As Nebraska’s new law restricting gender-affirming care for minors goes into effect this weekend, families with transgender children and the doctors who treat them are steeling themselves for change. But exactly what and how much change is anyone’s guess.

A key aspect of the law is a set of treatment guidelines that has yet to be created. Affected families, doctors and even lawmakers say they have largely gotten no response from health officials on when they can expect the new rules, which should lay out how and when transgender minors can be treated with puberty blockers and hormones.

Many of them fear Republican officials and their appointees in charge of administering the rules are slow-walking the regulations as a way to block treatment for new transgender patients under 19, the age of adulthood under Nebraska law.