Isabella Manhart of Omaha, who is nonbinary, testifies on the state’s proposed gender care regulations Tuesday, Nov. 28, 2023, in Lincoln. (Zach Wendling/Nebraska Examiner)
LINCOLN — Nebraskans weighed in Tuesday on the state’s proposed gender care regulations, with testifiers seeking fewer regulations outnumbered those supporting a full ban on such care, 25 to one.
By 2 p.m. — seven hours into the Nebraska Department of Health and Human Services’ 12-hour hearing — the first supporter of stricter regulations spoke, following testimony from 49 others who included health care providers, clergy, transgender youths and parents.
The regulations, required under Legislative Bill 574 approved by the Legislature last spring, address puberty blockers and cross-sex hormones. LB 574, when it took effect Oct. 1, also prohibited transition surgeries.
These guidelines set a new baseline for youths seeking care, including 40 hours of gender-identity-focused therapy and a seven-day waiting period between informed patient consent and the dispersal of medications.
With the state’s current shortage of mental health providers, a requirement that youths cannot bank more than two hours of therapy in a week, combined with other financial or travel barriers, multiple testifiers said the regulations — as written — could act as a de facto ban for youths or prevent care for at least five to 10 months (with therapy once or twice a week) and possibly for several years.
“Would you want to be told that you could not get a life-saving medication because you had not had enough therapeutic sessions to meet the government’s requirements?” Jill Dibbern Manhart, an Omaha mother, testified. One of her children is trans.
‘Impugns the expertise’ of providers
LaDonna Hart and Amy Arndt, nurse practitioners who co-own Hart & Arndt Family Health in Lincoln, testified that a requirement that youths receive hormone injections in the doctor’s office differs from all other types of care.
“Parents and guardians are partners in health care,” Arndt testified, noting they can be trained to give the medications at home, similar to Type 1 diabetes.
Dr. Alex Dworak, a physician with OneWorld Community Health Centers, said no medical literature, including the World Professional Association for Transgender Health, includes a minimum requirement for therapy.
“It impugns the expertise of Nebraska mental health professionals and the commitment of loving parents of trans youth,” Dworak said.
Leslie Dvorak, a nurse practitioner from Omaha, said her most memorable patients have been trans youths and their families and said she was often told by parents, “thank you for giving me back my child.”
Dana Maaske, whose teenage child is trans, testified in tears about the toll LB 574 and regulations have had on her and the experiences she had with state lawmakers this year.
“I hope all the supporters of this bill will be remembered in history as the terrorizers of trans children and their families that they truly are,” Maaske said.
Minimum regulations requirement
LB 574 sets the following base level for regulations, with no additional guidance:
- A minimum number of gender-identity-focused therapy hours.
- A waiting period between consent and the administration, prescription and delivery of blockers or hormones.
- Steps to obtain informed patient consent and to document patient medical records.
Dr. Timothy Tesmer, the state’s chief medical officer, wrote the guidelines and will finalize the regulations if any changes are needed. Substantive changes would require another hearing.
Tesmer did not attend Tuesday’s hearing. Jeff Powell, a DHHS spokesperson, said Tesmer had a previously scheduled surgery and said that all comments, written or spoken, will be “equally reviewed.”
The state’s temporary regulations will expire in December and could be extended once more, for a 90-day period, at which time DHHS anticipates final regulations to be approved by Attorney General Mike Hilgers and Gov. Jim Pillen.
Powell said Wednesday that DHHS received 475 total comments on the related LB 574 regulations. This is inclusive of the 77 oral testifiers, some of whom also submitted written comments.
Three speak in favor of a full ban
In total, 77 people had testified, according to a count by the Examiner. Three advocated for a full ban, more in line with how LB 574 was initially introduced in January.
Marilyn Asher of Omaha, a former state prison staff member and president of Nebraskans for Founders Values, equated the regulations to the story of a young prison inmate who had a lot of potential but had the numbers “1” and “8” tattooed on his face to show solidarity with his gang.
“The change will be much more than cosmetic,” Asher said of puberty blockers, hormones or surgeries.
Also in support of a full ban was Sherry Jones of Grand Island, a member of the State Board of Education and a retired teacher of 35 years.
In her experience, Jones testified, youths need counseling, not gender care, and said that if they were given therapy, they would not pursue a gender treatments as adults. Medical professionals have testified this is not the case and have said youths know who they are. No medical providers testified in favor of the regulations.
Asher and Jones told the Nebraska Examiner that the medical care in question requires an adult decision and said that while they may not agree with the care, people would be free to seek it after the age of 19.
‘Our message remains simple’
Those youths who testified Tuesday said they know who they are.
Levi White said they grew up feeling like a “two-hearted creature” trying to blend in before they found the word “transgender” to describe their feelings.
Aiden Whalen, a senior and student body president of Omaha Central High School, who is trans, testified with a request to those in favor of the regulations: “I want you to look me in the eyes, deep in my soul, and tell me why you are threatened by my joy.”
“I want you to look into the eyes of 13-year-old me, curled up in his bedroom corner with a stomach full of pills because you wanted death to take him from from a state that did not, does not want him,” Whalen testified.
“And I want you to tell him that the bill is ‘Let Them Grow’ — growing roots into the ground from inside a coffin … growing used to the lack of respect of basic human decency because your transgender identity means that while you are the child they claim to protect, claim to help grow, you are nothing more than a monster,” Whalen continued.
Charlie Yale, also a senior at Omaha Central, shared a letter signed earlier this year by more than 400 K-12 and college students, health care providers and parents. According to a list of names provided to the Examiner, signatories ranged from 13- to 76-year-olds.
The letter cites walkouts by hundreds of students in March and April in support of trans youths and calls for Gov. Jim Pillen to listen to trans voices when they say legislation will harm them.
“Our message was simple then, and our message remains simple now: transgender youth deserve respect and dignity,” the letter states.
Nebraska Examiner Senior Reporter Paul Hammel contributed to this report.Tuesd
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