Bad medicine for all Nebraskans

May 9, 2023 3:00 am

Debate over a bill banning gender-affirming care has roiled the State Legislature this year, prompting a parade of filibusters. Here, a protester holds a transgender pride flag in front of the Nebraska State Capitol during a demonstration in March (Zach Wendling/Nebraska Examiner)

Legislative Bill 574, introduced by State Sen. Kathleen Kauth, would strip parents’ rights to make certain medical decisions for their children: decisions that should be made with expert medical guidance, tailored for each child according to their individual needs and based on careful assessment of the potential risks and benefits of treatment.

It’s important for Nebraskans to understand that the key issue is not whether one supports or opposes a specific medical treatment. The issue is whether the government has the expertise — and, most importantly, whether the government has the right — to make our medical decisions. Libertarians and conservatives who believe in individual freedom should firmly oppose the Nebraska Legislature’s attempted intrusion into the exam room. Complex medical decisions should be between patients and their doctors. This legislative bill sets a dangerous precedent for the government to interfere with our private health care decisions.

Legislators are not trained to analyze medical literature, to keep up with the latest research and medical best practices or to tailor the options for treatment after careful analysis of risks and benefits to each individual situation and make recommendations. With LB 574, lawmakers are attempting to impose a sweeping ban on an evolving area of medicine, denying parental rights for those minors who may benefit from the appropriate care.

If state legislators are genuinely concerned for kids with gender diverse identities, then they can and should advocate for more funding for research to advance our knowledge, which would allow specialists and parents to provide the best guidance for kids. Again, the issue is not whether one favors or opposes a particular treatment option. The issue is whether the government should mandate health care decisions.

Despite the fact that the Nebraska Medical Association — along with every major medical society in the country, including the American Medical Association, American Academy of Pediatrics, American Psychiatric Association, Endocrine Society and World Professional Association for Transgender Health — opposes LB 574, the legislators pushing the bill point to support from the Nebraska Board of Health.

Nebraskans should know that the 17 members of the Board of Health are political appointees. Most are not even practicing physicians, and none has specific training or expertise in gender care. Worse yet, the board members were pressured to supply Sen. Kauth with unanimous approval. Several opposing members chose to be absent for the vote; only 11 voted in favor. (

Gov. Jim Pillen defends his support for the attempted ban by comparing the risk of appropriate medical care for minors with the risk of drinking alcohol. This is a false equivalent. Parents of children have the right to choose medical care with inherent risks because those are weighed carefully against potential benefits. For example, treating a child with leukemia carries a risk of meningitis, yet the risk of withholding treatment is death. Do Nebraska parents want the governor mandating medical options for their children? For the leader of our state to compare a well-thought-out medical decision with drinking alcohol is insulting to the families who painstakingly consider the best option for their child.

In addition to severely endangering patient freedom, LB 574 would hurt health care for all Nebraskans by driving good doctors out of our state. Those of us involved in training the next generation of physicians know this for a fact. It is not hyperbole or exaggeration. Several doctors are making plans to leave the state if this legislation passes. And that exodus is already happening in states that have passed similar restrictive health care laws. Laws restricting a physician’s ability to provide appropriate, life-saving care force ethical providers to practice elsewhere.

Rural communities are disproportionately impacted by physician shortages and stand to suffer most if future generations of doctors choose to establish their practices out of state. All Nebraskans should be concerned about the negative impact a bill like this has on their own ability to find a qualified health care provider.

Nebraskans need to know their patient freedom is at risk. Your autonomy to make health care decisions will be harmed if LB 574 passes. Do not be fooled by the benevolent sounding label for this bill. It will open the door to egregious government intrusion into complex medical decisions, and it will drive doctors out of our state.

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Kim Coleman
Kim Coleman

Dr. Kim Coleman, a Nebraska native, is a graduate of the University of Nebraska Medical Center and Wake Forest University School of Medicine, specializing in diagnostic and pediatric radiology. Dr. Coleman was awarded the Nebraska Medical Association Physician of the Year in 2017 based on her involvement in the local medical community as well as her long-term commitment to partnering with doctors serving in Haiti. This commentary reflects the sole opinion of the author.