GOP candidates and anti-LGBTQ groups have spent tens of millions of dollars on attack ads and mailed flyers targeting transgender youth ahead of the 2022 midterms, a Human Rights Campaign report has found.

According to the report, candidates and their allies have spent at least $50 million on anti-LGBTQ attack ads that primarily target trans youth, with ads —full of fearmongering and misinformation—appearing in at least 25 U.S. states, including Arizona, California, Georgia, and Florida. Many employ common themes and include harmful misinformation about critical gender-affirming healthcare.

Florida Republican Sen. Marco Rubio has spent more than any other candidate on anti-trans rhetoric, according to the report, which is unsurprising considering his state has been the epicenter of anti-trans policymaking. Just last week, the state’s medical board voted to start drafting rules that would ban lifesaving gender-affirming care for minors. 

“The radical left will destroy America, if we don’t stop them. They indoctrinate children and try to turn boys into girls,” Rubio said in one TV spot.

In reality, children aren’t being forced to transition. Gender-affirming care for youth is safe and effective, has been endorsed by several major governing medical bodies, and improves mental health outcomes for trans youth into adulthood.