Nebraska lawmakers request guidance, more information on gender care restrictions

LINCOLN, Neb. (Nebraska Examiner) — Days after Nebraska’s gender care restrictions took effect, lawmakers are asking for more information, including immediate guidance on how physicians should carry out the law.

In a Wednesday letter, State Sen. Megan Hunt of Omaha requested the state’s chief medical officer, Dr. Timothy Tesmer, to advise physicians on how to carry out the provisions of the “Let Them Grow Act” that took effect Sunday. Those provisions, included in Legislative Bill 574, ban transition surgeries and restrict puberty blockers and cross-sex hormones before age 19.

Though the law included a clause to “grandfather in” patients, Hunt said, some of those patients have been denied prescriptions. Hunt said these patients, according to supporters, were not meant to be subject to the law’s restrictions or subsequent emergency regulations.

“Any disruption or delay in a prescribed regimen is inconsistent with the plain letter of LB 574 and is inconsistent with the medical standard of care for these patients,” Hunt told Tesmer.

“I respectfully request that you immediately and unequivocally advise all Nebraska healthcare professionals — including pharmacists — about the need and their professional obligations to continue pharmaceutical care for patients who were receiving care prior to October 1, 2023,” Hunt added.

A spokesperson for the Nebraska Department of Health and Human Services confirmed the agency received and is reviewing Hunt’s letter and will respond accordingly. 

‘What we need is clarity fast’

Without guidance, Hunt said, LB 574 has a “chilling effect” on standards of care and the weight of a full ban.

“What we need is clarity fast,” Hunt said. “A lot of this could be avoided if DHHS had had a more transparent process in making these regulations.”

Tesmer, with Gov. Jim Pillen’s approval, issued emergency regulations Sunday that allow care to continue under set conditions, such as after 40 hours of therapy, setting a seven-day waiting period between patient consent and prescription and mandating patients live primarily as their preferred gender for at least six months.

This required therapy must be “clinically neutral and not in a gender-affirming or conversion context.” Beyond an initial assessment of up to four consecutive hours, patients could not bank more than two hours per week — pushing the minimum time of therapy to at least five months.

Some national researchers have stated that Nebraska’s regulations could lead to “Gender Exploratory Therapy,” a new form of conversion therapy, with the goal of exploring all possible causes for gender dysphoria “other than genuine transness.”

Families are seeking answers

Proponents said ongoing care would be fine, Hunt told the Nebraska Examiner, but she’s heard that some care has been disrupted. Hunt and at least State Sen. Machaela Cavanaugh of Omaha, two lawmakers who fought LB 574 in the spring, have requested more information on the regulations. 

Though both lawmakers opposed the legislation, Cavanaugh said Wednesday, LB 574 is now law and it should be treated seriously and followed appropriately. She sent a letter to Tesmer last week requesting information and heard a response Tuesday night, which Cavanaugh described as “insufficient.”

“It was just the publicly available information that was posted on the website, and it offers nothing in the way of what I’m supposed to tell families, which is why Senator Hunt’s follow-up letter, I think, is so essential,” Cavanaugh said.

Families have been suffering since LB 574 was introduced, Cavanaugh said, and the law appears to have gone further than initially expected by excluding gender-affirming therapy.

“If that is not what Dr. Tesmer’s intention was, that should be made abundantly clear that that is a misinterpretation on the part of all of us,” Cavanaugh said.

The path toward final regulations is ongoing with a public hearing anticipated for Nov. 28 from 7 a.m. to 7 p.m. in Lincoln. A draft of final regulations must be released at least 30 days prior.

Nebraska Examiner is part of States Newsroom, a network of news bureaus supported by grants and a coalition of donors as a 501c(3) public charity. Nebraska Examiner maintains editorial independence. Contact Editor Cate Folsom for questions: info@nebraskaexaminer.com. Follow Nebraska Examiner on Facebook and Twitter.