Text of NE LB 732 (2026)

LEGISLATURE OF NEBRASKA ONE HUNDRED NINTH LEGISLATURE SECOND SESSION LEGISLATIVE BILL 732 Introduced by Kauth, 31. Read first time January 07, 2026 Committee: A BILL FOR AN ACT relating to public health and welfare; to amend 1 sections 71-7301, 71-7303, 71-7304, 71-7305, and 71-7307, Revised 2 Statutes Cumulative Supplement, 2024; to change provisions relating 3 to the Let Them Grow Act; to define terms; to prohibit health care 4 practitioners from providing cross-sex hormones and puberty blockers 5 to individuals younger than nineteen years of age as prescribed; to 6 provide powers and duties to the Attorney General; to harmonize 7 provisions; and to repeal the original sections. 8 Be it enacted by the people of the State of Nebraska, 9 LB732 2026 LB732 2026 -1- Section 1. Section 71-7301, Revised Statutes Cumulative Supplement, 1 2024, is amended to read: 2 71-7301 Sections 71-7301 to 71-7307 and section 6 of this act shall 3 be known and may be cited as the Let Them Grow Act. 4 Sec. 2. Section 71-7303, Revised Statutes Cumulative Supplement, 5 2024, is amended to read: 6 71-7303 For purposes of the Let Them Grow Act: 7 (1) Biological sex means the biological indication of male and 8 female in the context of reproductive potential or capacity, such as sex 9 chromosomes, naturally occurring sex hormones, gonads, and nonambiguous 10 internal and external genitalia present at birth, without regard to an 11 individual's psychological, chosen, or subjective experience of gender; 12 (2) Congenital defect means a physical or chemical abnormality 13 present in an individual younger than nineteen years of age that is 14 inconsistent with the normal development of a human being of such 15 individual's biological sex, including abnormalities caused by a 16 medically verifiable disorder of sex development. Congenital defect does 17 not include gender dysphoria, gender identity disorder, or any mental 18 condition; 19 (3) (2) Cross-sex hormones means testosterone or other androgens 20 given to biological females in amounts that are larger or more potent 21 than would normally occur naturally in healthy biological sex females and 22 estrogen given to biological males in amounts that are larger or more 23 potent than would normally occur naturally in healthy biological sex 24 males; 25 (4) (3) Gender means the psychological, behavioral, social, and 26 cultural aspects of being male or female; 27 (5) (4) Gender-altering surgery means any medical or surgical 28 service that seeks to surgically alter or remove healthy physical or 29 anatomical characteristics or features that are typical for the 30 individual's biological sex in order to instill or create physiological 31 LB732 2026 LB732 2026 -2- or anatomical characteristics that resemble a sex different from the 1 individual's biological sex, including without limitation, genital or 2 nongenital gender-altering surgery performed for the purpose of assisting 3 an individual with a gender alteration; 4 (6) (5) Gender alteration means the process in which a person goes 5 from identifying with and living as a gender that corresponds to his or 6 her biological sex to identifying with and living as a gender different 7 from his or her biological sex and may involve social, legal, or physical 8 changes; 9 (7)(a) (6)(a) Gender-altering procedures includes any medical or 10 surgical service, including without limitation physician's services, 11 inpatient and outpatient hospital services, or prescribed drugs related 12 to gender alteration, that seeks to: 13 (i) Alter or remove physical or anatomical characteristics or 14 features that are typical for the individual's biological sex; or 15 (ii) Instill or create physiological or anatomical characteristics 16 that resemble a sex different from the individual's biological sex, 17 including without limitation medical services that provide puberty- 18 blocking drugs, cross-sex hormones, or other mechanisms to promote the 19 development of feminizing or masculinizing features in the opposite 20 biological sex, or genital or nongenital gender-altering surgery 21 performed for the purpose of assisting an individual with a gender 22 alteration; 23 (b) Gender-altering procedures does not include: 24 (i) Services to persons born with a medically verifiable disorder of 25 sex development, including a person with external biological sex 26 characteristics that are irresolvably ambiguous, such as those born with 27 46 XX chromosomes with virilization, 46 XY chromosomes with 28 undervirilization, or having both ovarian and testicular tissue; 29 (ii) Services provided when a health care practitioner has otherwise 30 diagnosed a disorder of sexual development that the health care 31 LB732 2026 LB732 2026 -3- practitioner has determined, through genetic or biochemical testing, that 1 the person does not have normal sex-chromosome structure, sex-steroid 2 production, or sex-steroid hormone action; 3 (iii) The acute and chronic treatment of any infection, injury, 4 disease, or disorder that has been caused by or exacerbated by the 5 performance of a gender-altering procedure, whether or not the gender- 6 altering procedure was performed in accordance with state and federal 7 law; or 8 (iv) Any procedure undertaken because the individual suffers from a 9 physical disorder, physical injury, or physical illness that would, as 10 certified by the health care practitioner, place the individual in 11 imminent danger of death or impairment of major bodily function unless 12 surgery is performed; 13 (8) (7) Genital gender-altering surgery means a medical procedure 14 performed for the purpose of assisting an individual with a gender 15 alteration, including without limitation: 16 (a) Surgical procedures such as penectomy, orchiectomy, 17 vaginoplasty, clitoroplasty, or vulvoplasty for biologically male 18 patients or hysterectomy or ovariectomy for biologically female patients; 19 (b) Reconstruction of the fixed part of the urethra with or without 20 a metoidioplasty; or 21 (c) Phalloplasty, vaginectomy, scrotoplasty, or implantation of 22 erection or testicular prostheses for biologically female patients; 23 (9) (8) Health care practitioner means a person licensed or 24 certified under the Uniform Credentialing Act; 25 (10) (9) Puberty-blocking drugs means gonadotropin-releasing hormone 26 analogues or other synthetic drugs used in biological males to stop 27 luteinizing hormone secretion and therefore testosterone secretion, or 28 synthetic drugs used in biological females which stop the production of 29 estrogens and progesterone, when used to delay or suppress pubertal 30 development in children for the purpose of assisting an individual with a 31 LB732 2026 LB732 2026 -4- gender alteration; and 1 (11) (10) Nongenital gender-altering surgery means medical 2 procedures performed for the purpose of assisting an individual with a 3 gender alteration, including without limitation: 4 (a) Surgical procedures for biologically male patients, such as 5 voice surgery or thyroid cartilage reduction; or 6 (b) Surgical procedures for biologically female patients, such as 7 subcutaneous mastectomy or voice surgery; and . 8 (12) Telehealth has the same meaning as in section 38-120.01. 9 Sec. 3. Section 71-7304, Revised Statutes Cumulative Supplement, 10 2024, is amended to read: 11 71-7304 (1) Except as provided in the Let Them Grow Act and the 12 rules and regulations adopted and promulgated pursuant to the act, a 13 health care practitioner shall not perform gender-altering procedures in 14 this state, including via telehealth to an individual located in this 15 state, for an individual younger than nineteen years of age. 16 (2) The intentional and knowing performance of gender-altering 17 procedures by a health care practitioner for an individual younger than 18 nineteen years of age in violation of subsection (1) of this section 19 shall be considered unprofessional conduct as defined in section 38-179. 20 (3) This section does not apply to the continuation of treatment 21 using puberty-blocking drugs, cross-sex hormones, or both when the course 22 of treatment began before October 1, 2023, and concluded on or before 23 January 1, 2027. 24 (4) This section does not apply to nonsurgical gender-altering 25 procedures when such procedures are provided: 26 (a) Prior to the effective date of this act in compliance with the 27 rules and regulations adopted and promulgated pursuant to subsection (1) 28 of section 71-7305; or . 29 (b) On and after the effective date of this act in compliance with 30 subsection (2) of section 71-7305. 31 LB732 2026 LB732 2026 -5- Sec. 4. Section 71-7305, Revised Statutes Cumulative Supplement, 1 2024, is amended to read: 2 71-7305 (1) Except as provided in subsection (2) of this section, 3 the The chief medical officer as designated in section 81-3115 shall 4 adopt and promulgate such rules and regulations as are necessary to 5 provide for nonsurgical gender-altering procedures for individuals 6 younger than nineteen years of age, such as puberty-blocking drugs, 7 cross-sex hormones, or both. Such rules and regulations shall be 8 consistent with the Let Them Grow Act and, at a minimum, include the 9 following: 10 (a) Specify that a health care practitioner may prescribe approved 11 puberty-blocking drugs, cross-sex hormones, or both to an individual 12 younger than nineteen years of age if such individual has a long-lasting 13 and intense pattern of gender nonconformity or gender dysphoria which 14 began or worsened at the start of puberty; 15 (b) Specific criteria, obligations, or conditions regulating the 16 administration, prescribing, delivery, sale, or use of puberty-blocking 17 drugs, cross-sex hormones, or both involving an individual younger than 18 nineteen years of age in accordance with subdivision (1)(a) of this 19 section, which shall, at a minimum, set forth the following: 20 (i) The minimum number of gender-identity-focused therapeutic hours 21 required prior to an individual receiving puberty-blocking drugs, cross- 22 sex hormones, or both; 23 (ii) Patient advisory requirements necessary for a health care 24 practitioner to obtain informed patient consent; 25 (iii) Patient medical record documentation requirements to ensure 26 compliance with the act; and 27 (iv) A minimum waiting period between the time the health care 28 practitioner obtains informed patient consent and the administration, 29 prescribing, or delivery of puberty-blocking drugs, cross-sex hormones, 30 or both to such patient; and 31 LB732 2026 LB732 2026 -6- (c) Specify that section 71-7304 does not apply to nonsurgical 1 gender-altering procedures when such procedures are provided in 2 compliance with the rules and regulations adopted and promulgated 3 pursuant to this section. 4 (2)(a) Beginning on and after the effective date of this act, a 5 health care practitioner shall not knowingly prescribe for or provide to 6 an individual in this state younger than nineteen years of age cross-sex 7 hormones or puberty-blocking drugs for the purpose of assisting the 8 individual with a gender alteration. 9 (b) A health care practitioner does not violate this subsection if: 10 (i) The cross-sex hormones or puberty-blocking drugs were prescribed 11 for or provided to an individual in this state younger than nineteen 12 years of age to treat the individual's congenital defect, precocious 13 puberty, disease, or physical injury; or 14 (ii) The cross-sex hormones or puberty-blocking drugs were 15 prescribed for or provided to an individual in this state younger than 16 nineteen years of age in compliance with the Let Them Grow Act and the 17 rules and regulations adopted and promulgated pursuant to subsection (1) 18 of this section and such treatment concluded on or before January 1, 19 2027. 20 (c) For purposes of subdivision (2)(b) of this section, disease does 21 not include any gender nonconformity, gender dysphoria, gender identity 22 disorder, or mental condition. 23 (d) The chief medical officer as designated in section 81-3115 shall 24 adopt and promulgate such rules and regulations as necessary to carry out 25 this subsection. 26 (3) (2) The Department of Health and Human Services may adopt and 27 promulgate rules and regulations not inconsistent with the rules and 28 regulations adopted and promulgated by the chief medical officer that are 29 necessary to carry out the Let Them Grow Act. 30 Sec. 5. Section 71-7307, Revised Statutes Cumulative Supplement, 31 LB732 2026 LB732 2026 -7- 2024, is amended to read: 1 71-7307 (1) An individual that received a gender-altering procedure 2 in violation of section 71-7304 after October 1, 2023, and while such 3 individual was younger than nineteen years of age, or the parent or 4 guardian of such an individual, may bring a civil action for appropriate 5 relief against the health care practitioner who performed the gender- 6 altering procedure. Appropriate relief in an action under this section 7 includes actual damages and reasonable attorney's fees. An action under 8 this section shall be brought within two years after discovery of 9 damages. 10 (2) If a court in any civil action brought pursuant to this section 11 finds that a health care practitioner knowingly violated section 71-7304, 12 the court shall notify the Attorney General and the Department of Health 13 and Human Services by mailing a certified copy of the court's order to 14 the Attorney General and the department. Notification pursuant to this 15 subsection shall be made upon the judgment of the court being made final. 16 Sec. 6. (1) The Attorney General may bring an action against a 17 health care practitioner that knowingly violates the Let Them Grow Act, 18 within twenty years of the violation, to (a) enjoin further violations 19 and (b) recover a civil penalty of twenty-five thousand dollars per 20 violation. 21 (2) Each time a health care practitioner performs a gender-altering 22 procedure, including each instance of prescribing or providing cross-sex 23 hormones and puberty-blocking drugs in violation of the Let Them Grow 24 Act, constitutes a separate violation. 25 (3) Any civil penalties collected pursuant to this section shall be 26 remitted to the State Treasurer for distribution in accordance with 27 Article VII, section 5, of the Constitution of Nebraska. 28 Sec. 7. Original sections 71-7301, 71-7303, 71-7304, 71-7305, and 29 71-7307, Revised Statutes Cumulative Supplement, 2024, are repealed. 30 LB732 2026 LB732 2026 -8-