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An appeals court hearing Wednesday in the blockbuster abortion pill case will set the stage for how the Supreme Court will eventually approach the legal dispute, where anti-abortion activists are asking the courts to pull the main drug used in medication abortions off the market.

For three months, a group of Nebraska lawmakers have ground nearly all legislative business in the state to a halt, grabbing the nation’s attention with a remarkable filibuster to stifle a bill that would end gender-affirming care for young transgender people. Late Tuesday 16 May, Republican lawmakers broke through, advancing a bill that not only bans gender-affirming care for trans people under 19 years old but also tacks on an amendment to outlaw abortion at 10 weeks of pregnancy and hands the state’s GOP-appointed medical officer the authority to set the rules for affirming care for trans youth. Lawmakers approved the amended version of legislative bill 574 by a vote of 33-14. The measure will go to a final round of votes before it heads to the desk of Republican Governor Jim Pillen, who intends to sign it into law. Hundreds of protesters filled the capital in Lincoln, standing outside the doors and in the gallery above lawmakers while chanting “one more vote to save our lives”; only one senator would have had to defect from supporters of the bill to kill the legislation. The vote – on the 78th day of a 90-day session – followed a series of maneuvers that opponents argued were bending and breaking the rules of the state legislature to hammer through the legislation and avert the filibuster, which would allow opponents to occupy their allotted time to speak the bill to death. “What you are attempting to do today is the lowest of the absolute lows,” state Senator Machaela Cavanaugh, who spearheaded the filibuster, told Republican lawmakers. “You literally have to cheat at every moment of this debate in every possible way. … You are allowing it to happen,” she added. “You do literally have blood on your hands, and if you vote for it, you will have buckets.” State Senator Megan Hunt, the first openly LGBT+ member of the state legislature and the mother of a trans child, lambasted lawmakers for their “escape routes” from the capitol to avoid facing protesters. “If you can’t go out and face them, you are not worthy,” she said. “Your legacy is filth.” In a statement following the vote, Governor Jim Pillen called the bill “an important step” to “protect” the future of the state’s children. Opponents of the bill forcefully opposed the inclusion of an abortion ban in a bill targeting gender-affirming care, two wholly separate issues combined into one, “but you all don’t care,” Ms Cavanaugh told Republican lawmakers. “You don’t care about due process, you don’t care about the people of Nebraska,” she added. “All you care about is the governor.” Abortion rights advocates and transgender rights advocates have frequently underscored the fact that anti-abortion measures and legislation targeting LGBT+ people are driven by the same lawmakers and activist groups, relying on similar arguments to restrict access to healthcare, with measures that have dominated state capitals across the country over the last few years. Lawmakers initially were set to only debate the gender-affirming care bill, which already went through two of three rounds of debate and votes. But legislative rules prohibit amendments on a final round, and opponents of the bill planned to filibuster through all two hours of debate to continue to block it. Last month, the filibuster blocked a measure from anti-abortion lawmakers to ban abortion at roughly six weeks of pregnancy. Attaching another anti-abortion measure, this time at roughly 10 weeks, gave proponents of the bill a second chance of both advancing an anti-abortion law and the gender-affirming care ban, marrying two controversial measures to get to the necessary 33-vote threshold to advance. In February, Ms Cavanaugh vowed to “burn the session to the ground” if the ban on gender-affirming care advanced, launching an epic filibuster that blocked every bill until the measure was withdrawn or defeated. State Senator Kathleen Kauth, an Omaha Republican who proposed the bill targeting gender-affirming care, said the amended version would protect children from what she called a “social contagion.” “Kids deserve the right to grow up and not deal with this until they are adults and can make informed decisions,” said Ms Kauth, who did not mention the fact that such decisions are made with families and their doctors. The anti-abortion measure provides no exceptions for pregnancies with fatal fetal anomalies and does not explicitly protect doctors who perform abortions from criminal prosecution. “What is wrong with you?” said Ms Hunt, calling the combined bill a “desperate attempt to institute an abortion ban that is unpopular, unnecessary, and unsafe.” More than a dozen states, mostly in the US South, have severely restricted or effectively outlawed abortion in the year after the US Supreme Court struck down Roe v Wade, which affirmed a constitutional right to abortion access. Nebraska’s legislation also joins a nationwide campaign that has seen hundreds of bills aimed at LGBT+ people, particularly at young trans people, filed in nearly every state within the last two years. At least 15 states have enacted laws or policies banning gender-affirming care for young trans people, and more than a dozen others are considering similar measures. Court injunctions have blocked bans from going into effect in three states. More than half of all trans youth in the US between the ages of 13 and 17 are at risk of losing access to age-appropriate, medically necessary and potentially life-saving gender-affirming healthcare in their home state, according to the Human Rights Campaign. The onslaught of legislation and volatile political debate surrounding the bills have also negatively impacted the mental health of an overwhelming majority of young trans and nonbinary people, according to polling from The Trevor Project and Morning Consult. A separate survey from The Trevor Project found that 41 per cent of trans and nonbinary youth have seriously considered attempting suicide over the last year. Read More Inside the ‘mentally exhausting’ protest shutting down Nebraska’s anti-trans legislation Inside Montana’s ‘disturbing’ attack on trans kids and the campaign to silence lawmaker Zooey Zephyr Exclusive: Zooey Zephyr responds to her political silencing and Montana’s attacks on trans children: ‘I show up with my head held high’ Anti-abortion laws harm patients facing dangerous and life-threatening complications, report finds

North Carolina's Republican-led Senate on Tuesday voted to override a veto from Democratic Gov. Roy Cooper over a bill that would ban most abortions after 12 weeks.

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North Carolina Democratic Gov. Roy Cooper vetoed a controversial bill that would ban most abortions after 12 weeks, setting up a likely override effort from the state legislature, where Republicans have a supermajority.

In front of an exuberant crowd, North Carolina’s Democratic governor vetoed legislation Saturday that would have banned nearly all abortions in his state after 12 weeks of pregnancy. Hundreds of abortion-rights activists and voters watched on a plaza in the capital of Raleigh as Gov Roy Cooper affixed his veto stamp to the bill. The veto launches a major test for leaders of the GOP-controlled General Assembly to attempt to override Cooper’s veto after they recently gained veto-proof majorities in both chambers. The bill was the Republican response to last year’s US Supreme Court decision overturning Roe v Wade. "We’re going to have to kick it into an even higher gear when that veto stamp comes down,” Mr Cooper told the crowd. “If just one Republican in either the House or the Senate keeps a campaign promise to protect women’s reproductive health, we can stop this ban.” Andrea Long, a 42-year-old mother of three from Cary, said she was honored be part of an “electric” crowd on what she called a “historic day for freedom” in North Carolina. “I couldn’t stop crying tears joy seeing the governor hold up the veto stamp, but I know it’s an uphill battle to keep this momentum going,” Ms Long said. Mr Cooper, a strong abortion-rights supporter, had until Sunday night to act on the measure that tightens current state law, which bans most abortions after 20 weeks of pregnancy. Mr Cooper spent the week on the road talking to North Carolinians about the bill’s lesser-known impacts and urging them to apply pressure upon key Republican lawmakers who hesitated about further restrictions during campaigns for office last year. The legislation passed along party lines in the last week in the House and Senate. Republicans have pitched the measure as a middle-ground change to state abortion laws developed after months of private negotiations between House and Senate GOP members. It adds exceptions to the 12-week ban, extending the limit through 20 weeks for rape and incest and through 24 weeks for “life-limiting” fetal anomalies. But Mr Cooper has said repeatedly the details contained in the 47-page bill show that the measure isn’t a reasonable compromise and would instead greatly erode reproductive rights. He cites new obstacles for women to obtain abortions — such as requiring multiple in-person visits, additional paperwork to prove a patient has given their informed consent to an abortion and increased regulation of clinics providing the procedure. Mr Cooper and allies have said those changes in practice will shut down clinics that cannot afford major upgrades mandated by new licensing standards and make it nearly impossible for women who live in rural areas or work long hours to access abortion services. Compared to recent actions by Republican-controlled legislatures elsewhere, the broad prohibition after 12 weeks can be viewed as less onerous to those in other states where the procedure has been banned almost completely. But abortion-rights activists have argued that it’s more restrictive than meets the eye and will have far-reaching consequences. Since Roe was overturned, many patients traveling from more restrictive states have become dependent on North Carolina as a locale for abortions later in pregnancy. Republicans call the legislation pro-family and pro-child, pointing to at least $160m in spending contained within for maternal health services, foster and adoption care, contraceptive services and paid leave for teachers and state employees after the birth of a child. Mr Cooper has singled out four GOP legislators — three House members and one senator — whom he said made “campaign promises to protect women’s reproductive health.” Anti-abortion groups accused Cooper of trying to bully them. One of those House members is Rep Tricia Cotham of Mecklenburg County, who voted for the bill mere weeks after she switched from the Democratic Party to the GOP. The move gave Republicans a veto-proof supermajority if all of their legislators are present and voting. Ms Cotham has spoken out for abortion rights in the past and even earlier this year co-sponsored a bill to codify abortion protections into state law. Rep Ted Davis of Wilmington — another targeted legislator — was the only Republican absent from last week’s initial House vote. The Senate margin already became veto-proof after GOP gains last November. Mr Davis said last fall that he supported “what the law is in North Carolina right now,” which was a 20-week limit. Davis has declined to comment on the bill, but House Speaker Tim Moore said recently that Davis is a “yes” vote for an override. 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South Carolina's Republican Gov. Henry McMaster has called the state legislature back for a special session Tuesday to continue to work on a bill that would ban most abortions as early as six weeks and other legislation.