Nebraska lawmaker introduces less restrictive amendment on abortion-gender care proposal

New amendment would offer immediate guidance on gender-affirming medications, ban abortion at 12 weeks post-fertilization

By: - May 18, 2023 7:00 pm

State Sen. Lynne Walz of Fremont previously indicated support for Riepe’s 12-week amendment but expressed concerns that the Hansen proposal excludes a fatal fetal anomalies exception. She also has concerns about what guidance the chief medical officer and DHHS would impose on gender-affirming care, preferring a list she crafted with State Sens. John Cavanaugh and John Fredrickson. (Zach Wendling/Nebraska News Service)

LINCOLN — An expected final vote Friday on the Nebraska Legislature’s efforts to further restrict abortions and limit gender-affirming care for minors may not be the last after a new amendment was filed Thursday. 

However, key senators said they would not support the changes proposed.

Supporters of trans rights hosted a small rally outside the Nebraska State Capitol on Tuesday, May 16, 2023, in Lincoln, Neb. (Zach Wendling/Nebraska Examiner)

State Sen. Lynne Walz of Fremont filed an amendment to Legislative Bill 574, the now-combined abortion-gender care proposal. LB 574 is one vote away from passage after Tuesday’s vote to combine and amend the respective measures.

The Walz amendment includes three key changes from the newly amended bill, which mirror an amendment from State Sen. Merv Riepe of Ralston on abortion:

  • Changing a 12-week abortion ban from gestational age to 12 weeks post-fertilization. This would allow abortions 12 weeks after fertilization rather than 12 weeks after a woman’s last period.
  • Adding a “fetal anomaly incompatible with life” exception for abortions. These are anomalies that “with reasonable certainty” would result in the death of a fetus within three months.
  • Specifying rules and regulations that youths must meet before receiving puberty blockers, hormone therapies or non-genital surgeries. Genital surgeries, which are not performed in Nebraska, would be prohibited.

Walz said she believes there need to be safeguards in place for gender-affirming care to support those youths. 

“I feel that it’s more important that we keep the care of our kids here in Nebraska,” she said. “If we don’t come up with some type of guidelines and allow the care after the requirements are met, the kids are just going to go ahead and cross state lines.”

LB 574 would gain Walz as a 34th vote if her amendment is adopted, though it’s unclear if doing so would lose any supporters.

Chief medical officer

Under the amended LB 574, the chief medical officer (Dr. Timothy Tesmer) would be authorized to outline the rules and regulations for blockers and hormones.

Tesmer, an ear, nose and throat doctor from Lincoln, was chair of the State Board of Health when it issued a statement in support of LB 574 in March. That version would have prohibited all surgeries as well as medications.

Supporters and opponents note that delegating the authority could lead to a full ban, though some, including Walz, hope the outlined regulations in her amendment could be a guide for Tesmer.

Those who have received the gender-affirming medications prior to Oct. 1, when that part of the bill goes into effect, could continue (though there are concerns about whether those patients could move to the next stage of treatment after Oct. 1).

Without the Walz amendment, there would be a full ban on new medications until new rules and regulations are in place.

Behavioral or mental health care would not be restricted.

Supporters have said LB 574 would protect kids. Walz said that without her proposed changes, that won’t happen.

“If we really want to protect kids, let’s keep the children here in Nebraska,” Walz said.

‘We’re done’

Walz’s amendment — filed one day before lawmakers are slated to approve LB 574 — appears defeated before it begins. It would need at least 25 supporters.

State Sen. Kathleen Kauth and others await the final vote on LB 574 on Tuesday, May 16, 2023, in Lincoln, Neb. (Zach Wendling/Nebraska Examiner)

State Sen. Kathleen Kauth of Omaha, LB 574’s introducer, said supporters of the current bill have already come a long way to where they are now.

“We’re done,” Kauth said, predicting that Friday’s vote would be the final vote.

State Sen. Ben Hansen of Blair, who introduced the amendment combining the abortion ban with restrictions on gender care for minors, said he appreciates Walz for her work but said it’s unlikely to garner the votes to pass.

“I’m not going to say it’s too little too late, but nobody’s going to want to go back to Select File [to adopt the amendment],” Hansen said. “The 33 people who voted for this bill are very comfortable with where they’re at, and I don’t get any indication that anyone’s looking for anything different.”

Thirty national and international organizations endorse gender-affirming care, but Kauth said the legislation is necessary because the care amounts to an “adult” decision that carries some permanent effects.

State Sen. Ben Hansen of Blair speaks on the floor of the Nebraska Legislature on Wednesday, March 22, 2023, in Lincoln, Neb. (Zach Wendling/Nebraska Examiner)

Kauth, Hansen and Walz used “listening sessions” between the second and third rounds of LB 574 debate to find a path forward, which led to some language in the respective amendments.

The other five senators who participated in those sessions were State Sens. John Arch of La Vista, Teresa Ibach of Sumner, John Cavanaugh of Omaha, John Fredrickson of Omaha and Tom Briese of Albion.

But Hansen said that his “compromise” is sufficient and that senators “compromised even more than we needed to, or even what some in support wanted to.”

“I think sometimes when you have two sides that are conflicting, they both kind of feel like they should have half the apple,” he said. “But when you have a majority on one side and a minority on the other, we both don’t get half.”

Mounting legal challenges

Cavanaugh also introduced an amendment to add the rules and regulations Walz did. The pair and Fredrickson led those efforts in the listening sessions.

State Sen. John Cavanaugh of Omaha speaks on the legislative floor on Tuesday, May 16, 2023, in Lincoln, Neb. (Zach Wendling/Nebraska Examiner)

Cavanaugh’s amendment will be up first Friday, and while he did not say whether he would pull his amendment to get to Walz’s amendment, he said it is a “lot more reasonable than the bill is currently written.”

“It’s more thoughtful and it integrates all of the lessons we learned or the ideas we took from the listening sessions,” he said.

LB 574 is expected to face significant legal challenges, not to mention questions over whether it abides by the Nebraska Constitution’s “single subject” requirement.

Cavanaugh said Walz’s change may fare better, legally speaking, with regard to surgeries, because of the Fourteenth Amendment’s prohibition of discrimination on the basis of sex.

He has not decided whether he will support Walz’s amendment.

Kauth said that while a gender-affirming care ban remains blocked in Arkansas and is moving through the courts, conversations with an Arkansas representative suggest the challenge could be defeated soon.

Kauth said she has support from Attorney General Mike Hilgers on the bill, too.

“He’s very confident that there’s not going to be a problem,” she said. “They’re ready for a fight if they need to, but he believes that this is a sound statute.”

Hilgers’ staff said they couldn’t comment on private conversations the attorney general may have had.

Final-round debate on LB 574 is scheduled for 2 p.m. Friday. Debate is allotted for up to two hours but could be extended based on procedural challenges. The bill could also come up earlier in the day and will follow a similar roadmap as Tuesday.

Proposed rules and regulations

The amendments offered by State Sens. John Cavanaugh and Lynne Walz include the following seven criteria before puberty blockers, hormones or gender-affirming top surgeries are allowed.

  1. The youth’s parent or guardian has provided voluntary and informed written consent.
  2. The patient demonstrates the “emotional and cognitive maturity” to provide informed consent.
  3. The patient meets diagnostic criteria of gender incongruence, which is “marked and sustained over time.”
  4. The patient has written documentation recommending treatment from at least two licensed mental health professionals, psychologists or psychiatrists who are not part of the same clinic.
  5. The patient has been informed of any reproductive effects and potential side effects or consequences of the treatments.
  6. The patient has reached a specific stage of puberty: Tanner stage two.
  7. Additional mental health concerns, if any, that may interfere with diagnostic clarity or the capacity to consent are “addressed sufficiently so that such surgery can be provided optimally.”

An additional eighth criterion requires that patients must have received care for at least 12 months before they could receive top surgery.



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Zach Wendling
Zach Wendling

Zach Wendling is a senior at the University of Nebraska-Lincoln, double-majoring in journalism and political science. He has interned for The Hill and The News Station in Washington, D.C., and has reported for the Nebraska News Service and The Daily Nebraskan.