A Nevada bill is seeking to secure gender-affirming health care for transgender and gender non-conforming individuals in the state.

SB 163 would require health insurance companies to provide coverage for treatments and procedures relating to gender dysphoria and gender incongruence.

Amy Koo - acting deputy director of ONE APIA Nevada - said health care in the U.S. is "convoluted" as is, but adds SB 163 would help recognize and streamline gender-affirming health care for folks in Nevada, setting what she calls a model for the rest of the country.

Koo said it is important to note a bill like this doesn't necessarily make it easier to access gender-affirming care, but aims to remove outside barriers.

"This bill is going to be helping those of us who are most vulnerable to the tides of discrimination," said Koo, "and so that is something I really want to highlight - that this doesn't make it easier for people to access the care, it just makes sure other outside factors aren't able to prevent people from accessing that care."

Koo said while many states around the country move to restrict or ban gender-affirming health care, she said she is pleased to see Nevada pushing to make health care more equitable for a population she says is high risk.

Preston Tang, an advisor with the Southern Nevada Asian Pacific Islander Queer Society, said they're always receiving calls from individuals trying to find providers and insurance plans that cover gender-affirming care.

He said the situation is "frustrating" but is happy to know SB 163 could change that.

Tang said there is growing consensus among experts and medical professionals that recognize the importance of gender-affirming health care. He said while advocating may seem intimidating, now is the time for action because many LGBTQ causes and rights are under attack.

"This is the time where we need to rally together, as human beings, as allies," said Tang, "to support our LGBT community and or transgender siblings so that we can ensure that they have equal access to medical care."

Senate Bill 163 is being sponsored by Sens. Melanie Scheible and Dallas Harris, both D-Las Vegas. The bill would require public and private health-care plans, including Medicaid, to cover medical services but would also establish requirements before the insurer will cover certain gender-affirming procedures.




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The Nebraska Legislature kicks off its new session a few weeks from today and issues related to gender identity are likely to be part of the mix.

LGBTQ+ advocates said they are in familiar territory, trying to establish a voice in the debate. Last year, a Nebraska bill to ban transgender students from playing school sports consistent with their gender identity narrowly failed. Republican Gov. Jim Pillen said he will try again this year.

Grant Friedman, legal fellow for the ACLU of Nebraska, said anyone opposed should try to set aside time with lawmakers to explain their concerns. From his perspective, Friedman argued policymakers should know other matters need attention.

"Getting folks to realize they're there to make Nebraska a better place for everyone and focus on the issues that need to be dealt with," Friedman urged. "Not kind of these 'fringe' issues that are being blown out of proportion across the country."

With Nebraska's budget on shaky ground and the need to address affordable housing gaps, he said advocates can pinpoint a number of topics they want lawmakers to look at instead. Polls show most Americans oppose transgender restrictions but Republicans' recent campaign messages have found some captive audiences. Backers of the bills said their mission is to protect students and families.

The ACLU is part of a coalition including OutNebraska, serving as a guide for LGBTQ+ individuals navigating a divisive political environment. Friedman emphasized local government is an avenue to push for protections if state and federal lawmakers are not showing a collective interest in advancing the rights of the LGBTQ+ population.

"The three areas in which you tend to see your city protections are going to be workplace, housing and public accommodations," Friedman outlined.

Friedman added they have found some allies among faith leaders willing to push for unity as marginalized communities fall under the political spotlight. Groups like the Trevor Project said bills deemed hostile toward LGBTQ+ populations can have a damaging effect on the mental health of community members.

Inauguration Day is still five weeks away and gay married couples are already watching for signs conservative lawmakers and the courts may attempt to turn back the clock.

In Obergefell v. Hodges, the Supreme Court ruled in 2015 it was unconstitutional to prohibit same-sex marriage.

Marshall Martinez, executive director of the advocacy group Equality New Mexico, said it is concerning two justices have publicly suggested the 2015 court decision should be re-litigated but encouraging Congress passed the "Respect for Marriage Act" in 2022.

"What we know right now, even if Obergefell is overturned, as long as New Mexico maintains the legalization of same-sex marriages, the federal government will still recognize those New Mexicans' marriages," Martinez outlined.

In supporting the high court's decision to overturn abortion rights in 2022, Justice Clarence Thomas said the court also should revisit the same-sex marriage decision. Justice Samuel Alito has also criticized the landmark ruling. President-elect Donald Trump did not make marriage equality a campaign issue but has surrounded himself with anti-LGBTQ+ staff and appointees.

Martinez reported within the first two days after the Nov. 5 election, LGBTQ+ crisis lines in the U.S. experienced a 700% increase in calls from people concerned about what the outcome might mean for those who identify as gay. He stressed fear and anxiety are premature.

"We're not going to sugarcoat it forever but we have been saying, 'It's not time to panic,'" Martinez explained. "And what we mean by that is we don't know what's going to happen yet. We have some ideas of what they might want to do but we don't know and there's nothing helpful about sort of sitting around in despair and panic, trying to anticipate the worst-case scenario."

Martinez believes some conservative states will continue to criminalize the LGBTQ+ community through bans on gender-affirming care, while others worry newly appointed Trump officials will attempt to slash federal funding for HIV prevention and treatment.

By Andrew Tobias for Signal Cleveland.
Broadcast version by Shanteya Hudson for Ohio News Connection reporting for the Signal Ohio-Public News Service Collaboration

State Sen. Nickie Antonio of Lakewood and other Democrats in the Ohio Senate gave a forceful defense of their party’s stance on transgender rights this week after majority Republicans approved a bathroom bill for state schools and universities.

The bill would require K-12 schools and colleges to designate bathrooms and locker rooms for single-sex use based on students’ sex assigned at birth. The bill passed 23-7, with all Republicans voting “yes” and Democrats voting “no.” It now heads to Gov. Mike DeWine, who soon will decide whether or not to sign it into law.

The vote offered an early example in Ohio of how Democrats may approach LGBTQ issues following the Nov. 5 election. Before the election, Republicans hammered Sen. Sherrod Brown and other vulnerable Democrats on transgender issues.

Since then, some Democrats have suggested backing off of defending transgender rights to try to broaden the party’s appeal, particularly among minority and working-class voters who tend to be more socially conservative. Polling commissioned by Ideastream Public Media, WKYC and Signal Ohio found a majority of Northeast Ohio voters surveyed, including a significant number of Democrats, support the Republican position. LGBTQ advocates have said transgender-related issues are misunderstood by the public unless they have a personal connection. 

But Antonio, who in 2010 became the first openly gay person elected to the state legislature, said Senate Democrats didn’t privately debate the bill’s political merits ahead of the vote. Rather, their discussion focused on how they viewed it as morally wrong.

“We are not going to kick transgender people to the curb and say, well, you’re just dragging us down,” Antonio told Signal Statewide.

During the debate on the floor of the Ohio Senate on Thursday before the vote on the transgender bathroom bill, Republican senators said the election results reinforce that public opinion is on their side.

“Ohioans and Americans … don’t want boys in girls’ sports, they don’t want boys in girls’ locker rooms. They don’t want girls in boys’ bathrooms. It’s for the safety of the kids. And this message was sent loud and clear last week during the national election,” said state Sen. Kristina Roegner, a Hudson Republican.

But Democrats said they view the matter as a civil rights issue.

Antonio said she’s previously resisted private calls to remove the “T” from an LGBTQ nondiscrimination bill that a coalition of gay-rights groups and businesses have tried to pass unsuccessfully for years.

“There has been an effort to segment them off because they are the most marginalized, the most vulnerable, the most misunderstood,” Antonio said of transgender people. “That doesn’t mean we should do it. That means a lot more work has to happen for people to understand rather than malign them.”


Andrew Tobias wrote this article for Signal Cleveland. This story was produced in association with Media in the Public Interest and funded in part by the George Gund Foundation.


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