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Nebraska Supreme Court upholds law restricting both medical care for transgender youth and abortion

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OMAHA, Neb. (AP) — A Nebraska law that combined abortion restrictions with 
another measure to limit gender-affirming health care for minors does not 
violate a state constitutional amendment requiring bills to stick to a 
single subject, a majority of the Nebraska Supreme Court ruled Friday.

The state’s high court acknowledged in its ruling that abortion and 
gender-affirming care “are distinct types of medical care,” but found the 
law does not violate Nebraska’s single-subject rule because both abortion 
and transgender health fall under the subject of medical care.

The majority relied, in part, on a passage from an 1895 ruling to find the 
state constitution offers wide latitude on what composes a single subject.

“Ultimately, ‘if a bill has but one general object, no matter how broad 
that object may be, and contains no matter not germane thereto, and the 
title fairly expresses the subject of the bill, it does not violate’” the 
state constitution’s single-subject rule, Chief Justice Mike Heavican 
wrote for the court.

The ruling came in a lawsuit brought by the American Civil Liberties Union 
representing Planned Parenthood of the Heartland challenging the law that 
has restricted abortion to 12 weeks of pregnancy, banned gender-confirming 
surgery and restricted the use of hormone treatments in transgender minors 
since 2023. The high court rejected arguments by ACLU attorneys which 
argued the hybrid law passed last year violates Nebraska’s single subject 
rule.

Republican lawmakers in the officially nonpartisan Nebraska Legislature 
had originally proposed separate bills: An abortion ban at about six weeks 
of pregnancy and a bill restricting gender-affirming treatment for minors. 
The GOP-dominated Legislature added a 12-week abortion ban to the existing 
gender-affirming care bill only after the six-week ban failed to defeat a 
filibuster.

The combination law was the Nebraska Legislature’s most controversial in 
the 2023 session, and its gender-affirming care restrictions triggered an 
epic filibuster in which a handful of lawmakers sought to block every bill 
for the duration of that session — even ones they supported — in an effort 
to stymie it.

A district judge dismissed the lawsuit last August, and the ACLU appealed.

In arguments before the high court in March, an attorney for the state 
insisted the combined abortion- and transgender-care measures did not 
violate the state’s single subject rule, because both fall under the 
subject of health care.

But an attorney for Planned Parenthood argued that the Legislature 
recognized abortion and transgender care as separate subjects by 
introducing them as separate bills at the beginning of last year’s 
session.

“It pushed them together only when it was constrained to do so,” ACLU 
attorney Matt Segal argued.

A scathing dissent by Justice Lindsey Miller-Lerman accused the majority 
of applying different standards to bills passed by the Legislature and 
those sought by voter referendum. She pointed to the high court’s ruling 
in 2020 that blocked a ballot initiative seeking to legalize medical 
marijuana after finding that its provisions to allow people to use 
marijuana and to produce it were separate subjects that violated the 
state’s single-subject rule.

Miller-Herman chastised the majority for granting leeway and indulging the 
Legislature “at the expense of the Constitution.”

“It was the duty of the Legislature ... to compose legislation, including 
titling, which stated ‘one subject’; failure to so compose renders the 
bill unconstitutional,” Miller-Lerman wrote. “It is not the role of this 
court to rescue legislative bills.”

Opponents decried the ruling, with the ACLU Nebraska Executive Director 
Mindy Rush Chipman vowing the ruling “will not be the final word on 
abortion access and the rights of trans youth and their families in 
Nebraska.”

Ruth Richardson, president and CEO of Planned Parenthood North Central 
States, called the ruling “heart-wrenching and infuriating” and said 
Planned Parenthood would continue providing abortions in Nebraska up to 12 
weeks of pregnancy.

“This ban has already devastated Nebraskans’ lives and will undoubtedly 
widen dangerous health inequities for people in rural areas, people of 
color, people with low incomes and young people,” she said.

Nebraska Gov. Jim Pillen and the state’s attorney general, both 
Republicans, lauded the ruling. Pillen noted in a statement that he had 
worked with lawmakers to fold the 12-week abortion ban into the bill 
restricting gender-affirming care for minors.

“We worked overtime to bring that bill to my desk, and I give thanks to 
God that I had the privilege to sign it into law,” Pillen said.

Most Republican-controlled states have implemented abortion bans of some 
sort since the U.S. Supreme Court overturned Roe v. Wade and ended the 
nationwide right to abortion in 2022.

Fourteen states currently have bans on abortion at all stages of 
pregnancy, with some exceptions; three ban it after about six weeks’ 
gestational age, before many women know they are pregnant, with a fourth 
such restriction, in Iowa, expected to take effect next week. Nebraska and 
North Carolina are the only states that have moved to bans that kick in 
after 12 weeks of pregnancy.

Most GOP-controlled states in the last few years have also moved to bar 
gender-affirming care for transgender minors. Twenty-two states are 
currently enforcing such restrictions.

Several Democratic-controlled states have adopted policies in the last two 
years to ensure access to both abortion and gender-affirming care, 
including by trying to block investigations of healthcare providers in 
their states from authorities in places with bans.

Voters could have the final say on abortion access in Nebraska. Two 
competing questions on the subject are likely to appear on the November 
ballot: One would add a right to abortion to the state constitution. The 
other would enshrine in the state constitution Nebraska’s current 12-week 
ban.

https://apnews.com/article/transgender-health-abortion-nebraska-supreme-
court-62a1022df835adc6697f5c96b8a35c16

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