Nebraska Gender-Affirming Care Laws: What Families and Providers Need to Know in 2025
In 2025, gender-affirming care laws are changing rapidly across the country—and Nebraska is one of the most impacted states. Following the Nebraska Supreme Court’s decision to uphold LB574, families, healthcare providers, and LGBTQ+ advocates are navigating new legal barriers to care for transgender youth. This guide breaks down what LB574 does, what it doesn’t do, how it compares to other states, and what practical steps you can take if you’re affected.
What Is Gender-Affirming Care?
Gender-affirming care includes medical, psychological, and social services that support a person’s gender identity. These may include:
Puberty blockers
Hormone therapy (testosterone or estrogen)
Mental health counseling
Gender-affirming surgeries (rarely performed on minors)
Medical groups such as the American Academy of Pediatrics and American Medical Association recognize this care as essential for the well-being of transgender youth when clinically appropriate.
What Does Nebraska’s LB574 Actually Do?
In 2023, the Nebraska Legislature passed LB574, and in July 2024, the Nebraska Supreme Court upheld the law, allowing it to take full effect. Here’s what the law currently does:
Bans Gender-Affirming Surgeries for Minors
Surgical procedures to alter a minor’s sex characteristics are prohibited for individuals under 19.
Regulates Puberty Blockers and Hormone Therapy
Requires at least 40 hours of therapeutic counseling focused on gender identity
Enforces a 7-day waiting period after signing an informed consent form
Mandates parental consent and specific documentation
Applies only to minors under 19
Does Not Ban Mental Health Care
Trans youth can still access therapy and counseling without restriction under LB574.
Excludes Medicaid Coverage
Nebraska’s Medicaid program explicitly does not cover gender-affirming care—for any age group.
How Nebraska Compares to Other States
As of August 2025:
27 states have laws restricting gender-affirming care for minors
23 states + Washington, D.C. allow or protect access to this care
Examples:
Nebraska: Restricts surgeries and regulates hormone-related care under LB574; Medicaid coverage excluded
California: Protects access and offers legal protections for trans youth, including those from out-of-state
Tip: Laws change quickly. For up-to-date maps and legal resources, consult ACLU Nebraska, Lambda Legal, or Nebraska Appleseed.
What Should Families and Providers in Nebraska Do?
If you’re impacted by LB574, here are concrete steps to protect yourself and your family:
1. Consult a Lawyer
Work with an attorney who understands Nebraska healthcare law and LGBTQ+ rights. Legal guidance is essential for navigating treatment, documentation, and interstate care questions.
2. Document Everything
Keep records of provider notes, denial letters, counseling hours, and conversations about care. This may be useful if you file complaints or appeals.
3. Stay Updated
LB574 is now in effect, but it could be changed through court decisions or future legislation. Monitor reliable advocacy organizations for updates.
4. Connect with Support Networks
Helpful resources include:
Local: ACLU Nebraska, Nebraska Appleseed
National: Transgender Law Center, Lambda Legal, Human Rights Campaign
What Are the Real-Life Impacts of LB574?
Families in Nebraska have reported:
Delays or interruptions in medical care due to the 40-hour therapy requirement
Difficulties accessing competent providers
Financial burdens from traveling out of state or paying for private services
Emotional stress for both youth and parents navigating restrictions
Stat to Know: As of mid-2025, over 150,000 transgender youth live in states with active gender-affirming care restrictions.
Frequently Asked Questions (FAQ)
Is gender-affirming care legal in Nebraska?
Partially. LB574 bans gender-affirming surgery for anyone under 19 and regulates puberty blockers and hormones. Mental health counseling remains legal.
Can families travel out of state for care?
Yes—but it’s important to understand the laws in both Nebraska and the state you’re traveling to. Some families pursue this option, often called “care tourism,” but legal risks vary. Talk to an attorney first.
Does Nebraska Medicaid cover gender-affirming care?
No. Nebraska’s Medicaid program does not cover gender-affirming care at any age.
Are doctors penalized for violating LB574?
Yes. Providers who don’t comply could face disciplinary action or lose their licenses under Nebraska’s regulatory system.
Can trans youth still access therapy?
Yes. LB574 does not restrict or prohibit mental health counseling, including gender-affirming therapy.
How Our Law Firm Can Help
We represent families, healthcare providers, and organizations impacted by Nebraska’s gender-affirming care laws. Our legal services include:
Helping families understand their rights under LB574
Advising healthcare providers on compliance and risk
Exploring options for out-of-state care
Assisting with legal advocacy, policy navigation, or litigation