Transgender people who are able to receive gender-affirming surgery reported improved mental health outcomes, according to a new study published Wednesday. The study, published in JAMA Surgery found that overall, gender-affirming surgery was associated with a 42 percent reduction in psychological distress in transgender individuals, a 44 percent reduction in suicidal thoughts and a 35 percent reduction in tobacco smoking. Those who were not yet able to undergo procedures to have their body reflect their gender identity were nearly twice as likely to report negative mental health symptoms and associated behaviors, the study noted. “This study adds to a growing body of evidence showing affirmation in all forms can be life-saving for trans and gender-diverse people,” said lead author Anthony Almazan, a fourth-year medical student at Harvard Medical School, according to NBC News. He added, “Policies that limit access to care can put lives at risk. Our evidence shows we should be expanding gender-affirming care, not limiting it.” Results from the study come as a slew of state legislatures across the U.S. have introduced bills banning gender-affirming medical care, including puberty blockers, hormones and surgeries for transgender youth.