Nebraska trans youth can access gender-affirming care, but only after invalidating therapy

Nebraska's Republican governor has approved restrictions around gender-affirming care for minors, requiring youth in the state to undergo hours of scrutinous therapy before they can access the life-saving treatment.

The regulations are part of an amendment to Legislative Bill 574, which was signed into law by Gov. Jim Pillen last year. The legislation banned gender-affirming surgery for people under 19 for the purpose of gender transition, and gave the state’s chief medical officer, appointed by the governor, the power to regulate use of puberty blockers and hormones.

Nebraska Chief Medical Officer Timothy Tesmer soon after put forth emergency regulations on such care, which were first adopted in October and officially approved Tuesday. Transgender youth in the state are now forced to jump through several hoops before receiving care, including undergoing counseling that could invalidate their gender identity.

Patients under the age of 19 are required to undergo 40 “gender-identity-focused contact hours of therapy” before receiving puberty blockers or hormone therapies. These counseling sessions are supposedly meant to "be clinically objective and non-biased," but are explicitly required to “not merely affirm the patient’s beliefs.”

Patients are also required to continue therapy for at least one hour every 90 days while on the treatment. There is a minimum waiting period of seven calendar days between the time a patient's informed consent is documented and the time medications can be prescribed or administered.

Grant Friedman, ACLU of Nebraska legal fellow, said in a statement that "young trans Nebraskans and their families have been struggling to access needed gender-affirming care under the emergency regulations, and now they know that will continue under these discriminatory final regulations."

“State officials have decided to flatly ignore the serious concerns raised by impacted young people as well as their family members and their medical and mental health providers,” he said. “To be clear, we are talking about gender-affirming care that is endorsed by major medical organizations and recognized as often life-saving care."

The American Medical Association, the American Psychiatric Association, the American Academy of Pediatrics, the American Academy of Child & Adolescent Psychiatry, the World Medical Association, and the World Health Organization all agree that gender-affirming care is evidence-based and medically necessary not just for adults but minors as well.

The Nebraska chapters of the American Civil Liberties Union and Planned Parenthood filed a lawsuit against the restrictions last year, which has since escalated to the state Supreme Court. Friedman continued to say that "as we await the Nebraska Supreme Court’s decision, our team continues to explore all options to ensure that trans youth have access to the care they need.”

"Trans youth deserve access to gender-affirming care, and they deserve a lot better than this," he said.