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The Iowa Supreme Court unanimously ruled Friday that the state could no longer ban Medicaid recipients from receiving taxpayer-funded sex change operations, ruling that transition surgeries are medically necessary.

Transgender women Eerieanna Good and Carol Beal had sued the Iowa Department of Human Services for discrimination over its administrative code classifying transition-related surgeries as “cosmetic, reconstructive or plastic surgery.” The code explicitly bans “surgeries for the purpose of sex reassignment.”

The plaintiffs insist “gender-affirming” surgeries are “medically necessary” for them in order to treat their gender dysphoria, and a district court ruled in their favor. DHS appealed, with Assistant Attorney General Matthew Gillespie arguing that the case was not about the discrimination of transgender Iowans, but whether the state had appropriately denied coverage for surgeries intended to treat psychological conditions, the Washington Examiner reported.

The Supreme Court upheld the lower court’s decision, with Justice Susan Christensen writing that the state’s “bar on Medicaid coverage for gender-affirming surgical procedures discriminates against transgender Medicaid recipients in Iowa” under Iowa civil rights laws. The justice pointed to the fact that the state amended the Iowa Civil Rights Act in 2007 to add “gender identity” to the list of protected groups.

Justice Christensen also noted in the decision that Medicaid already covers the costs of some cosmetic or reconstructive procedures, such as “‘[r]evision of disfiguring and extensive scars resulting from neoplastic surgery’ and ‘[c]orrection of a congenital anomaly.’ Yet, it prohibits coverage for this same procedure if a transgender individual.”

According to the Des Moines Register, transgender surgeries can range in cost from $20,000 to $100,000, “putting it out of reach of individuals who qualify for the assistance.” Now, those out-of-reach costs must be covered by taxpayers.

John Knight of the American Civil Liberties Union — who represented the plaintiffs — hailed the court’s decision, saying in a statement: “The ruling means that many transgender Iowans will be able to obtain life-saving medical care that they were unable to get in the past. We are thrilled that the Iowa Supreme Court rejected the Department’s effort to minimize the importance of this surgery by labeling it as cosmetic and unanimously struck down this harmful ban on necessary health care.”

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17 Comments

17 Comments

  1. ann

    March 12, 2019 at 2:51 am

    I have held a job since high school and never used public assistance yet I now find I have a hernia the size of a grapefruit and am putting off surgery because I can’t afford the copays and deductibles for my self pay insurance. Not to mention what’s left that the insurance won’t cover anyway. But if you are a lazy freak and dependant on other people’s money there is no limit and no cost to high to pay. When will the crazy end?

    • Wilson

      March 12, 2019 at 3:22 am

      Tell em you want hernia “transition” surgery. Just make up some BS mental illness to go with it.

    • Granny

      March 12, 2019 at 8:42 am

      You are so right. My son was hit by a car but until he pays his deductable $6,650.00 , insurance doesn’t do anything. He was a special ed student but never on welfare. He has worked all his life And contributes to society. Then a freak comes along and they hand them money for shit. Makes me so angry I could spit bullets. Why? My question to these idiot judges, why? You put all that money into them and then they kill themselves because this is a mental problem, not a health problem. Ask someone who lost an arm or leg while working how hard it is to get fixed. Ask them you stupid judges?

  2. Lisa Balla Millar

    March 12, 2019 at 3:44 am

    Absolutely stupid to pay for transgender operation. Heard of a guy in prison that wanted it; don’t know if he got it. Why do our idiots in DC or in the courts come up with the stupidest thing. Its an unnecessary surgery and waste of taxpayers money. Who are these stupid people! Others, vets included, often go without needed medical care. Boy do these idiots know how to waste our money!

  3. Kay

    March 12, 2019 at 4:11 am

    A Travesty of Justice! This Trans Mental Illness Epidemic needs to be Stopped, not Encouraged!

  4. John R. Pyles III

    March 12, 2019 at 6:40 am

    so elective surgery such as this is okay, no meat for kids on mondays in New York City. AOC telling We the People she’s our boss the list goes on and on. America a storm from the left coast is coming be prepared

  5. Margaret Leonardi

    March 12, 2019 at 6:56 am

    Many people would like surgeries such as breast reductions, hair and teeth implants that would greatly improve their mental and physical state. I myself would like a few improvements done but my insurance company considers these surgeries as cosmetic. Where do these confused individuals get off of getting this paid for? I don’t know who has the bigger problem, the ones who can’t figure out their genders or these wacko judges.

  6. Sleroangel

    March 12, 2019 at 6:58 am

    This is absolutely outrageous.. People who work hard and need medical surgery hold off because they can’t afford it and yet these people who don’t know who or what they are can go and get transgender surgeries and tax payers pay for it.. That is SO WRONG ON SO MANY LEVELS. Get a job and pay for insurance like the rest of us. Medicaid is for poverty level assistance for medical not for changing you gender.. I don’t live in Iowa but those tax payers need to fight this big time.. It is not right. It is not an emergency or medically needed surgery.

  7. Doris Frazier

    March 12, 2019 at 7:00 am

    This is absolutely outrageous.. Tax payers should not have to pay for such surgeries.. Medicaid is for povertly level individuals who need medical attention. Transgender surgery is not an emergency situation.. People need to get a job and pay for their insurance to get such surgeries..Why should tax payers have to pay.. this is wrong in so many ways.

  8. Earnie Bailey

    March 12, 2019 at 7:46 am

    I’ve had enough of these judges. Elective surgery has never been covered. That is what it is. I’m not sure who these judges are but they need to rethink their bullshit!
    All of these positions are spending our money without asking the taxpayers. What happened to the voice of the people?

    • Granny

      March 12, 2019 at 8:45 am

      We are represented by idiots. We have them in Pa and every other state in this union. Time to march on DC and tell them whose the boss.

  9. fred

    March 12, 2019 at 10:46 am

    `when is the next pecker transplant scheduled ? I’m straighr but could stand a new improved size.

  10. Edward Bennett

    March 12, 2019 at 10:47 am

    In this case I think it would be justifiable to have these denizens of the court system transgendered to the opposite sex, whatever that might be, just to see if the system works.
    What a bunch of clowns, playing with other people’s money without a care for decency

  11. Country gal

    March 12, 2019 at 12:21 pm

    Dental insurance is not given. Teeth are not just for cosmetic reasons. Why. when you have perfectly working parts would the government pay to change them?? It is not medically necessary.

  12. carolyn

    March 12, 2019 at 12:24 pm

    What utter bull! Maybe you should look into paying for mental health services instead of trying to make boys into girls and vice-versa! Our Creator made us either male or female. Ever notice that he has done the same thing in the animal kingdom? 2 genders, get it? If these people are so deranged that they think that they’re really supposed to be the opposite sex, let them pay for their own surgeries.
    There are many people who are in real need of surgery which could be the difference between life and death.Yet many can’t afford the needed treatment due to the sky high deductibles, insurance won’t cover,etc.,yet they can’t get the ‘state’ to help them! This really makes me mad!
    I’ll be very careful as to what judges that I vote for in the future…

  13. Joe E

    March 12, 2019 at 4:22 pm

    Lets test the system. Assume that a biological male with average male genitalia is depressed and exhibits debilitating gender dysphoria because he isn’t hung like a male porn star. He is unable to sate his profound desire to enhance his lifestyle without undergoing radical penis lengthening surgery. The surgeries would restore his mental health and wellbeing by giving him the opportunity to live the lifestyle of his choice rather than that provided at birth.

    Would the Iowa Supreme Court rule in his favor and allow this Medicaid recipient to receive his taxpayer-funded sex change operations by ruling that his penis lengthening surgical procedures are medically necessary to satisfy his debilitating mental dysphoria?

  14. Linda

    March 12, 2019 at 6:07 pm

    So, within the decade will taxpayers be burdened with the bill to reverse the huge mistake these oddities made??? Sex change should be considered cosmetic surgery, as far as, I am concerned….it is not life saving.

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