Medical care for minorsRestriction▾
LB574 / Neb. Rev. Stat. §§ 71-7304–71-7305 and 181 NAC 8. Gender-altering surgery banned under 19. New puberty blockers and hormones require a gender-dysphoria pattern that began or worsened at puberty, at least 40 gender-identity therapy hours, informed consent, and a seven-day wait (181 NAC 8). A course that began before October 1, 2023 may continue. Not a clean England-style ban.
Nebraska Legislature (LB574)
MedicaidFederal funding ended (minors)▾
Medicaid doesn't pay for sex-change procedures at any age. A federal CMS rule ends federal Medicaid and CHIP money for puberty blockers, cross-sex hormones and surgery for minors.
42 C.F.R. 441.800–802, 457.476 (91 Fed. Reg. 52406)
State employeesNo explicit policy▾
State-employee plans have no explicit rule on sex-change procedures.
Nebraska DAS State Personnel Wellness and Benefits: Health and Prescription Plan (das.nebraska.gov)
SportsSex-based (constitution)▾
Girls' sports are protected. Nov 3, 2026: voters approved Initiative 442 (~68% yes), writing into the state constitution that female school teams are closed to males, from grade school through college. The 2025 Stand With Women Act (LB89) already did this by statute.
Initiative 442; LB89
FacilitiesNo state law▾
No state law keeps males out of women's and girls' bathrooms and changing rooms.
No state law identified (statute review, Oct 2026)
Pronouns and parent noticeNo state law▾
No state law requires schools to tell parents if their child socially transitions at school.
No state law identified (statute review, Oct 2026)
CurriculumNo state law▾
No state law on gender-identity lessons; local school boards decide.
No state law identified (statute review, Oct 2026)
Sex definitionDefined by biology (executive order)▾
State executive order defines male and female by biology for state purposes.
Nebraska Executive Order 23-16, Women's Bill of Rights (Aug 2023)
ID markersBirth-certificate sex changed only with surgery▾
Birth-certificate sex changed only with surgery; licence sex change needs a provider form.
LEGISLATIVE BILL 885 Approved by the Governor aPril 19, 1994 (nebraskalegislature.gov)
Shield lawNone▾
No shield law.
No shield statute identified
AdultsRestricted (funding)▾
Adults: no taxpayer money for sex-change procedures (Medicaid exclusion at all ages).
471 NAC 10-004 (since 1990
DetransitionNo state law▾
No special right for detransitioners to sue.
No state law identified
PrisonsBy sex at birth / post-surgery, case-by-case review▾
Inmates are generally assigned by birth sex or post-surgery status, with case-by-case review.
NDCS AR 115.11 (2025)
Pending billsNo active bills▾
No active bills (checked 13 Oct 2026). The 2026 regular session has adjourned (or the legislature does not meet in 2026), so 2025-26 bills are no longer moving. LegiScan search linked.
LegiScan search, checked 13 Oct 2026 (adjourned legislature)
LitigationNone identified▾
No active court case on these laws identified in this review.
Review, Oct 2026
Key datesNone upcoming▾
No upcoming effective dates or court deadlines identified.
Review, Oct 2026
Sources
- Nebraska Legislature (LB574)
- 42 C.F.R. 441.800–802, 457.476 (91 Fed. Reg. 52406)
- 471 NAC 10-004 (since 1990
- Nebraska DAS State Personnel Wellness and Benefits: Health and Prescription Plan (das.nebraska.gov)
- Initiative 442; LB89
- Nebraska Executive Order 23-16, Women's Bill of Rights (Aug 2023)
- LEGISLATIVE BILL 885 Approved by the Governor aPril 19, 1994 (nebraskalegislature.gov)
- NDCS AR 115.11 (2025)
- LegiScan search, checked 13 Oct 2026 (adjourned legislature)