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.
Last week, New Jersey Democratic Gov. Phil Murphy signed a law prohibiting school boards from arbitrarily banning books based on their content, setting into place a process for dealing with potentially controversial works in school libraries.
Under the "Freedom to Read Act," the state Commissioner of Education and State Librarian are tasked with creating "model policies" that will serve as an example of how library materials are curated or removed, and how any challenges will be evaluated.
The law requires local school boards and governing bodies of public libraries to establish their own individual policies -- preferably based on the model policies -- for curating and removing library materials, including a process for determining whether a challenged book may remain in the library's collection.
The Montana Supreme Court upheld a temporary injunction blocking the state from enforcing its ban on gender-affirming care for transgender youth.
The unanimous ruling is historic, marking the first time that a state Supreme Court has found that a ban on gender-affirming care is likely unconstitutional.
On December 11, the court ruled that SB 99, a 2023 law categorically banning all transition-related medical interventions on minors, violates the Montana State Constitution's privacy clause, which prohibits the government from interfering with private medical decisions.
Ohio has passed a bill prohibiting schools from allowing transgender students to use bathroom facilities that match their gender identity.
The "Protect All Students Act" sailed through the Ohio State Senate on November 13 by a 24-7 party-line vote.
The bill's House counterpart was passed by the House of Representatives in June.
The bill now heads to the desk of Republican Gov. Mike DeWine, who has 10 days to sign it into law or veto it.
DeWine has said he's inclined to sign the monstrous bill, but wishes to conduct a legal review first to determine whether it will withstand scrutiny, according to The Associated Press.
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