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'Happily surprised': Gender care practitioner reacts to rules for Nebraskans 18 and under

The 'Let Them Grow' Act essentially left blanks in how minor gender care would be restricted, but Gov. Jim Pillen approved temporary rules Sunday.
Posted at 6:59 PM, Oct 02, 2023

OMAHA, Neb. (KMTV) — This spring, despite a weeks-long filibuster, the Nebraska Legislature pushed through a law that restricts gender-affirming care for minors 18 and under.

The law bans gender-affirming surgery, but how it would impact nonsurgical care, including puberty blockers and hormones, was left unclear. The bill essentially left blanks for Nebraska's Chief Medical Officer, Timothy Tesmer, to fill through Nebraska's process for creating rules and regulations.

Temporary "emergency" regulations were approved by Gov. Jim Pillen on Sunday, the day the bill went into effect.

The temporary regulations for Nebraska minors are here, but highlights include:

  • A patient must receive 40 hours of gender-identity focused therapy before being prescribed puberty blockers or sex hormones.
  • A patient must live primarily as their preferred gender for at least six months before being prescribed blockers or hormones.
  • There's a seven day waiting period after patient consent before a practitioner can prescribe blockers or hormones.
  • Before blockers or hormones, patient's parents or guardians must sign a consent form that includes side effect information and alternatives.

Public comment will be taken at a hearing that's "anticipated" for Nov. 28 from 7 a.m. to 7 p.m. at the Lancaster Council Event Center in Lincoln. Thirty days before then, a draft of the proposed final regulations will be released. Written comments will be taken, too, beginning 30 days before the hearing.

Leslie Dvorak, owner of and practitioner at Pride Health Clinic in Omaha, said the rules are "a little more stringent" than the World Professional Association for Transgender Health's guidelines.

"I'm so glad it's not a hard 'no, you have to wait until you're 19,'" she said.

She said she was "happily surprised ... that Dr. Tesmer was able to put politics aside and think 'okay, what do I feel as a physician is the best thing to do.'"

She added she was glad there wasn't a delay after the law went into effect that there weren't emergency regulations.

But Dvorak has some concerns, though. She wants to ensure the therapy will be accessible to those who can't afford it. She says there's a shortage in therapists.

She also wonders about a requirement of the therapy to be "clinically neutral and not in a gender-affirming or conversion context." She's not sure what that means or if it would impact therapy from a clinic like hers.

3 News Now asked the Nebraska Department of Health and Human Services about that requirement. A spokesperson said: "This section was put in place to ensure a minor is evaluated properly. It is important that mental health professionals are objective and neutral during therapeutic sessions to determine the best possible care for the minor."

The spokesperson has not yet responded to an inquiry on whether it means therapists focusing or specializing in gender care would qualify for the requirement.

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