Court rules Iowa Medicaid can’t deny gender confirmation surgery

Aiden Vasquez and Mika Covington. Photos courtesy of ACLU of Iowa

Last week a judge ruled that Iowa Medicaid’s refusal to cover gender confirmation surgeries violates state law and the state constitution.

The Associated Press reported that Judge William Kelly ordered the Iowa Department of Human Services to provide coverage for gender confirmation surgeries when ordered to treat gender dysphoria.

The AP reported that 12 states specifically exclude transition healthcare while 18 specifically include it.

Illinois has specifically included transition healthcare in its Medicaid program since 2019. Nationally, more than 152,000 trans adults rely on Medicaid.

The decision is the latest in years of legal battles between Iowa and LGBTQ advocates in covering gender confirming health care. The ACLU of Iowa said this follows a five-year fight. A court had required coverage in 2019, but the state legislature passed a law that specifically excluded trans people. They filed the suit in 2017 on behalf of Mika Covington and Aiden Vasquez.

Rita Bettis Austen, ACLU of Iowa Legal Director, said, “This is a historic win for civil rights in Iowa. It recognizes what we’ve long known, that transgender Iowans must not be discriminated against, and that they are protected by the Iowa Constitution’s guarantee of equal protection, as well as by the Iowa Civil Rights Act.”

“Not all transgender people need surgery, but I do,” said Vasquez. “I am a man, but I was born into a body that I experience as not being who I am without this surgery. That’s why this surgery will be life-changing. I have seen too many other transgender people suffer because they can’t get the care they need. I’m doing this for them, too.”

“This is so important because it affects the lives of so many transgender people in Iowa,” said Covington. “Days like today make me proud to be an Iowan.”