Iowa Medicaid Provider Agrees to Cover Treatment for Gender Dysphoria for Transgender Man

Des Moines, Iowa – Today the ACLU of Iowa and the national ACLU LGBT Project announced that one of Iowa’s private Medicaid providers, Amerigroup, has agreed to pay for medically necessary gender-affirming surgery for a transgender Iowa man.

ACLU client Andrew Evans, a resident of central Iowa, was seeking Medicaid coverage for surgery to treat his gender dysphoria, a condition that is officially accepted by medical experts in the United States. Evans was initially unable to obtain coverage for the procedure, because of a ban in Iowa law against paying for transition-related surgeries even when medically necessary and even though the same procedures are covered by Medicaid for persons who are not transgender.

“I am so happy that I will be able to receive the care I need,” said Evans. “I wanted to fight for coverage so that I and other transgender Iowans can get Medicaid coverage for the medical care we need, like everyone else.”

It is widely recognized that transition-related surgery is medically necessary to treat gender dysphoria for some transgender people. For many transgender people, surgery can literally save their life. In Andrew’s case, medical professionals determined that surgery was medically necessary for him.

While Amerigroup agreed to pay for Evans’ procedure, they did not indicate whether it would cover any other Medicaid recipients’ gender-affirming care in the future. Even with this victory for Evans, Iowa’s discriminatory insurance regulation banning coverage for such surgery remains in place.

Rita Bettis, ACLU of Iowa legal director said, “It’s a core Iowa value to treat all people fairly. Iowa’s discriminatory ban on Medicaid coverage for the medical care that transgender people need is inconsistent with basic fairness. It needs to go.”

“We stand with transgender Iowans against all forms of discrimination and will continue to fight to end the Medicaid ban on transition-related care. We encourage other transgender Iowans who have Medicaid to contact us if they are denied coverage for transition-related surgeries, since we intend to fight to end Iowa’s discriminatory ban,” Bettis said.

The case is the second ACLU action seeking insurance coverage for surgery to treat gender dysphoria. The ACLU is also representing Jesse Vroegh, an Iowa prison nurse, who in July filed

a complaint with the Iowa Civil Rights Commission, because his employer, the Iowa Department of Corrections, denied him health coverage for transition-related surgery.

“I’m thrilled that Andrew’s fight for the surgery he needs is over and hope we can assist others in securing this life-saving medical care,” added John Knight, senior staff attorney at the ACLU’s LGBT Project.

The ACLU LGBT Project recently announced that it was successful in striking down a similar ban in Minnesota.