Nebraska Gov. Pillen signed LB574, restricting gender-affirming care for minors under 19

On May 22, 2023, Nebraska Governor Jim Pillen signed LB574 into law at the State Capitol in Lincoln, enacting restrictions on gender-affirming medical care for transgender minors. The bill's "Let Them Grow Act" bars anyone under 19 from receiving gender-altering surgery and directs the state's chief medical officer — a gubernatorial political appointee — to set the terms under which minors may access puberty blockers and cross-sex hormone therapy, with the care restrictions taking effect October 1, 2023. Absent regulations, the statute would have imposed a full ban on such treatments for minors.

The Nebraska Legislature passed the measure 33-15 on May 19, 2023, after a contentious floor fight in which conservative senators ended a filibuster to secure final passage. LB574 was a single enrolled bill that combined the Let Them Grow Act with a separate "Preborn Child Protection Act" imposing a 12-week abortion ban, which took effect immediately under an emergency clause. The gender-affirming-care provisions treat transgender adolescents differently from their peers, restricting access to medical treatments — surgery, puberty blockers, and hormones — on the basis of a protected characteristic.

Updates

2023-05-30 — ACLU and Planned Parenthood sued to overturn LB574 [5, 6]

On May 30, 2023, the ACLU of Nebraska and Planned Parenthood of the Heartland filed suit in Lancaster County District Court, arguing that combining the abortion ban and the transgender-care restrictions in one bill violated the Nebraska Constitution's single-subject requirement.

2023-10-01 — Gender-care restrictions took effect with emergency regulations [1, 7]

On October 1, 2023, the gender-affirming-care provisions took effect. Governor Pillen approved emergency regulations drafted by state chief medical officer Dr. Timothy Tesmer that permit puberty blockers and hormones for minors only under conditions including a minimum number of therapeutic hours, informed-consent requirements, and a waiting period.

2024-07-26 — Nebraska Supreme Court upheld the law [8, 9]

On July 26, 2024, the Nebraska Supreme Court, in a split decision, rejected the single-subject challenge and upheld LB574, leaving the abortion ban and transgender-care restrictions in effect.