The American Civil Liberties Union of Iowa has challenged the Iowa Department of Human Services in a recent lawsuit over the banning of Medicaid coverage for transgender Iowans.

Rita Bettis, the ACLU of Iowa legal director, said in a release that coverage for transition-related medical care, including surgery, is essential for some transgender Iowans.

“Every major medical association agrees that denying surgical care to transgender people who have a medical need for that surgical care is dangerous and contrary to prevailing standards of care developed based on decades of research,” she said in the release. “Our clients’ doctors have prescribed this surgical care, which they have found to be medically necessary. It is being withheld for non-medical reasons based on a blanket ban on coverage that stems from outdated and faulty assumptions about the nature of transgender health care.”

The lawsuit was filed on behalf of Carol Ann Beal of northwestern Iowa and EerieAnna Good of the Quad Cities.

“This surgery is not just something that I want,” Good said in the Iowa ACLU release. “It’s something that I very much need to resolve the depression and anxiety I face because my outside fails to match who I know I am: a woman.”

Beal agreed, and she said she looks forward to the day when people don’t have to go to court to get medical care.

“Transition-related care is a medical issue, plain and simple,” Beal said in the same release. “It’s like any other surgery that a doctor would recommend for you or a family member. Public or private insurance would pay for it, and you’d just do it and move ahead with your life.”

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Transition-related medical services for transgender people have been verified by professional associations including American Medical Association, American Psychological Association, the American Psychiatric Association, the American Academy of Family Physicians, and the National Association of Social Workers, according to the Iowa ACLU.

One Iowa, an LGBTQ advocacy organization, backed the ACLU of Iowa in its decision.

“Not only is this blanket ban discriminatory, but it also incorrectly categorizes gender-affirming surgery for transgender people as merely ‘cosmetic,’ ” said One Iowa Executive Director Daniel Hoffman-Zinnel in a statement released to The Daily Iowan. “This runs counter to the expertise of most major medical associations like the American Medical Association, American Psychological Association, American Academy of Family Physicians, the National Association of Social Workers, and the World Professional Association for Transgender Health. All of these prestigious organizations assert that gender affirming surgery is not “cosmetic” but medically necessary for many transgender people who experience gender dysphoria.”

Hoffman-Zinnel noted that the Iowa Civil Rights Act has protected Iowans from discrimination based on gender identity for years.

“We cannot sit idly by while this critical treatment is illegally denied to many in our state’s transgender community,” he said. “One Iowa is proud to stand with the ACLU of Iowa, EeriAnna Good, and Carol Beal to dismantle this discriminatory and misguided Medicaid ban.”

Kimberly Andresen-Reed, the executive director of Transformative Healing, an Iowa City-based group that works to end sexual violence in the lesbian, gay, bisexual, transgender, queer, questioning, and intersex community, suggested that people should address oppression of transgender people at several levels, not just legislatively but personally. She said questions alleging illegitimacy come from the unknown — these procedures, she said, are absolutely necessary.