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- 83rd Session (2025)
Senate Bill No. 171–Senators Ohrenschall and Scheible
CHAPTER..........
AN ACT relating to health care; prohibiting health care licensing
boards from disqualifying from licensure or disciplining a
person for providing or assisting in the provision of
medically necessary gender-affirming health care services;
prohibiting in certain circumstances the Governor from
extraditing a person who is charged with a crime in another
state related to medically necessary gender-affirming health
care services; prohibiting state agencies from assisting in
certain investigations and proceedings initiated in other states
related to medically necessary gender-affirming hea lth care
services; requiring certain health care licensing boards to
examine the feasibility of reciprocal licensure for health care
providers who provide gender -affirming health care services
in other states; and providing other matters properly relating
thereto.
Legislative Counsel’s Digest:
Existing law regulates the licensing, certification and registration of various
providers of health care in this State. (Chapters 630 -637B and 639 -641D of NRS)
Existing law prohibits a health care licensing board fro m disqualifying from
licensure or subjecting a person to discipline solely: (1) for providing reproductive
health care services that are lawful and consistent with the practice of the relevant
profession in this State; or (2) as a consequence of certain ad verse actions
threatened or imposed in another jurisdiction for the provision of such reproductive
health care services. (NRS 629.250) Section 1 of this bill additionally prohibits a
health care licensing board from taking similar actions against a person for
providing or assisting in the provision of medically necessary gender -affirming
health care services that are lawful in this State. Section 4 of this bill requires each
health care licensing board that licenses providers of health care who provide
gender-affirming health care services to examine the feasibility of providing
reciprocal licensing to providers of health care in other states to facilitate the
provision of gender-affirming health care services to persons from other states who
seek such medically necessary services in this State.
In accordance with the Extradition Clause of Section 2 of Article IV of the
United States Constitution, existing state law requires the Governor to extradite to
another state any person charged in that state with a c rime, who is found in this
State. (NRS 179.181) Under existing law, the Governor is also authorized, but not
required, to extradite to another state any person in this State charged in the other
state with committing an act in this State intentionally resu lting in a crime in the
state demanding extradition. (NRS 179.189) Existing law, with certain exceptions,
prohibits the Governor from extraditing any person in this State who is charged
with a crime in another state if the crime alleged involves the provision or receipt of
or assistance with reproductive health care services. (NRS 179.540) Section 2 of
this bill similarly prohibits the Governor from extraditing a person in this State who
is charged with a crime in another state if the crime involves the pro vision or
receipt of or assistance with medically necessary gender -affirming health care
services, unless the crime charged in the other state would also be a crime in this
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State. Section 2, as an exception to this prohibition, authorizes the extradition o f a
person who was physically present in the other state at the time of the commission
of the alleged offense.
Existing law prohibits a state agency from providing any information or
expending or using any resources in furtherance of any investigation or proceeding
initiated in or by another state that seeks to impose civil or criminal liability or
professional sanction on a person or entity for providing, securing, receiving,
making an inquiry concerning or providing certain assistance concerning
reproductive health care services that are legal in this State, except under certain
limited circumstances. (NRS 232.0088) Section 3 of this bill prohibits state
agencies in the Executive Department of the State Government from providing
information or expending a ny resources of the State in furtherance of such an
investigation or proceeding concerning medically necessary gender -affirming
health care services, except under certain limited circumstances.
EXPLANATION – Matter in bolded italics is new; matter between brackets [omitted material] is material to be omitted.
THE PEOPLE OF THE STATE OF NEVADA, REPRESENTED IN
SENATE AND ASSEMBLY, DO ENACT AS FOLLOWS:
Section 1. Chapter 629 of NRS is hereby amended by adding
thereto a new section to read as follows:
1. A health care licensing board shall not disqualify a person
from licensure or subject any person to discipline solely:
(a) For providing or assisting in the provision of medically
necessary gender-affirming health care services; or
(b) As a consequence of any judgment, discipline or other
sanction threatened or imposed under th e laws of the District of
Columbia or any state or territory of the United States for
providing or assisting in the provision of medically necessary
gender-affirming health care services,
if the gender-affirming health care services were provided with
parental consent, unless the minor would have been expressly
authorized to consent to the services under the laws of this State,
and the services, as provided, would have been lawful in this State.
2. As used in this section:
(a) “Gender-affirming health care services”:
(1) Means medical, surgical, counseling or referral services
that respect the gender identity or expression of the patient and
are found by a competent medical professional to be appropriate
based upon the wishes of a patient and in acco rdance with the
laws of this State, including, without limitation:
(I) Interventions to suppress the development of
endogenous secondary sex characteristics;
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(II) Interventions to align the appearance or physical
body of the patient with the gender identity or expression of the
patient;
(III) Interventions to alleviate symptoms of clinically
significant distress resulting from gender dysphoria, as defined in
the most recent edition of the Diagnostic and Statistical Manual of
Mental Disorders published by the American Psychiatric
Association; and
(IV) Developmentally appropriate exploration and
integration of identity, reduction of distress, adaptive coping and
strategies to increase family acceptance.
(2) Does not include conversion therapy, as defined in
NRS 629.600.
(b) “Health care licensing board” means:
(1) A board created pursuant to chapter 630, 630A, 631,
632, 633, 634, 634A, 634B, 635, 636, 637, 637B, 639, 640 , 640A,
640B, 640C, 640D, 640E, 641, 641A, 641B, 641C or 641D of NRS.
(2) The Division of Public and Behavioral Health of the
Department of Health and Human Services.
(c) “Medically necessary” means health care services or
products that a prudent provider of health care would provide to a
patient to prevent, diagnose or treat an illness, injury or disease, or
any symptoms thereof, that are necessary and:
(1) Provided in accordance with generally accepted
standards of medical practice;
(2) Clinically appropriate with regard to type, frequency,
extent, location and duration;
(3) Not provided primarily for the convenience of the
patient or provider of health care;
(4) Required to improve a specific health condition of a
patient or to preserve the exi sting state of health of the patient;
and
(5) The most clinically appropriate level of health care that
may be safely provided to the patient.
A provider of health care prescribing, ordering, recommending
or approving a health care service or product does not, by itself,
make that health care service or product medically necessary.
Sec. 2. Chapter 179 of NRS is hereby amended by adding
thereto a new section to read as follows:
1. Notwithstanding the provisions of NRS 179.177 to 179.235,
inclusive, the Governor shall not surrender, or issue a warrant
pursuant to NRS 179.191 for the arrest of, any person in this State
who is charged in another state with a criminal violation of the
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laws of that other state if the violation alleged involves the
provision or receipt of or assistance with medically necessary
gender-affirming health care services, unless the acts forming the
basis of the prosecution of the crime charged would constitute a
criminal offense under the laws of the State of Nevada.
2. The provisions of this section do not apply in the
circumstance where a demand for the extradition of a person
charged with a crime in another state is ma de in accordance with
NRS 179.183, and the person who is the subject of the demand
was physically present in the demanding state at the time of the
commission of the alleged offense and thereafter fled from that
state.
3. The provisions of this section s hall not be construed to
apply to the provision of medically necessary gender -affirming
health care services without parental consent unless the minor is
authorized to consent to those services under the laws of this State.
4. As used in this section:
(a) “Gender-affirming health care services”:
(1) Means medical, surgical, counseling or referral services
that respect the gender identity or expression of the patient and
are found by a competent medical professional to be appropriate
based upon the wish es of a patient and in accordance with the
laws of this State, including, without limitation:
(I) Interventions to suppress the development of
endogenous secondary sex characteristics;
(II) Interventions to align the appearance or physical
body of th e patient with the gender identity or expression of the
patient;
(III) Interventions to alleviate symptoms of clinically
significant distress resulting from gender dysphoria, as defined in
the most recent edition of the Diagnostic and Statistical Manual of
Mental Disorders published by the American Psychiatric
Association; and
(IV) Developmentally appropriate exploration and
integration of identity, reduction of distress, adaptive coping and
strategies to increase family acceptance.
(2) Does not inc lude conversion therapy, as defined in
NRS 629.600.
(b) “Medically necessary” means health care services or
products that a prudent provider of health care would provide to a
patient to prevent, diagnose or treat an illness, injury or disease, or
any symptoms thereof, that are necessary and:
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(1) Provided in accordance with generally accepted
standards of medical practice;
(2) Clinically appropriate with regard to type, frequency,
extent, location and duration;
(3) Not provided primarily for the conv enience of the
patient or provider of health care;
(4) Required to improve a specific health condition of a
patient or to preserve the existing state of health of the patient;
and
(5) The most clinically appropriate level of health care that
may be safely provided to the patient.
A provider of health care prescribing, ordering, recommending
or approving a health care service or product does not, by itself,
make that health care service or product medically necessary.
(c) “Provider of health care” has the meaning ascribed to it in
NRS 629.031.
(d) The words and terms defined in NRS 179.179 have the
meanings ascribed to them in that section.
Sec. 3. Chapter 232 of NRS is hereby amended by adding
thereto a new section to read as follows:
1. Except as otherwise required by the order of a court of
competent jurisdiction, a state agency shall not provide any
information or expend or use time, money, facilities, property,
equipment, personnel or other resources of the State in
furtherance of any investigation or proceeding initiated in or by
another state that seeks to impose civil or criminal liability or
professional sanction upon a person or entity for:
(a) The provision, securing or receiving of, or any inquiry
concerning, medically necessary gender-affirming health care
services that are legal in this State; or
(b) Any assistance given to any person or entity that relates to
the provision, securing or receiving of, or any inquiry concerning,
medically necessary gender-affirming health care services that are
legal in this State.
2. The provisions of subsection 1 do not apply to any
investigation or proceeding where the conduct that is subject to
potential liability under the investigation or proceeding initiated in
or by the other state would be subject to civil or criminal liability
or professional sanction under the laws of the State of Nevada, if
committed in this State.
3. Notwithstanding the provisions of this section, a state
agency or an employee, appointee, officer or other pers on acting
on behalf of a state agency may provide information or assistance
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in connection with such an investigation or proceeding in
response to a written request by the person who is the subject of
the investigation or proceeding.
4. The provisions of this section shall not be construed to
apply to the provision, securing or receipt of medically necessary
gender-affirming health care services without parental consent,
unless the minor is authorized to consent to th ose services under
the laws of this State.
5. As used in this section:
(a) “Gender-affirming health care services”:
(1) Means medical, surgical, counseling or referral services
that respect the gender identity or expression of the patient and
are found by a competent medical professional to be appropriate
based upon the wishes of a patient and in accordance with the
laws of this State, including, without limitation:
(I) Interventions to suppress the development of
endogenous secondary sex characteristics;
(II) Interventions to align the appearance or physical
body of the patient with the gender identity or expression of the
patient;
(III) Interventions to alleviate symptoms of clinically
significant distress resulting from gender dysphoria, as defined in
the most recent edition of the Diagnostic and Statistical Manual of
Mental Disorders published by the American Psychiatric
Association; and
(IV) Developmentally appropriate exploration and
integration of identity, reduction of distress, adaptive coping and
strategies to increase family acceptance.
(2) Does not include conversion therapy, as defined in
NRS 629.600.
(b) “Medically necessary” means health care services or
products that a prudent provider of health care would provide to a
patient to prevent, diagnose or treat an illness, injury or disease, or
any symptoms thereof, that are necessary and:
(1) Provided in accordance with generally accepted
standards of medical practice;
(2) Clinically appropriate with regard to type, frequency,
extent, location and duration;
(3) Not provided primarily for the convenience of the
patient or provider of health care;
(4) Required to improve a specific health condition of a
patient or to preserve the existing state of health of the patient;
and
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(5) The most clinically appropriate level of health care that
may be safely provided to the patient.
A provider of health care prescribing, ordering, recommending
or approving a health care service or product does not, by itself,
make that health care service or product medically necessary.
(c) “Provider of health care” has the meaning ascribed to it in
NRS 629.031.
(d) “State agency” means an agency, bureau, board,
commission, department, division, officer, employee, appointee or
agent or any other unit of the Execu tive Department of the State
Government.
Sec. 4. 1. Each health care licensing board that licenses
providers of health care who provide gender -affirming health care
services shall examine the feasibility of providing opportunities for
reciprocity of licensure to providers of health care who provide
gender-affirming health care services in other states to facilitate the
provision of quality gender-affirming health care services to persons
from other states who seek medically necessary gender-affirming
health care services in this State.
2. As used in this section:
(a) “Gender-affirming health care services” has the meaning
ascribed to it in section 1 of this act.
(b) “Health care licensing board” has the meaning ascribed to it
in section 1 of this act.
(c) “Medically necessary” has the meaning ascribe d to it in
section 1 of this act.
(d) “Provider of health care” has the meaning ascribed to it in
NRS 629.031.
Sec. 5. This act becomes effective upon passage and approval.
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