Our Medicaid system should treat everyone, including transgender Iowans, equally and fairly. However, the state is currently denying Medicaid coverage for gender-affirming surgery that's medically necessary.
That's why the ACLU has filed a lawsuit on behalf of Aiden Vasquez. This lawsuit follows an earlier, similar lawsuit by Aiden and Mika Covington that also asked the courts to declare the state's practice of denying coverage unconstitutional.
Both Mika, who lives in central Iowa, and Aiden, who lives in southeast Iowa, are transgender and qualify for Medicaid. Their doctors agree strongly that they need gender-affirming surgery to treat gender dysphoria.
Iowa law intentionally discriminates against Medicaid recipients simply because they are transgender. It brings significant harm to people like Aidena and Mika and others who rely on Medicaid and who desperately need this surgery. This law has no basis in medicine or science, and gender dysphoria is a serious medical condition that, in some cases, puts people at risk for death by suicide.
The consensus among major medical associations is that gender dysphoria is a serious medical condition and that surgical treatment is medically necessary for some transgender people.
Aiden said that jumping through so many hoops just to try getting coverage for the surgery has been mentally and emotionally very draining and difficult—especially when he knows other Iowans on Medicaid are able to get coverage for the surgeries they need.
"I would like everyone to understand that we are not talking about cosmetic surgery or something superficial,” Aiden said. “This has affected my whole life in a negative way and has threatened my mental well-being. I am a man, but in a body that does not reflect who I am. That’s why this surgery will be life-changing. I have seen too many other transgender people suffer because they are unable to get the care they need.”
Mika, who is a University of Iowa student studying psychology and German, came out as trangender more than a decade ago. Yet she is forced to live in a body that does not align with her gender.
"Being able to finally get the surgery that my doctors have determined is medically necessary for me will do nothing less than give me my life back,” Mika said. “It will help me build a life in which my body is in harmony with my gender, so I can overcome the depression, lack of confidence, isolation, and other problems my gender dysphoria causes."
The state’s policy of denying transgender people coverage for medically necessary gender-affirming surgery is a clear violation of equal protection under the Iowa Constitution.
We’re determined to keep working in the courts to strike down this discriminatory law.