. But she declined Friday to offer full support or disapproval.

The bill would allow for physicians who perform surgeries, administer hormone therapy or prescribe puberty-blocking medication to minors to be prosecuted with a misdemeanor. The Republican-dominated House will debate the bill next week.

“When you take public policy and try to fill parenting gaps with more government, you have to be very careful about the precedent you're setting,” Noem told reporters.

Democrats and LGBT activists say the bill targets transgender children and could lead to an increase in suicides. Supporters, including many Republicans in the House, say the bill would prevent children from receiving ideologically motivated treatment that harms them.

Sanford Health, one of the largest medical providers in the state, has said it treated fewer than 20 minors seeking treatment for gender dysphoria last year, according to Mitch Rave, a lobbyist for the business.

Leading medical authorities, including the Endocrine Society and the World Professional Association for Transgender Health, do not recommend gender-change surgeries for minors. For youths experiencing puberty and older adolescents, the Endocrine Society recommends that a team composed of expert medical and mental health professionals manages treatment, which can include puberty-blocking drugs or hormone therapy.

Business groups have also clashed with social conservatives over the legislation. The South Dakota Chamber of Commerce and Industry said policies that discriminate against LGBT people dissuade businesses from investing in the state.

“There will be blowback,” said House Minority Leader Jamie Smith, a Sioux Falls Democrat. “We'll be labeled as a state that is not welcoming and is not inclusive.”

Noem has made economic growth a priority for her administration this year and said she will “aggressively” recruit businesses to relocate to the state.

House Majority Leader Lee Qualm, of Platte, is a co-sponsor of the bill. Qualm claimed North Carolina experienced economic growth after passing a “bathroom bill” barring transgender people from using public bathrooms that don't correspond with the sex on their birth certificates. North Carolina’s legislature rolled back the law a year after it was passed.

An Associated Press analysis found that the state could have lost more than $3.76 billion over a dozen years after losing out on business projects, conventions and sports tournaments.

Qualm said executives he has spoken to don't object to the bill, but that he expects it to be a close vote in the House.

Former Gov. Dennis Daugaard vetoed a bathroom bill introduced in the South Dakota legislature in 2016. Noem said in 2018 during her campaign for governor that she would have signed the bill.

The American Civil Liberties Union on Thursday threatened to mount a legal challenge to the ban if it became law.

When asked about the legal threats to the proposed law, Noem said it was something she would consider.