“Let them Grow Act” takes effect in Nebraska
On Sunday, Oct. 1, the “Let Them Grow Act,” took effect in Nebraska. The Act, included in Legislative Bill 574, prohibits transitional surgeries and restricts puberty blockers and hormones for minors. In Nebraska, any individual under 19 is considered a minor.
The bill bans transitional surgeries, but leaves the specifics of restrictions for puberty blockers and hormones to the Nebraska Department of Health and Human Services. On Sunday, the DHHS issued 90-day emergency regulations for the bill. The emergency regulations were drafted by the state chief medical officer, Dr. Timothy Tesmer. The final regulations from the DHHS must be released 30 days before a public hearing, currently expected on Nov. 28. Currently, minors can continue treatment that they were receiving before the law was enacted.
The new regulations provide definitions for gender dysphoria and gender nonconformity, set guidelines for informed patient consent, and give requirements for continued care. In order to obtain informed patient consent, the physician must address all known side effects, alternative treatments, FDA approval, and discuss appropriateness of care.
Under the new regulations, before receiving prescriptions for puberty-blockers, patients must attend 40 hours of gender-identity-focused contact therapy that is “clinically neutral and not in a gender-affirming or conversion context.” The therapy must also include “sufficient parental or legal guardian support during and post treatment.'' There is a limit of 2 hours a week of therapy after an initial 4-hour assessment. This creates a minimum of five months of therapy which corresponds to the six months where patients must live as their preferred gender.
Governor Jim Pillen approved the emergency measures and praised the DHHS for completing the emergency regulations by the law’s effective dates. He stated,“These regulations provide the guidance necessary to ensure that Nebraska kids are protected from medical treatments and surgeries that could result in irreparable harm.”
The temporary regulations have been met with mixed reactions. Dr. Alex Dworak of OneWorld Community Health Centers in Omaha was surprised and pleased that the guidelines largely follow current standards of care. He praised Tesmer for looking out for the best interest of patients and not bowing to political pressure. Other groups worry about the requirement for therapy “not in a gender affirming context,” arguing that the guidelines are supporting “Gender Exploratory Therapy” which discourages gender affirmation and has been accused of being conversion therapy under another name.
State Senators Megan Hunt and Macheaela Cavanah have requested more information from the DHHS. Hunt stated that her office was contacted by families with reports of pharmacists refusing to provide gender-affirming medications because of the “Let Them Grow Act.” She has requested that Tesmer inform Nebraska health care professionals, including pharmacists, that the law does not prohibit ongoing treatment.
By Aubrey Benton