LINCOLN — The Nebraska State Legislative Commission sparked controversy Thursday by appointing a new chief medical officer, who will be responsible for determining new rules and regulations regarding gender-affirming care for minors.
Members of the Health and Human Services Committee went ahead with the appointment of Dr. Timothy Tesmer by a 4-2 vote. It was a moment of tense questioning, senators yelling at each other behind closed doors, and a months-long battle over gender-affirming care that erupted within the committee.
Tesmer is an otolaryngologist who until recently practiced in Lincoln. He is a graduate of Nebraska Wesleyan University and the University of Nebraska Medical Center and has practiced in Louisville, Kentucky. Springfield, Missouri. and Colorado Springs, Colorado.
He told the commission how he set up his private practice in 2020, saying he had a “vision” and had brought in legal, financial and marketing experts to start making it happen.
“I created the policies, set the standards, and made sure the team met those standards,” Tesmer said. “The skills I bring to this role today are my ability to set a vision, make tough decisions when necessary, and work with experts to achieve goals.”
An “interdisciplinary” team is created
But much of Tesmer’s hearing depends on how he addresses the powers granted him under Congressional Bill 574, which was signed into law by Gov. Jim Pillen on Monday.
Through LB 574, the Chief Medical Officer has sole responsibility for regulating pubertal blockers and hormone therapy for minors in transitional care.
Tesmer said the law stipulates that it falls “on the shoulders of the chief medical officer,” but that final rules and regulations will be evidence-based and rational.
“In practice, it will be achieved by a multidisciplinary team of health care providers,” Tesmer said, including input from local, regional and national experts in providing gender-positive care.
Senator Lynn Walz of Fremont, along with Senators John Kavanaugh and John Fredrickson of Omaha, had proposed certain rules and regulations that were not adopted in the debate on LB 574.
Mr. Waltz, a member of the committee, asked Mr. Tesmer if he had seen those protocols and if he would consider them.
“I would be happy to consider it,” Mr Tesmer replied. “But we have to apply it to the boundaries of the legal context.”
Two doctors, Dr. Helen Grace, a pediatrician, and Dr. Alex Dworak, a family physician, testified neutrally and said they were potential sources of information for Tesmer.
They said that if Tesmer could set aside personal opinions and consult an expert, it would be more important than previous expertise in the field of gender-affirmative care.
Grace said cooperation is important because no doctor knows everything about Nebraska.
The gender-care aspect of LB 574 will be passed into law on October 1, banning transitional surgery, but lifting potential restrictions on puberty inhibitors and hormone therapy in the future.
The other half of LB 574, a ban on abortion for about 10 weeks, is already law.
At the LB 574 signing ceremony, Mr Piren said gender-positive care as a blanket solution was the work of “Lucifer,” another point of contention among witnesses on Thursday.
“We believe it is important to protect our children and to ensure that parents and children are not fooled by the silly ‘this will make us happy’ idea,” Piren said on Monday. rice field. “He’s just the best Lucifer.”
Abi Swattsworth, executive director of Auto Nebraska, testified to Tesmer about its role in supporting the original form of LB 574. statementshe denounced Pyren’s comments as “appalling” and “inflammatory”.
One testified in favor of Tesmer, five against, and two neutral. Senator Ben Hansen of Blair, who played a key role in passing LB574, said four supportive comments, 83 dissenting comments, and seven neutral comments were submitted. Stated.
Does ‘One Problem’ Define a Chief Medical Officer?
One of the few question-and-answer moments was when Omaha Senator Makaela Kavanaugh asked Tezmer whether advanced breast surgery was appropriate for minors.
She said the questions were designed to assess his legal and medical understanding, pointing out that surgery on transgender youth would be prohibited.
Tessmer said breast implants and implants are appropriate for cisgender minors but irreversible for transgender youth.
Kavanaugh lashed out at it as discriminatory and said she feared LB 574 was part of a campaign to end transgender people in Nebraska. She has made similar comments on the floor of Congress.
She added she feared the mission could go forward based on Tesmer’s remarks.
“I desperately hope I’m so off the mark and wrong,” Kavanaugh said. “I am asking you to show me how wrong I am with my words today and my actions going forward. I am concerned and very concerned about the discrimination you openly share with us today.”
Tesmer said he, like everyone, has his own opinions and biases, but he relies on his team when it comes to complying with the law.
“I assure you that personal opinions are set aside here and now,” he replied. “This issue, this he hopes that no one issue will define the entire role of the chief medical officer.”
Senators Merv Ripe of Ralston, Senator Beau Ballard of Lincoln and Jenn Day of Omaha pointed to other tasks chief medical officers must face, pointing out the need to move to care. He sought advice on expanding access to HIV, responding to sexually transmitted infections in Douglas County, and providing guidance on health care. Physician involved in abortion.
Rules and regulations process
Julia Keown, a registered nurse, testified that she supported Tesmer’s nomination.
“I have the utmost confidence in Dr. Tesmer’s ability to uphold his medical oath and adhere to the American national code of what constitutes best medical practice,” Keown said.
These practices have already been advocated by multiple medical associations and societies, including specific guides from the Endocrine Society.
Endocrine Treatment of Gender Dysphoric/Gender Mismatched Persons: The Endocrine Society clinical practice guidelines are “interestingly very similar” to the LB 574 amendments drafted by Waltz and John Kavanaugh, Keown added.
Based on norms and his own professional experience, Keown said it would be natural for Tesmer and other chief medical officers to adopt these already-formulated policies. Some opponents fear Tesmer will use his powers to enforce a blanket ban on blockers and hormones.
“You are at the epicenter of everything”
During the multi-line questioning, Mr. Kavanaugh and Mr. Tesmer interrupted each other.
Kavanaugh told Tesmer that LB 574 will define the 2023 session. She was one of the main voices against the bill, which included a three-month filibuster on nearly every bill.
Kavanaugh and Day also said Tesmer was involved in passing LB574 when he served as chairman of the state board of health from early 2022 until a week before becoming acting CMO on March 27. criticized.
On March 20, the committee released a statement supporting LB 574 in its entirety, outlawing puberty blockers and hormone therapy in addition to puberty blockers.
Tesmer claimed he had no knowledge of the statement until it was announced and voted on at a meeting on the afternoon of March 20. He said the statement was derived from that morning’s subcommittee meeting.
State Senator Kathleen Cowse of Omaha, who introduced LB 574, coordinated with some board members to prepare a statement before the bill was debated on the floor, according to a public records request. Became. The request did not disclose any written correspondence by email or text message with Tesmer prior to the board’s final vote.
Hansen said it’s not uncommon for state health boards to issue statements related to legislation.
But Day said Tesmer’s ignorance of the statement as chairman of the board called into question his leadership.
“You used your position of power to make this a definitive issue, and now you are in another position of power whose mission is this,” Kavanaugh told Tesmer. “So you are at the epicenter of all this.”
“Okay, if that’s how you characterize the role, I’m happy to be the epicenter of this role,” Tesmer replied. “If that is the definition of this CMO role, then I am happy to do so.”
Tesmer said he supported the statement because he was against transitional surgery for minors and signed the bill because it had “irreversible” language. However, there is one mention against both “irreversible surgical and hormonal manipulation of minors for the purpose of gender reassignment.”
The minutes of the March 20 meeting show that Tesmer tried to remove the language from the final draft and ultimately supported it.
“Author of Your Own Destruction”
At a closed-door meeting just before the 4-2 vote to accelerate Tesmer’s appointment, Mr. Day expressed concern that Mr. Tesmer would bias future jobs.
Lipe said he puts the emphasis first on character and says he’s heard from Lincoln-based doctors that Tesmer has a good personality.
Looking at Mr. Waltz’s gaze, Mr. Kavanaugh commented: … These four gentlemen of hers don’t care,” she said, referring to her four male colleagues who would vote to support Tesmer and her LB 574.
Hansen said the characterization was not fair. He said there is a difference between compassion and disagreement.
As Hansen and Kavanaugh argued, state senator Brian Hardin of Goering, the commission’s vice chairman, leaned forward to speak.
“You’re the one who ruined yourself,” he told Kavanaugh.
Hansen, Hardin, Ballard and Ripe supported Tezumer, while Kavanaugh and Day voted against. Waltz attended rather than voted.
Hansen said the entire parliament will consider Tesmer’s appointment next week.