On January 18, 2023, the Iowa Supreme Court heard oral arguments in our continuing litigation regarding discrimination in coverage of medically necessary gender-affirming surgery for transgender care.
A timeline of this litigation can be found here.
Below are media statements from the clients and attorneys involved.
Statement from Aiden Vasquez (pronounced Vas-KEZ)
“For me and many others, being transgender is not easy and something that many other people may not yet understand. My gender dysphoria means I have a body that doesn’t match who I know I am–a man. This is made worse by a society that labels me as wrong or sinful, mentally ill or odd. Which is not the case.
"Because of this, transgender people are continuing to be discriminated against and their civil rights threatened. This is something that doesn’t just affect me. I have spoken to thousands of transgender people, moms, dads, family members. The stories of hate, suicidal ideation and attempts, the loss of a child and parents, misunderstandings and unequal treatment of transgender people, breaks my heart—along with the denial of healthcare I’ve received .
"I am proud to be a part of this history making litigation and proud to be standing up for the justice of all transgender Iowans and hope to set a precedent for other states to do the same . What we need to realize is that everyone in our society deserves to be treated with respect, dignity and allowed healthcare and equal opportunities."
Statement from Mika (pronounced MIKE-uh) Covington
"I have been an Iowan for years now, but I grew up in Nebraska, which does not include transgender people in its civil rights code. Because of that, I personally experienced discrimination in so many aspects of my life, just because I was transgender, in situations where gender shouldn't matter—like being denied care for a serious kidney condition and instead being referred to mental health providers.
"I am so glad that here in my state, Iowa law recognizes that transgender people should be treated just like everyone else and we include transgender people in our civil rights code. That’s why it was so devastating when the Iowa legislature changed our civil rights act to take away that equal treatment for transgender people on Medicaid. I am hopeful that the Court will return things to the fair way it used to be.
"This litigation has been a long and difficult journey. I am glad that Iowa Medicaid no longer has a rule that specifically prohibits transgender people from getting certain types of surgery, including surgery they would cover for people who are not transgender. That's the way it should be when it comes to medically necessary care. A person needs surgery, recommended by their doctor, and insurance pays for it.
"I hope that moving forward, for all the transgender people who come after me, that this litigation has resolved that and they can get the care they need without judgment and unfair roadblocks."
Statement from Seth Horvath, cooperating attorney with Nixon Peabody in Chicago
"The case argued today is an important one for all Iowans. We’ve asked the Supreme Court to restore, once and for all, the important protections the legislature took away in 2019. We’re hopeful that the Court will affirm the district court’s ruling that the legislature’s amendment to the Iowa Civil Rights Act is unconstitutional.
"In 2019 the Iowa Supreme Court found that denying Medicaid coverage for medically necessary gender-affirming surgery violates the Iowa Civil Rights Act. Less than two months later, the legislature passed a law— using a procedural tactic in a budget bill—to allow the discriminatory denials to continue.
"Make no mistake: The Legislature knew exactly what it was doing when it took away civil rights protections for transgender Iowans. By limiting the rights of these people, the legislature jeopardized the rights of each and every citizen of this state. If it can happen to them, it can happen to you.
'Mr. Vasquez and Ms. Covington aren’t asking for special treatment. They’ve spent nearly four years fighting for equal access to medically necessary health care prescribed by qualified medical professionals. They want, and are entitled to, the same access as every other Iowan. Their patience and their dedication are a credit to every single Iowan who cares about fundamental fairness, good government, and the rule of law."
Statement from ACLU of Iowa Legal Director Rita Bettis Austen
"The amendment to the Iowa Civil Rights Act has no basis in medicine or science. Every major medical association agrees gender dysphoria is a serious medical condition and that surgical treatment is medically necessary for some transgender people. That includes the American Medical Association, the American Psychological Association, the American Academy of Family Physicians, the American College of Obstetricians and Gynecologists, the National Association of Social Workers, and the World Professional Association of Transgender Health (WPATH).
"It is a clear violation of equal protection under the Iowa Constitution because it facially and intentionally discriminates against people simply because they are transgender."