State legislators across the country proposed a record number of bills targeting LGBTQ rights last year, but less than 1 in 10 have become law, a report published Thursday by the Human Rights Campaign found. 

The LGBTQ advocacy group’s 2022 State Equality Index, an annual review of state legislation and policies that affect the rights of lesbian, gay, bisexual, transgender and queer people, found that state legislators introduced 315 bills that the Human Rights Campaign described as “anti-equality.” Just 29 became law. 

The majority of the new laws target transgender minors. In the last three years, 18 states have banned trans youths from playing school sports on the teams that align with their gender identities, and four states — Alabama, Arizona, Arkansas and Tennessee — have restricted or prohibited their access to gender-affirming medical care. 

Supporters of such measures claim that trans girls have an unfair advantage in sports and that minors are too young to receive gender-affirming medical care. The American Medical Association, the American Academy of Pediatrics and other medical associations oppose efforts to restrict gender-affirming care for minors. 

JoDee Winterhof, the senior vice president of policy and political affairs at the Human Rights Campaign, said the 315 bills are part of a coordinated conservative response to LGBTQ rights gained over the last few years.

“We consider this to be part of the backlash from the gains around marriage equality, from the gains in overall equality through the courts or through cities and other states,” Winterhof said. 

Some lawmakers, she added, believe the bills will motivate conservatives to head to the polls, although she said the track record of last year’s anti-LGBTQ bills and midterm election polling have led her to believe otherwise. 

She pointed to a Human Rights Campaign poll of 1,000 voters, who were surveyed online and by phone the week of the midterm elections, that asked which issues motivated them to head to the polls. The top two were inflation, at 52%, and abortion, at 29% (an NBC News Exit Poll found the same two issues were also top-of-mind for voters). Gender-affirming care for trans youths or trans participation in sports came in last, with less than 5% identifying them as issues that motivated them to vote, the Human Rights Campaign found. 

“For many people, the jig is up,” Winterhof said, adding that targeting LGBTQ people would harm conservative lawmakers in future elections. “I know they don’t see that, but these are not winning issues.”

This year’s State Equality Index also found that state legislators introduced 156 “pro-equality” bills, of which 23, or just under 15%, became law. 

Twenty states and Washington, D.C., are in the index’s highest of four categories, “Working Toward Innovative Equality,” while 23 states are in the lowest-rated category, “High Priority to Achieve Basic Equality.” 

States are scored on whether they have “pro-equality” laws, including those that would prohibit discrimination in public accommodations, housing or adoption, among other areas of life; anti-bullying laws or laws that protect youths from conversion therapy; and measures that bar insurance companies from refusing to cover transgender care. “Anti-equality” laws — such as those that target transgender youths, bar the discussion of LGBTQ topics in schools or allow business owners to refuse to serve LGBTQ people — hurt a state’s score.

An increasing number of states are passing “pro-equality” legislation, according to the Human Rights Campaign. For example, 21 states restrict conversion therapy, which is the discredited practice of trying to change a person’s sexual orientation or gender identity; 25 ban insurance exclusions for transgender medical care; and 38 allow trans people to update their names and gender markers on their driver’s licenses, while 27 allow them to do the same on their birth certificates. 

However, many states still have “anti-equality” laws on the books. Nearly half of states (22) don’t protect people from discrimination in public accommodations based on sexual orientation, and 23 don’t provide protections based on gender identity. Seventeen states bar Medicaid from covering certain transgender medical care.

The report warns that, even though 2022 was a record-breaking year for legislation targeting LGBTQ people, 2023 is already expected to outpace it. In just the first few weeks of the year, state legislators have introduced nearly 150 such bills, the majority of them continuing to target LGBTQ youths, according to an NBC News analysis.