In a unanimous ruling, the Supreme Court in the state of Iowa ruled that sexual transition procedures must be covered by Medicaid as sex change operations are “medically necessary” according to the ruling.
According to The Washington Examiner, the American Civil Liberties Union (ACLU) represented two plaintiffs, transgender women Eerieanna Good and Carol Beal, in their case against the Iowa Department of Human Services (DHS) calling their administrative code discriminatory. The code previously treated sex-change and related surgeries as cosmetic, with an explicit ban on sex reassignment surgeries themselves.
Carol Beal was quoted as saying “This has been a long time coming. I’m so glad that I can get the care I need, and I’m glad that other Iowans can now get the same care. Transition-related care is a medical issue, plain and simple.”
The plaintiff’s case laid in redefining the sex change operations as medically necessary in the treatment of the gender dysphoria that they experience.
They initially won in a district court ruling, however, that was appealed by DHS countering that the existing codes were not discriminatory and the situation was more a matter of ensuring the use of Medicaid funds went towards medically necessary procedures rather than to treat psychological problems.
The initial ruling was upheld in the Supreme court stating that the code was, indeed, discriminatory and the procedures will henceforth need to be covered.
Key factors in the case included Medicaid funds already being used for various forms of reconstructive and some cosmetic surgeries, and that in Iowa since 2007 transgendered persons and gender identity, in general, has been listed as part of the protected groups under their Iowa Civil Rights Act.
Whether this particular ruling will spill into other states with similar protections from gender identity groups has yet to be seen, however, the ACLU and the two plaintiffs were thrilled by the results and consider it to be a win for trans persons overall.