House Speaker Cameron Sexton speaks at an America First Policy Institute event in Franklin on Tuesday.

Republican members of the Tennessee House of Representatives issued a letter to Vanderbilt University Medical Center on Wednesday asking its board of directors to "take immediate action by halting all permanent gender transitioning surgeries being performed on minor children."

The letter follows allegations in a thread of tweets by Daily Wire political commentator and activist Matt Walsh that the Nashville hospital is operating a “child castration business.”

Walsh’s posts created a firestorm of Republican outrage in Middle Tennessee and across the national conservative media landscape, and resulted in Gov. Bill Lee calling for an investigation into the Pediatric Transgender Clinic at the Monroe Carell Jr. Children’s Hospital at Vanderbilt.

"While those 18 years and older are recognized as legal adults and free to make decisions in their best interests, it is an egregious error of judgment that an institution as highly respected as Vanderbilt would condone (and promote) harmful and irreversible procedures for minor children in the name of profit," the letter reads in part, calling the clinic's practices "nothing less than abuse."

The House Republicans are asking for a response from VUMC within 10 days.

“We have been and will continue to be committed to providing family-centered care to all adolescents in compliance with state law and in line with professional practice standards and guidance established by medical specialty societies,” VUMC said in a statement last week.

Tuesday evening, House Speaker Cameron Sexton (R-Crossville) made an unannounced appearance at a Franklin hotel where he took part in a panel discussion at the America First Policy Institute's America First Agenda Town Hall Tour. At the event, he addressed the ongoing controversy around transgender health care at Vanderbilt.

AFPI is a self-described "non-profit, non-partisan research institute" that "exists to advance policies that put the American people first" with their listed guided principles including "liberty, free enterprise, national greatness, American military superiority, foreign-policy engagement in the American interest and the primacy of American workers, families and communities in all we do."

While AFPI describes itself as "non-partisan," the group's ranks include GOP stalwarts like former U.S. House Speaker Newt Gingrich, former Texas Gov. Rick Perry, and former Trump aides Kellyanne Conway and Larry Kudlow.

"I think what you'll see [is] us come back in January and prohibit it from even happening in their state under reassignment surgeries for any minor — parental consent or anything, just wipe it off," Sexton told the crowd of around 40 people on Tuesday. “You also have hormone blockers or puberty blockers going on — I think you'll see us ban those as well."

Sexton also spoke on the General Assembly's plan to take on insurance companies and make changes in regards to TennCare.

"So what you'll see [is] us come back next year and … really say that these things are elective — if you want to pay cash, that's what you want to do, so be it, but we're not going to have this when a female is diagnosed with breast cancer, and they'll pay for the mastectomy, but they won't pay for the reconstruction, but they're going to pay for reassignment surgeries?” Sexton said. “There's something that's wrong in the insurance world, and they're too scared to do it themselves, so we'll do it for them."

Sexton added that the legislature will also explicitly prohibit TennCare from paying for gender-affirming surgeries for minors. TennCare does not cover gender-affirming surgeries for minors, according to spokesperson Amy Lawrence. Hormone blockers are covered if deemed “medically necessary.”  Additionally, TennCare does cover reconstructive breast surgery as a result of a mastectomy, Lawrence said.

The latest standards of care released earlier this month from the World Professional Association for Transgender Health do not give a specific age recommendation for chest masculinization surgery, but instead base it on the child’s development and medical team recommendations.

“Chest masculinization surgery can be considered in minors when clinically and developmentally appropriate as determined by a multidisciplinary team experienced in adolescent and gender development,” the document reads.

The standards of care do not recommend phalloplasty in youth under 18, and explained that while vaginoplasty surgeries are relatively uncommon in minors, “there may be a benefit for some adolescents to having these procedures performed before the age of 18.” The children’s hospital has not said whether or how often such procedures are performed on minors.

On Wednesday, Lee and House Majority Leader William Lamberth (R-Portland) addressed the controversy on SuperTalk 99.7’s Matt Murphy Show, with Lee calling it “wrong on so many levels,” adding that he expects there to be changes in state law.

“I think it's really sad when you think about children who are having life-altering, permanent procedures, changing their bodies at a time in life when we are not capable of making decisions to do that, that will affect the rest of their lives,” Lee said. “It’s just sad. And we have a responsibility to protect the children of the state, and that was the driving force behind my response.”

Lamberth said that he was unaware that gender-affirming surgeries were occurring at the children’s hospital prior to Walsh contacting him and Senate Majority Leader Jack Johnson (R-Franklin), but that he was aware of the practice in general, characterizing it as “evil” pressures from adults onto children who he said are likely suffering from mental health issues.

“I don't want to just focus just on Vanderbilt,” Lamberth said. “I guarantee you this is going on in other places in this state, and we have got to stop it here so that these children get the help that they need. Whatever mental health issue is going on, whatever developmental issue is going on, focus on those issues. When they become adults, they can do whatever they want to do, but leave our children alone, leave them out of whatever it is that adults are trying to push on them, because most of the time, there's other issues that are being combined into this.”

This article originally appeared in our sister publication the Nashville Post.