With states still threatening to pass legislation aimed at restricting access to transition-related care for transgender youth, LGBTQ advocacy groups and major U.S. businesses are warning the enactment of such measures could have dire economic consequences.

The focus of the warning is an open letter, complied by the Human Rights Campaign and Freedom for All Americans, which was signed by 40 major business against anti-trans bills and made public Wednesday.

“Laws that would affect access to medical care for transgender people, parental rights, social and family services, student sports, or access to public facilities such as restrooms, unnecessarily and uncharitably single out already marginalized groups for additional disadvantage,” the letter says. “They seek to put the authority of state government behind discrimination and promote mistreatment of a targeted LBGTQ population.”

Among the 40 companies that signed the letter are Airbnb, Amazon, American Airlines, Apple, AT&T, Google, Hilton, IBM Corp,. Lyft, Marriott International, Microsoft, Nike, PayPal and Uber.

In numerous state legislatures, lawmakers have introduced bills aimed at restricting access to transition-related care, such as hormone therapy, puberty blockers and transgender surgeries, for youth below age 18. Other measures seek to inhibit transgender youths’ ability to play in school sports consistent with their gender identity.

One measure against transition-related care for youth in South Dakota was killed in committee, but others are still pending before legislatures and, in some cases, advancing forward. 

In Alabama, the Senate approved this week SB219, which would not only ban transition-related care for youth, but require school officials and medical practitioners to out transgender youth to their parents. The House version of this legislation, HB303, has been approved in committee. 

In Arizona, the House last month approved legislation, known as HB2706 and the “Save Women’s Sports Act,” seeking to block transgender youth’s participation in sports. 

In the letter signed by 40 businesses, the companies make a veiled threat those companies may not bring money to states that pass legislation along these lines.

“As we make complex decisions about where to invest and grow, these issues can influence our decisions,” the letter says. “America’s business community has consistently communicated to lawmakers at every level that such laws have a negative effect on our employees, our customers, our competitiveness, and state and national economies.”

In a conference call with reporters on Wednesday, LGBTQ rights advocates said the potential economic costs of the anti-trans legislation is clear.

Carmarion Anderson, the Human Rights Campaign Alabama State Director, urged lawmakers to look at those potential costs when considering the legislation.

“These national corporations can see that anti-transgender grandstanding and demonization only hurts the state of Alabama, the entire LGBTQ community and their own bottom line,” Anderson said.

Anderson said organizers are engaged in conversations with lawmakers in Alabama, including Speaker Mac McCutcheon, to ensure the anti-legislation is defeated, and killed with inaction as the legislature session comes to an end. The last day of the regular session of the Alabama legislature is May 18.

The Washington Blade has placed a request in with McCutcheon seeking comment on his plans for the legislation.

Also on the call was Dan Eggers, an 18-year old transgender youth in Alabama who told his personal story about struggling with suicidal ideations and eating disorders before obtaining transition-related care.

“For the first time in my life, I’m healthy and genuinely happy,” Eggers said. “That is directly because of these treatments. In fact, after I received the treatments that I needed my middle school gym teacher, after spotting me from across the room, sought out my mother and told her he never seen me experience joy before that moment.”

The Alabama legislation, Eggers said, the measure would have “require[d] him to report my identity before I was ready, exposing me to higher risks of violence at home, and even homelessness.” 

An estimated 30 percent of transgender people experience homelessness, Eggers said, and the average age of being kicked out is 13-and-a-half.

Bridget Sharpe, Arizona state director for the the Human Rights Campaign, echoed the sense businesses are fully behind efforts in Arizona to defeat anti-trans legislation.

“Major businesses understand that supporting equality isn’t only isn’t only the right thing to do, it’s good businesses sense,” Sharpe said. “Legislation promoting discrimination directly affects businesses: Full stop.”

The nationwide letter from the 40 businesses builds on a letter specific to the anti-trans legislation in Arizona signed by around 200 local and national businesses, including the Arizona State Tourism Association and the Arizona Diamondbacks.

Also on the call was Jennifer Brown, the mother of a transgender athlete, whose daughter — whom she referred to as “K” to protect her anonymity — competed on the men’s crew team in Fairfax, Va, before transitioning and joining the women’s team. 

“There are many reasons that rolling on that women’s team was so incredibly important for K,” Brown said. “At a point in time when she hated almost every piece of her body, rowing was a gift that her body gave back to her. It gave her a reason to keep herself safe and healthy. Being part of a team, a team that depended on her, gave her a reason to go on.”

Brown said her daughter is now in college in Arizona may be found at the campus gym on the rowing machine.

According to data from Change Research presented by the Human Rights Campaign, 55 percent of Arizona residents, including 58 percent of Independents, believe supporters of the Arizona anti-trans bill are “further stigmatizing already vulnerable children to push their political agenda and further divide us.” 

Further, the poll found 64 percent of Arizona residents believe the legislators are too focused on divisive issues and only 1 percent of Arizona Republicans say legislation on transgender issues should a top priority.

A Human Rights Campaign spokesperson said a similar poll wasn’t available in Alabama at this time.

Kasey Suffredini, CEO of Freedom for All Americans, said in a statement the letter from the 40 companies show the business community has “consistently taken a strong stand opposing legislation that discriminates against LGBTQ workers and customers.”

“Business leaders understand that discrimination is bad for business, and their economic competitiveness relies on fair and inclusive work and community environments for their employees and their families,” Suffredini said. 

The sponsor of HB303 in the Alabama House, State Rep. Wes Allen, and the sponsor of SB219 in the Alabama Senate, State Sen. Shay Shelnutt, didn’t respond to the Blade’s request to comment on the economic threat to the state over the legislation. 

Shelnutt, defending the legislation on the Alabama Senate floor, was quoted in AL.com as saying SB219 was necessary because kids should not be “given experimental drugs or surgeries that could have irreversible consequences for the rest of their life.”

“Kids are not fully developed until later in life,” Shelnutt reportedly said. “I think we can all agree that kids aren’t capable of making certain decisions until certain ages. And so, we want to just stop these procedures from happening in Alabama.”

The sponsor of HB2706 in Arizona, State Sen. Nancy Barto, couldn’t be reached for comment on the potential business impact of the bill.

“This bill is about fairness,” Barto told ABC News at the time it passed in the Arizona House. “That’s it. What is fair on the field, the court, the track and in the pool.”

The Alabama and Alabama chambers of commerce also didn’t respond to the Blade’s request to comment on the anti-trans legislation pending in their respective state legislatures.

LGBTQ rights advocates can point to precedent on anti-trans legislation having dire economic consequences. 

After North Carolina enacted House Bill 2, which bars transgender people from using restrooms in state-owned buildings consistent with their gender identity, economic boycotts resulted in an a loss of more than 1,750 jobs and more than $77 million in investments and visitor spending, according to a 2016 analysis from Time Warner Cable News.

Cathryn Oakley, state legislative director for the Human Rights Campaign, said on the call she doesn’t have a specific dollar amount for potential economic costs to states that pass anti-trans legislation, but North Carolina is a good example.

“It’s not difficult to connect the dots between…exactly what happened in North Carolina and HB2 with businesses saying, ‘Look we’re not coming here,’ and these businesses speaking out at this point.” Oakley said.