In the most recent Nebraska legislative session, two controversial bills introduced by state senator Kathleen Kauth would place regulations on gender-affirming care, sports, and bathrooms in an attempt to protect children’s privacy and bodies. Opponents of the bills have raised concerns about their impacts on transgender youth, who already face discrimination and mental health struggles.

LB 574, known as the “Let Them Grow Act,” prohibits gender-affirming care for anyone under age 19 and was signed into law in May. TheNebraska Chief Medical Officer provided temporary regulations for the Let Them Grow Act. These regulations will be in place until December 30, 2023.

“LB 574 has the explicit goal of denying trans youth access to life-saving gender care that is based on individual needs and medical expertise,” Grant Friedman, legal fellow of the American Civil Liberties Union of Nebraska, said in a story by the Omaha World-Herald.

The regulations do not yet ban gender-affirming care. However, they require transgender youth to live at least six months in their preferred gender, attend at least 40 hours of therapy, and wait seven days after a prescription before receiving gender-affirming care. Supporters of the regulations say they allow transgender youth to fully consider the effects of such care. Minors using puberty blockers or hormones for reasons other than gender-affirming care will not have to follow the regulations, according to the Omaha World-Herald.

“My bill has encouraged kids to get the mental health care, that support they need,” Kauth said. “And the goal is to let them grow in their bodies until they have brain functions that can support this decision… these are experimental and irreversible drugs.”

At a hearing for the Let Them Grow Act on Nov. 27, a majority of public speakers opposed the bill. According to the Omaha World-Herald, many physicians raised concerns about the regulations. For young people from low-income families or rural areas, it may be difficult to access therapy. Opponents also targeted a regulation requiring some hormone therapy to be administered at a doctor’s office, saying that this would create a difficult time commitment for some families. They have also argued that the regulations’ language is unclear and biased.

“I firmly believe these anti-trans measures are government overreach. I believe all young people in Nebraska should have an opportunity to receive medical care as they need it in consultation with their parents and healthcare providers,” state senator Danielle Conrad said in a statement. Sens. Hunt, Cavanaugh, and Fredrickson, who opposed the bill, did not respond to Tom Tom requests for comment.

The Let Them Grow Act defines gender-affirming care as medical treatment that would change an individual’s characteristics to resemble a gender identity different from their biological sex. Puberty blockers and hormone therapy, the most common treatments for transgender youth, are at least partially reversible, according to the American Academy of Pediatrics (AAP). Gender-affirming surgery is not reversible.

“Gender affirmation among adolescents with gender dysphoria often reduces the emphasis on gender in their lives, allowing them to attend to other developmental tasks, such as academic success, relationship building, and future-oriented planning,” the AAP said in a 2018 study.

The other bill regarding transgender youth, known as the “Sports and Spaces Act,” would require students to use bathrooms and locker rooms and participate in sports aligned with their biological sex, rather than their gender identity. The Sports and Spaces Act did not pass but may be considered in the 2024 legislature.

“This bill doesn’t say that kids who are dealing with gender dysphoria cannot play sports. It’s saying that they need to play sports on the appropriate biological team,” Kauth said. “Because there are significant differences in biology as far as athletic ability… those differences lead to leaner body muscle mass, longer limbs, more ability to jump, to run. It provides significant differences in biology and for competitiveness… it’s just not fair.”

A study published by the American College of Sports Medicine found that “adult males are faster, stronger, more powerful than females because of fundamental sex differences in anatomy and physiology.” Biological males, after puberty, have greater muscle mass, lower body fat, larger hearts, and larger lung capacity. Also, males are typically taller and have longer limbs, characteristics that lend themselves to greater athletic ability.

“In some part, I could understand banning from sports cause testosterone and estrogen are two completely [different] things. And let’s say… there was a male that was transitioning to a woman, and they wanted to be on the women’s team, but they weren’t transitioned fully, I could understand why that would be a problem,” sophomore Devonte Heenan, who identifies as a transgender male, said. “But when it comes to a trans male trying to get put on the male’s team, I just don’t understand why they want to not allow that. Like if they want to compete on the men’s team, then they should compete on the men’s team.”

If the bill were to pass, it would overrule the Nebraska School Activities Association (NSAA)’s pre- existing transgender athlete policy. The NSAA requires transgender student-athletes to apply to compete on a sports team consistent with their gender identity. The application re-quires confirmation of a student’s gender identity from parents/guardians and a doctor, as well as medical documentation of gender-affirming care.

“I did track in eighth grade and they did talk to me about that, and they just said that I could just join the men’s if I wanted to. I didn’t know that was really an option,” Heenan said.

The application also requires male-to-female transgender athletes to complete a minimum of one year of gender-affirming care and show that they do not “possess physical or physiological advantages over genetic females of the same age group.” The NSAA has received seven applications since 2016.

“All [transgender students] want to do is fit in. It’s tough enough as it is. Please don’t support a bill that would take away a part of their high school experience and make it that much harder to fit in,” said Louis Rens, who has a transgender daughter, at a hearing in February.

The Sports and Spaces Act would also regulate that students use bathrooms and locker rooms consistent with their biological sex, not their gender identity. Supporters of the bill argue that it would protect the privacy of young people.

“I feel uncomfortable sometimes, like when we have to use locker rooms, and when you have to change,” Heenan said. “I mostly just use the men’s when changing– the men’s bathroom, not the locker room. Changing in the men’s locker room would not make me very comfortable, but the bathroom works because it’s private, there’s a stall.”

If students feel uncomfortable with a transgender student sharing a private area, the Bellevue Public Schools “Transgender Students” board policy offers solutions, such as the use of a private area in the locker room, a separate changing schedule, or the use of a nearby private area. However, Kauth said she believes that it is necessary to separate bathrooms and locker rooms based on biological sex to make students feel completely comfortable.

“When you have a locker room that is designed for either boys or girls, the expectation of privacy remains,” Kauth said. “And if you have someone who does not share that same biological sex, it can be very upsetting and stressful… so getting the guidelines and rules to say this is an all-female space, or this is an all- male space, it provides that peace of mind for people in the locker room.”

With transgender-related legislation on the rise around the country, discussion of transgender youth’s mental health has come to light. According to the Trevor Project, over half of nonbinary and transgender youth considered suicide in 2022. Opponents of the Let Them Grow and Sports and Spaces Acts say that these bills would increase the mental health struggles of transgender youth.

“I also believe all young people should have an opportunity to participate in extracurricular activities which are positive for physical, mental, social, and emotional development,” Conrad said. “We should all be working together to create a culture of belonging for all Nebraskans to acknowledge our shared humanity.”

Public comment for the Sports and Spaces Act can be submitted online at nebraskalegislature.gov.