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Iowa sued over prohibition on Medicaid for gender surgery

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DES MOINES, Iowa (AP) — The American Civil Liberties Union of Iowa filed a lawsuit Friday challenging a new state law that prohibits the use of Medicaid funding for gender reassignment surgery.

Iowa Gov. Kim Reynolds signed a bill on May 3 that included language amending the state’s Civil Rights Act so that government officials are not required to pay for gender reassignment surgery.

The ACLU sued Reynolds, the state and the Iowa Department of Human Services on behalf of One Iowa, a group that advocates for transgender rights, and two transgender Iowans who qualify for Medicaid and whose doctors say they need the surgery to treat gender dysphoria.

The lawsuit filed in state court asks a judge to declare the measure invalid because it’s unconstitutional and order the state to halt enforcement.

The lawsuit claims it violates the inalienable rights to liberty, safety and happiness and equal protection sections of article 1 of the Iowa Constitution.

The equal protection claim asserts that the state is intentionally singling out transgender Iowans as a class for discrimination.

ACLU of Iowa Legal Director Rita Bettis Austen says the measure “has no basis in medicine or science.”

“This is an extraordinarily ugly law and an extraordinarily dangerous law because it acts to take away rights that have previously been given under the state civil rights act,” she said.

She said major medical associations agree that surgical treatment is medically necessary for some transgender people and it is not an elective procedure.

Conservative Republicans in the Iowa Legislature passed the measure as part of a last minute addition to a human services budget bill in response to an Iowa Supreme Court ruling in March. The court said the Iowa Department of Human Services cannot block Medicaid from paying for gender reassignment surgery for two transgender women whose doctors recommended the procedure.

Republican Sen. Jake Chapman said as the bill was introduced that some lawmakers were hearing from their constituents who were upset by the court’s decision and believe “this is an elective surgery that if Iowans want to do, that’s fine but not with our taxpayer dollars.”

Reynolds spokesman Pat Garrett said she will work with the attorney general’s office to defend “this narrow provision clarifying that Iowa’s Civil Rights Act does not require taxpayer dollars to pay for sex reassignment and other similar surgeries — the state’s position for years.”

Aiden Vasquez, 51, is one of the transgender Iowans the ACLU is representing in the lawsuit.

He said he’s known he’s male since age 2 and his doctors have agreed that surgery is necessary to treat anxiety and depression caused by gender dysphoria, a condition experienced by some transgender individuals. He had scheduled a pre-operative consultation with a surgeon but after the Iowa law went into effect the surgeon’s office couldn’t confirm that Medicaid would pay for the consultation and the appointment was canceled.

“I am participating in this lawsuit to get the medical care I desperately need, and to pave the way for other transgender Iowans who need it too,” he said. “Tragically, society shames transgender people just for being who they are. But I’m not hiding anymore. I’m determined to help myself, and in that way, help others.”