Ban on gender-altering surgery, abortion restrictions approved

Senators passed a bill May 19 that bans “gender-altering” surgeries for minors and enacts a 12-week ban on abortion in Nebraska.

LB574, sponsored by Omaha Sen. Kathleen Kauth, creates the Let Them Grow Act and the Preborn Child Protection Act.

Beginning Oct. 1, 2023, the Let Them Grow Act prohibits physicians from performing gender-altering surgical procedures on individuals under age 19. The bill grants the state’s chief medical officer the authority to establish regulations regarding non-surgical gender-altering procedures for minors in Nebraska, including the use of hormone therapy and puberty blockers.

At minimum, the regulations must require that a health care practitioner may prescribe approved puberty-blocking drugs and/or cross-sex hormones for a patient younger than 19 only if the individual has a “long-lasting and intense pattern of gender nonconformity or gender dysphoria” that began or worsened at the start of puberty.

Other minimum requirements include a minimum number of gender-identity focused therapeutic hours and a waiting period between the time a health care practitioner obtains informed patient consent and the prescribing of hormone therapy and puberty blockers.

The state Department of Health and Human Services may adopt rules and regulations consistent with those established by the chief medical officer.

LB574 allows individuals who began receiving gender affirming care prior to the ban’s effective date to continue treatment.

A physician who knowingly violates the bill’s provisions will be subject to review by the state’s medical licensing board. An individual who received a gender-altering procedure while under the age of 19, or their parent or guardian, could bring a civil action against the physician within two years of discovery.

The bill prohibits the distribution or use of state funds for any entity, organization or individual that provides gender-altering surgery for minors in Nebraska.

Also included in LB574 is the Preborn Child Protection Act, which narrows Nebraska’s current 20-week post-fertilization abortion ban to instead ban the procedure after the gestational age of 12 weeks. Gestational age calculates a pregnancy from the first day of a pregnant individual’s last menstrual cycle rather than from the moment of fertilization.

The act includes exceptions for sexual assault, incest and medical emergencies but does not include exceptions for fetal anomalies.

The following are excluded from the definition of an abortion under the bill:
• removal of an ectopic pregnancy;
• removal of the remains of an unborn child who already has died;
• an act done with the intention of saving the life or preserving the health of the unborn child; and
• termination or loss of life of an unborn child who is not being carried inside an individual’s body during the practice of in vitro fertilization or other assisted reproductive technology.

Health care providers who violate the bill’s provisions may be subject to removal of their license to practice medicine.

After two hours of discussion on final reading regarding a motion to return the bill to select file for consideration of a specific amendment, Kauth offered a motion to invoke cloture, which ends debate and forces a vote on the bill. The motion was adopted 33-15. Thirty-three votes were needed.

LB574 then passed on a vote of 33-15 and takes effect immediately.