Nevada Gov. Joe Lombardo has signed two bills expanding the ability of transgender adults to access gender-affirming health care.
The move is contrary to the positions being taken by most Republican elected officials.
Earlier this week, Lombardo signed a bill requiring health insurance providers, including Medicaid, to cover all gender-affirming surgeries designated as medically necessary by a person’s physician. A nearly identical law was recently signed into effect in Oregon by Democratic Gov. Tina Kotek last month.
Lombardo also signed a second bill requiring the state’s Department of Corrections to adopt evidence-based, up-to-date mental and medical health standards for transgender and gender-nonconforming people inside the state’s prisons. That bill also requires guards at state penitentiaries to undergo LGBTQ cultural competency training.
Both bills were passed on party-line votes in both chambers, with Democrats supporting the measures and Republicans opposed.
Lombardo’s decision to sign the bill into law comes as Democratic-controlled legislatures, like Nevada’s, have passed bills to protect transgender health care and civil rights, while Republican-led legislatures — aided by Republican governors — have sought to curtail those rights.
But Lombardo also occupies a rare status as one of only two Republican governors — the other being Vermont’s Phil Scott — to lead a state where Democrats control both chambers of the legislature. As such, Lombardo has to moderate his stances on “culture war” issues.
“Nevada has for a very long time been a live-and-let-live type of state,” Brooke Maylath, a transgender rights advocate who worked with legislators to craft the pro-transgender health care bills, told the Associated Press. “And I’m glad to see that this governor has not been hijacked by the divisiveness that we’ve see in other states.”
But Maylath criticized Lombardo for vetoing a bill earlier this month that would have protected medical professionals who provide gender-affirming treatments from losing their medical license.
The bill would also have prohibited executive branch agencies from assisting with investigations into medical staff or parents who enable minors to access gender-affirming care in states where the practice has been outlawed.
In his veto message, Lombardo said the bill would hinder his office’s ability to “be certain that all gender-affirming care related to minors comports with State law” and to ensure that providers are abiding by public health and safety standards.
Despite rejecting the bill dealing with bans on gender-affirming care for minors, Lombardo was still criticized by his fellow Republicans for signing the measures applying to transgender adults.
He angered his party members earlier this month when he signed another bill into law to ensure commissions overseeing medical licensing do not discipline or disqualify doctors who provide abortions.
Nevada’s Republican National Committeewoman, Sigal Chattah, criticized Lombardo’s support of gender-affirming care for adults, calling the governor a “laughingstock across the nation” in a tweet.
When asked by a reporter about his decision, Lombardo defended his actions, arguing that the bill simply codifies into law what is already a common policy among insurers with respect to providing coverage for transition-related health care.
“I implore people to read the bill in its entirety,” Lombardo said. “And you will see it’s not as draconian or detrimental or immoral as people are portraying it to be. It’s for the benefit of the whole, versus the few.”
The bill also complies with Nevada’s existing policy prohibiting the denial of medically necessary care based on a patient’s gender identity, as well as the state’s law prohibiting discrimination based on gender identity.
Most importantly, the measure ensures that transgender people can receive the same type of insurance coverage as their cisgender counterparts. For example, without the bill, a mastectomy for a cisgender female cancer patient might be covered, but a transition-related procedure for a transgender man might have been deemed “cosmetic” and thus ineligible for coverage — even if both procedures were deemed “medically necessary” by the respective patients’ doctors.
In new guidance posted to its website, the U.S. Department of Health and Human Services announced that healthcare workers, clinic staff, and third parties could file complaints against medical providers thought to be providing people under age 19 with hormones, puberty blockers, and gender-affirming surgical procedures.
LGBTQ advocates are deriding the online portal as a "snitch line."
The guidance is intended to align with an executive order signed by President Donald Trump prohibiting the provision of gender-affirming care to people under the age of 19 and barring federal funds from being spent on medical treatments meant to assist a person of any age in transitioning genders.
U.S. Rep. Sarah McBride (D-Del.), the first openly transgender person ever elected to Congress, has reportedly cautioned Democrats about the need to foster conversations when it comes to engaging with those who have reservations about certain issues like transgender participation in sports.
"We have to create more space in our tent," McBride told NOTUS about how Democrats should approach people with reservations or genuine questions about transgender inclusion. "If, for instance, we want to have a majoritarian coalition -- not just electorally, but specifically on issues around trans rights -- that, by necessity, is going to have to include people who have a range of thoughts.
Colorado Gov. Jared Polis signed a law repealing the state's statutory ban on same-sex marriage, just over five months after Colorado voters repealed the state's constitutional ban on recognizing such unions.
The bill, sponsored by State Sen. Jessie Danielson (D-Wheat Ridge) and State Reps. Lorena Garcia (D-Adams Co.) and Brianna Titone (D-Arvada), the state's first out elected transgender lawmaker, repealed the statutory ban, which was implemented in 2006, the same year voters approved prohibiting same-sex nuptials.
In a reflection of how Coloradans' attitudes toward same-sex marriage have changed in just under two decades, last November's ballot initiative, Constitutional Amendment J, passed by a nearly two-to-one margin, winning by healthy margins even in some of the state's more rural counties, and racking up large margins in Denver, Fort Collins, and Boulder metropolitan areas.
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