Iowa was "cruel" and violated its state constitution by allowing government officials to withhold Medicaid funds for surgeries for individuals with gender dysphoria, The American Civil Liberties Union (ACLU) said on Friday.
The group's Iowa chapter filed a lawsuit, challenging a state amendment to its Civil Rights Act granting officials that discretion. According to the lawsuit, the state's Supreme Court said those types of restrictions violated its Civil Rights Act in addition to the equal protection guarantee of the state's constitution.
"This cruel amendment 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," Rita Bettis Austen, Legal Director of the ACLU of Iowa, said.
"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)."
At the federal level, President Trump's administration disputed the idea that sex-based discrimination under law included protections for gender identity. The Health and Human Services Department, in May, angered progressive advocates with rules that both allowed doctors not to perform certain surgeries and ruled that "gender identity" was not protected under sex discrimination law in health care.
While it's unclear how Iowa's court will rule, Gov. Kim Reynolds, R, has already signaled that her administration wouldn't back down from the amendment. Her approval also seemed to come as a reaction to the Iowa Supreme Court's decision on the state's Civil Rights Act.
"This takes it back to the way it's always been," she said, according to a local CBS affiliate. "This has been the state's position for decades."
The ACLU, however, indicated that another one of its cases may provide a basis for striking down Reynolds' amendment. In Vroegh v. Iowa Department of Corrections et al., a jury awarded the group's client thousands of dollars after the state refused to pay for its employee's surgery.
While Reynolds' amendment addressed the public accommodations portion of the Civil Rights Act, that particular lawsuit was brought under a different provision regarding employment discrimination.