Skip to main content

Small victories

 The right wing keeps trying but this time it's another victory for justice and common sense...

"An Iowa law that prohibits Medicaid coverage for sex reassignment surgeries for transgender residents violates state law and the state constitution, a judge ruled in a decision made public Monday.

Judge William Kelly ordered the Iowa Department of Human Services to provide coverage for sex reassignment surgeries when ordered to treat gender dysphoria, a psychological distress that results from an incongruence between one’s sex assigned at birth and one’s gender identity. It often begins in childhood, and some people may not experience it until after puberty or much later, according to the American Psychiatric Association.

At least nine states across the U.S. explicitly exclude gender-affirming care in Medicaid coverage, while 24 states and Washington, D.C., explicitly include this type of care, according to the Movement Advancement Project, an LGBTQ think tank. The remaining states have no explicit policy.

The ruling is a victory for Aiden Vasquez and Mika Covington, two Iowans represented by the American Civil Liberties Union of Iowa.

Kelly said state and federal courts in the past 16 years have found that gender identity discrimination is a form of sex discrimination which is prohibited under civil rights laws. He also found the law violated the equal protection clause of the state constitution.

It is not challenged in the record that surgical treatment for gender dysphoria is a serious medical condition and the surgery is recommended for Vasquez and Covington by medical professionals as necessary and effective, the judge said. He said Medicaid coverage is fundamental to ensure the availability of that treatment for economically disadvantaged Iowans.

“Once the medical community determined that surgery is medically necessary to treat this health issue, the government lost its rational basis to refuse to pay for the surgery,” Kelly said in a ruling signed on Friday but posted publicly with online court records on Monday. “The law appears to draw an arbitrary distinction. So, there is no plausible policy reason advanced by, or rationally related to, excluding transgender people from Medicaid reimbursement for medically necessary procedures.”

Rita Bettis Austen, legal director of the ACLU of Iowa, called the decision “a historic win for civil rights” in Iowa.

“It recognizes what we’ve long known, that transgender Iowans must not be discriminated against, and that they are protected by the Iowa Constitution’s guarantee of equal protection, as well as by the Iowa Civil Rights Act,” Bettis Austen said.

The ACLU of Iowa filed a lawsuit in April against the state of Iowa challenging a 2019 law that allows Medicaid to deny payment for sex reassignment surgeries for transgender residents.

Vasquez and Covington initially sued in 2017 and a state court judge found the policy violated the Iowa Civil Rights Act and the Iowa Supreme Court in 2019 upheld that decision. The court concluded that Iowa’s Medicaid program may not categorically discriminate against transgender people seeking gender-affirming, medically necessary care.

Shortly after the court ruling, Republicans in the Iowa Legislature passed an amendment as part of a last-minute addition to a human services budget bill in response to the court’s ruling. That change stated that any government agency in Iowa may decline to use taxpayer money for “sex reassignment surgery” or “any other cosmetic reconstructive or plastic surgery procedure related to transsexualism, hermaphroditism, gender identity disorder, or body dysmorphic disorder.”

Vasquez and Covington, however, had to take their cases through the Department of Human Services system and apply for surgery, have it denied based on the new law and then again pursue a challenge in court. The Iowa DHS has since denied coverage to them. Vasquez is a transgender man who was diagnosed with gender dysphoria in 2016 and Mika Covington is a transgender woman who was diagnosed with gender dysphoria and began receiving hormone therapy in 2015.

Gov. Kim Reynolds signed the bill into law in May 2019, arguing it only narrowly clarifies that Iowa’s Civil Rights Act does not require taxpayer dollars to pay for sex reassignment and other similar surgeries.

Reynolds’ spokesman Alex Murphy said she is disappointed by the ruling “and disagrees with the district court’s ruling on Medicaid coverage for transgender reassignment surgeries. We are reviewing the decision with our legal team and exploring all options moving forward.”


Popular posts from this blog

One transgender woman's take on AGP

This entry from the transhealth website dates back to 2001 and it offers a very nice dissection of the now mostly debunked but still controversial AGP theory and how this transgender woman could care two cents about it. People who have been trying to marginalize the experience of gynephilic transwomen have pushed for the stigmatizing idea that they are actually perverted men. Well this soul, who couldn't give a hoot either way, isn't buying any of it and her frankness at times had me chuckling to myself as I read her posting. If we ever met I would give her a hug for seeing through the BS but mostly for being herself: "About a year ago I was reading on Dr. Anne Lawrence’s site about a new theory of the origin of trans called “autogynephilia.” This theory asserts that many trans women—and transsexual women in particular—desire reassignment surgery because they are eroticizing the feminization of their bodies. The first thing that struck me about it, of course, was t

Never Say Never....

 I was certain that I would never post here again and yet, here I am. It’s been several years, and life has changed me yet again. I have burrowed further into my psyche to discover more internal truths about myself all in the silence of a life lived with more periods of reflective solitude than ever before. After attempting for many years to be a problem solver for others, I needed to dig deeply to discover who I was, which should be a necessity for all people and an absolute imperative for those of us who dare rub against the grain of conventional society. The most important thing we can do for ourselves is honor the internal voice which has driven us since childhood. That whisper which we were compelled to ignore through our initial indoctrination must be listened to again for guidance. I knew I had spent too long heeding messaging that wasn’t working for me as a trans person, and it was time to stop. For the world gleefully basks in a level ignorance and hypocrisy we are not abl

my last post

This will be my last blog post. When I wrote recently that this blog had another seven years of life in it I was trying to convince myself that it was true. It was in fact a little bit of self delusion. With almost 3,000 posts to date I have accomplished what I set out to do which was to heal myself and in the process share some of the struggle I had been through with others on the chance they might find some value in my words. After seven years of writing, my life still isn't perfect; no one's is. But I have discovered a path forward completely free of the trappings which society would have had me adopt so I could fit in. Over the last 25 years of my life I have turned over every stone I could find while exploring this topic and in the process realized that we haven't even begun to scratch the surface of this deeply complex subject. What I have ultimately learned is that my instincts have more value than what someone who isn't gender dysphoric writes about me. We