LINCOLN, Neb. (AP) — A bill that would ban gender-affirming care for minors in Nebraska is one final step from passing after lawmakers advanced it Thursday, but not before a promise was made behind closed doors to hammer out a compromise between supporters and opponents of the bill before it's passed.

Opponents of the bill fell one vote short of the 17 they needed to successfully filibuster the bill and kill it for the year. It advanced 33-16. But that vote came only after Speaker of the Legislature Sen. John Arch took the extraordinary move of suspending business on the floor for nearly an hour to hash out the agreement behind closed doors with conservative lawmakers who dominate the unique one-house, officially nonpartisan Legislature.

Both Arch and the bill's author, freshman Sen. Kathleen Kauth, said details of a compromise have yet to be worked out. But Kauth said she expected to sit down with a handful of supporters, opponents and medical experts in the coming days.

She doesn't have much time. There are fewer than 30 days left in the 90-day session. The final round of debate on the bill has not yet been scheduled.

The vote was telegraphed by opponents who used their time in the final minutes of debate to apologize to the LGBTQ+ community and castigate lawmakers who supported the bill.

Omaha Sen. Machaela Cavanaugh, who has been among the most vocal in opposing the bill, sobbed on the mic.

“I am sorry,” she cried, addressing parents of transgender children. “I'm sorry there's nothing more I can do in my power. You are loved. Your children are loved. You matter.”

The bill has proved to be the session's most contentious, with Cavanaugh leading an effort to every bill before the Nebraska Legislature for weeks to protest it. That effort has largely hamstrung the body’s work. While lawmakers have managed to advance a number of bills, it had not passed a single bill by Thursday.

The trans health bill last month after supporters and opponents angrily accused each other of being hateful and lacking collegiality.

Even before Thursday's debate, opponents signaled that deliberations would become heated. Omaha Sen. Megan Hunt lashed out at supporters of the trans health ban Wednesday night. For Hunt, the debate is deeply personal; she shared on the floor of the Legislature during the bill's first round that her teenage son is transgender. She has since refused to speak to lawmakers who voted to advance the proposal.

“Unless the bill is killed, every bill will be filibustered, and we will talk about LB574 every day on every bill,” Hunt said.

Opponents have noted that Nebraska's bill is nearly identical to an Arkansas law that has been by federal courts as a judge considers whether to strike that state's ban as unconstitutional.

Cavanaugh laid bare the argument that such a ban is unconstitutional, noting that it targets a protected class of people. The bill does not keep teenage girls who identify as girls from getting breast reduction surgery, she said. Nor does it keep teen boys who identify as boys from having surgery to remove excess breast tissue.

“You don't want to ban top surgery for minors. You want to ban top surgery for transgender minors,” Cavanaugh said. “That is targeting a group of people because of how they identify. And that is discrimination.”

Rhetoric around the bill again grew heated at times Thursday, with some conservative lawmakers suggesting that gender-affirming treatments have led to an increase in suicide and suicidal thoughts in transgender teens.

Sen. John Lowe of Kearney repeated a common refrain among conservative activists and politicians, saying children were “being groomed” in schools to develop gender dysphoria. Sen. Brian Hardin of Gering said those urging lawmakers to follow accepted science on transgender health care “are the same people who chanted ‘follow the science’ on COVID-19 until it was no longer fashionable to do so about a year ago.” Kauth referred to transgenderism in youth as “a social contagion.”

Hunt shot back at those assertions.

“You don't know what you're talking about,” she said. “By supporting this bill, you're telling these kids that you reject them. And that's what's leading to suicidal ideation in kids.

“You are throwing gasoline on the fire.”

Kauth has maintained the bill is intended to protect children from undertaking gender-affirming treatments they might later regret as adults and called gender-affirming treatments experimental. She has relied on testimony from activists and some medical reports to say they cause long-lasting damage.

The American Medical Association, the American Academy of Pediatrics and the American Psychiatric Association all support gender-affirming care for youths. Kauth insinuated Thursday that greed might be driving that support, saying “medicine is also a business.”

“There is not enough research to justify this kind of risk,” Kauth said. “My fear is that 10 years down the road, people will look back and say, ‘Where were the adults to say take it slow?’”

The bill was the genesis of a nearly carried by Cavanaugh, who followed through on her vow in late February to filibuster every bill before the Legislature — even those she supported — declaring she would “burn the session to the ground over this bill.” When the bill advanced anyway last month, several other lawmakers joined in the filibuster.

The Nebraska bill, along with another that would ban trans people from using bathrooms and locker rooms or playing on sports teams that don’t align with the sex listed on their birth certificates, are among that have been introduced in state legislatures this year.

At least 13 states have now enacted laws restricting or banning gender-affirming care for minors: Alabama, Arkansas, Arizona, Georgia, Idaho, Indiana, Iowa, Kentucky, Mississippi, Tennessee, Utah, South Dakota and West Virginia. Bills await action from governors in Kansas, Montana and North Dakota. In addition to Arkansas' ban, a federal judge has blocked enforcement of a similar law in Alabama, and nearly two dozen states are considering bills this year to restrict or ban care.

Despite the promise of a compromise, the bill's two most vocal critics — Cavanaugh and Hunt — angrily declared after Thursday's vote that they weren't interested in compromise.

“You care more about legislating hate than anything else," Cavanaugh yelled into the mic. “Actually, that's not true. you care more about hurting me than you care about anything else.”

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