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SB163: The Most Explosive Bill of 2023 Nevada Legislature, Part IV

(Chuck Muth) – When last we left off (click these links for Part I, Part 2, and Part 3), we learned that the provisions of SB163 come down to this: Are sex-change operations for men who want to be women, or women who want to be men, considered “medically necessary” or “cosmetic”?

Rational people would surely say cosmetic.  But what will the courts say?

Uh-oh, here we go…

According to the Legislative Counsel’s Digest, EXISTING LAW already requires public and private health insurance policies – including Medicaid – “to include certain coverage.”

As conservatives, we’re opposed to such government mandates on private companies.  But the boneheads in the Legislature keep piling them on, session after session, driving the cost of health insurance through the roof.

SB163 is just the latest example.  It adds to mandated coverage “the treatment of conditions relating to gender dysphoria and gender incongruence.”  Meaning: sex change operations.


Contrary to the hysteria being whipped up by the likes of Nevada Republican National Committeewoman Sigal Chattah – an angry woman clearly weaned on a pickle – the bill does NOT “serve up children for genital mutilation.”

A critically important amendment was added to the bill that protects children from being pressured into sex change procedures by unscrupulous social workers, psychiatrists, psychologists, and speech-language pathologists.

The amendment specifically allows health insurance companies to “prescribe requirements that must be satisfied before the insurer covers surgical treatment of conditions relating to gender dysphoria or gender incongruence for an insured who is less than 18 years of age.”

And one of those allowed requirements is…PARENTAL CONSENT.

“While state lawmakers largely found that insurance often already covers these procedures,” reported the Pahrump Valley Times this morning, “SB163 clarified that minors in Nevada need permission from their parents or guardians before undergoing gender-affirming operations.”

Now unless you want to argue that children belong to the government and not the parents, we have to accept the fact that some bone-headed parents are not only going to allow sex-change operations for their kids, but will actually encourage it.

If that bothers you, and you think the government SHOULD ban such procedures on minors, even with parental consent, I’ve got some bad news for you.

Four states – Alabama, Arkansas, Texas and Arizona – have passed laws prohibiting sex-change procedures for minors.

The Texas and Alabama laws have been temporarily blocked. And the Arkansas law – which had been vetoed by Republican Gov. Asa Hutchinson and then over-ridden by the Legislature – was struck down by a federal judge on Tuesday.

In any event, unlike those four states, Nevada has a Democrat-controlled Legislature, and such a ban will never be passed under the current make-up. So even if you favor such a ban, political reality says it ain’t gonna happen here.

Nevertheless, that’s not what we’re talking about when it comes to SB163.

Rather than banning sex-change procedures, this bill requires insurance companies and Medicaid in Nevada to cover such procedures if deemed “medically necessary” and with “parental consent” when it comes to minors.

So why not veto the bill instead of signing it, since vetoing the bill would only leave Nevada exactly where we are today?  I’ve heard the arguments…

  • Many major insurance companies in Nevada already voluntarily cover these procedures, so the bill only codifies what’s pretty much already in place.
  • 38 other states already cover these procedures in Medicaid.
  • Federal courts in Georgia and West Virginia have now ruled that those states must provide such coverage in Medicaid.
  • Refusing to cover these procedures may, down the road, be considered a violation of Title XIX (that’s “19,” Sigal) of the federally mandated Social Security Act.
  • And states which aren’t covering these procedures may eventually be ruled in violation of Section 1557 of ObamaCare as “sex discrimination.”

So one could legitimately argue that this is likely coming to Nevada one way or the other, sooner or later, like it or not.  I’m not trying to defend the bill; only explain the counter-arguments.

Me? I wish Gov. Lombardo had vetoed it.

Even though it pretty much only codifies what’s already being covered by most private insurance companies, and it seems inevitable that the courts will eventually force every state to cover these procedures in Medicaid, and even with the parental consent provision…

I still don’t like it.

But I’m not the governor. It was his call. And he had a lot more information about exactly what all was going on behind the scenes than you and I because we’re a republic, not a democracy.

So on this one, he and I will just agree to disagree.  And I’m sure it won’t be the last time.  Heck, I don’t even agree with myself 100% of the time!

But all in all, I’ll still take this bill along with the 75 bills the governor DID veto, over this bill PLUS the 75 crappy bills Democrat Gov. Steve Sisolak would have signed.

Remember, if you don’t like this bill, the real fault lies in Democrats controlling both houses of the Legislature.  And by signing the bill in this now-purple state, the governor has taken the issue off the table as an issue in next year’s legislative races.

Just consider what Democrat State Sen. Melanie Scheible – the bill’s lead sponsor – said after the bill was actually SIGNED

“At a time when states across the country are passing Draconian laws to restrict trans and nonbinary people’s rights to exist, Nevada is doing the opposite.”

What total, unreconstituted bull-$#&!

Nobody’s trying to pass laws denying anyone’s “right to exist.” The question is who should pay for these cosmetic procedures and how to protect children from getting them without parental consent.

Now just imagine what trans-radicals like Scheible and liberal blubber-blogger Jon Ralston would say if the governor had vetoed the bill!

So get your butt in gear and help beat some of these Democrats next year so we can block bills like this from even reaching the governor’s desk in the future.

And if you still want to obsess over this bill and chattah-bate like a banshee, have at it.  I get it.  I don’t like this trans-radical nonsense any more than you do.

But what’s done is done.  I’m moving on…

Muth’s Truths PLUS+

Got back in the MTP+ saddle again yesterday after my daddy-daughter road trip.

Made my first two endorsements for the 2024 election cycle, along with a long list of insider info on Nevada politics that piled up while I was away, including…

  • The passing of the man who helped launch my political writing career
  • A planned coup attempt in the Republican Assembly Caucus
  • Candidates who should be running for something else or somewhere else
  • Consultant Woody Woodpeckerhead’s latest boner
  • The Clark County GOP chair race
  • The “fake news” about Adam Laxalt’s Basque Fry last week
  • More on the Chattah fatwa now that she’s running the Nevada GOP
  • A space cadet blogger’s goofy, out-of-this-world scheme/scam
  • My new policy on Twitter trolls

For information on how to join the Inner Circle and get your copy of Muth’s Truths PLUS+, click here.  Enter the promo code “member99” for $50 discount.


“Governor Lombardo signed this legislation (SB163) since it strengthens parental consent and tightens restrictions on procedures associated with minors. Furthermore, this legislation is consistent with existing insurance coverage, state law and regulations, federal healthcare mandate, and established legal precedent.” – Office of Gov. Joe Lombardo

“Ditto to everything you said, Chuck.  You know, I had a friend who died years ago who had transitioned.  I told him at the time, ‘That’s weird Rob, but what the hell, I’m kinda weird too.’  We just went on with our lives and our friendship and that was that.  Too damn bad these friggin lefties just don’t get it.” – Name withheld

“Let’s talk about American values. If you are able-bodied, you work. If you take out a loan, you pay it back. If you commit a violent crime, you go to jail. If you’re a man, you should play sports against men.” – Sen. Tim Scott (R-SC)

Mr. Muth is president of Citizen Outreach, publisher of Nevada News & Views, and founder of  You can sign up for his conservative, Nevada-focused e-newsletter at  His views are his own.


This blog/website is written and paid for by…me, Chuck Muth, a United States citizen. I publish my opinions under the rights afforded me by the Creator and the First Amendment to the United States Constitution as adopted by our Founding Fathers on September 17, 1787 at the Constitutional Convention in Philadelphia, Pennsylvania without registering with any government agency or filling out any freaking reports. And anyone who doesn’t like it can take it up with George Washington, Thomas Jefferson, Ben Franklin and John Adams the next time you run into each other.

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