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The Iowa Supreme Court picked an interesting way to celebrate International Women’s Day.

The court ruled on Friday that Iowa’s Medicaid program can no longer categorically ban “gender-affirming” surgery for transgender Iowans.

The ACLU of Iowa brought the lawsuit because the Iowa Department of Human Services had a ban on Medicaid coverage for transition-related care for transgender people.
The court by the decision was unanimous. DHS had argued such medical care was primarily for psychological or cosmetic reasons.

The Iowa Supreme Court highlighted the Iowa Civil Rights Act, which prohibits discrimination based on gender identity. A lower court’s decision was affirmed in saying gender dysphoria has a biological component and the current medical consensus no longer supports the conclusion that gender affirming surgery is not therapeutic. Medical thinking and Iowa law has changed.

Carol Ann Beal, one of the clients, said this is health care transgender people desperately need.

“I’m so glad we finally won. I’m still processing this,” she said. “But I’m extremely happy for those people who will come after me, that we’ve made a path for them so that they can get the medical care and surgery they need.”

State legislators have sounded off about the decision on social media.

Republican Rep. Phil Thompson posted: “I worked with constituents depending on Medicaid dollars this morning troubleshooting the system…then this…let’s talk about priorities, friends.”

Republican Rep. Steven Holt posted: “The danger of having protected classes in Iowa Code. Now, taxpayers must pay for these procedures, when the cost of Medicaid is already out of control. Gender identity is not a protected class in federal code. When gender identity was put into Iowa code as a protected class, while Democrats were in control, it made this ruling inevitable. The moral and financial implications of this ruling are profound and must be addressed.”

Republican Rep. Skyler Wheeler posted: “Your tax dollars will now be used to pay for people changing their genders. We need to pull gender identity out of the civil rights code and put a stop to this ridiculousness.”

Democrat Sen. Claire Celsi posted: “Once again, Iowa’s fair and impartially chosen Supreme Court does the right thing for Iowans.”

One Iowa, the state’s LGBTQ advocacy group, called it “an incredible victory that will, quite literally, save lives.”


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