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The fight over transgender issues, waged on several fronts in recent years, has increasingly focused on medical treatments for children.

Major medical groups — along with transgender advocates — back what is known as gender-affirming care, which involves supporting a child’s gender identity and social transition, often through clothes or a name. Such care can also eventually include puberty-blockers or hormone treatments, though genital surgery is not typically recommended for children. While acknowledging some uncertainty and risk, they cite evidence that the approach can improve children’s mental health and reduce suicide.

Opponents — including some large conservative organizations — argue that children are too young to decide for themselves and must be shielded from potentially life-altering treatments that have only recently gained broader acceptance among the medical community.

Those at the center of the conservative push for new state laws include a coalition of familiar groups — the Heritage Foundation, Family Policy Alliance and Alliance Defending Freedom — that came together in the last two years.

Then last month, a newer player on the right, American Principles Project, took up the cause in Texas, spending more than $600,000 to run a series of highly produced ads on cable television featuring the case of Mr. Younger, who has become an outspoken supporter of restrictive legislation on transgender issues. The ads directly targeted Mr. Abbott during a hard-fought Republican primary, accusing the governor of not taking steps to “protect our children.”

By that point, Mr. Younger, 57, had testified repeatedly at the Capitol in Austin on measures to restrict transgender medical treatments. After the bills failed, he entered the Republican primary for an open seat in the Texas House of Representatives.

Last week, Mr. Younger came in second place, qualifying for the May runoff.

For conservative activists, the legislative push has been part of a broader national struggle over social issues, including legislation in Florida to ban teaching about gender identity in schools. Some of the same activists who defend the rights of parents in battles over school curriculum argue that, on the question of transgender treatment, children need protection from their own parents.

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