Russian President Vladimir Putin signed new legislation Monday which marked the final step in outlawing gender-affirming procedures, a crippling blow to Russia’s already embattled LGBTQ+ community. The bill, which was approved unanimously by both houses of parliament, bans any “medical interventions aimed at changing the sex of a person,” as well as changing one’s gender in official documents and public records. The only exception will be medical intervention to treat congenital anomalies. It also annuls marriages in which one person has “changed gender” and bars transgender people from becoming foster or adoptive parents.