Iowa OK's Denial of Public Funds for Gender-Affirmation Surgeries

Iowa's governor has signed into law a bill that allows the state and municipalities to opt out of using public funds, including Medicaid, to pay for residents' gender-confirmation surgery.

"The opt-out applies to any other cosmetic reconstructive or plastic surgery procedure related to 'transsexualism, hermaphroditism, gender identity disorder, or body dysmorphic disorder,'" The Des Moines Register reports.

The provision is part of the state's budget bill, signed into law Friday by Gov. Kim Reynolds, a Republican. It comes in reaction to a decision by the Iowa Supreme Court in March that struck down a ban on the use of Medicaid funds for gender-confirmation surgeries.

"This narrow provision simply clarifies that Iowa's Civil Rights Act does not require taxpayer dollars to pay for sex reassignment and other similar surgeries. This returns us to what had been the state's position for years," said a statement issued by Reynolds spokesman Pat Garrett.

LGBTQ rights groups denounced the measure, which is the first piece of explicitly anti-trans legislation signed by a governor since Pat McCrory of North Carolina signed the infamous House Bill 2 in 2016. "By signing this cruel legislation into law, Gov. Reynolds has told every transgender Iowan that they are second-hand citizens and unwelcome in our state," One Iowa Action said in a statement.

"This bill will not save Iowan taxpayers a nickel but will force transgender Iowans to face severe hardship," added Mara Keisling, executive director of the National Center for Transgender Equality, in a press release. "The entire medical world knows exclusions like these put dangerous barriers between people and the safe and effective health care their doctors say they need. I'm sorely disappointed to see Governor Reynolds put her signature on such a backwards policy, one that will certainly stain Iowa's reputation as a welcoming place for employers, current residents, and visitors."

"It's deeply disappointing that Gov. Kim Reynolds is caving to the pressure from some radical lawmakers in the Iowa Senate, instead of protecting the rights and dignity of transgender Iowans," said a statement from JoDee Winterhof, senior vice president of policy and political affairs at the Human Rights Campaign. "Gov. Reynolds had the option to line-item veto this provision and leave the rest of the funding bill intact, but she did not. This sends a strong message that she is not working for all of her constituents and a craven desire to please Iowa's most extreme lawmakers. As a native Iowan, Iowa deserves better -- and different -- leaders."

Activists pointed out that the anti-trans provision was added to the budget bill at the last minute. So was another controversial section, which "cuts off about $260,000 in federal money from two grant programs [administered by the state] that went to sex education programs offered by Planned Parenthood," the Register reports. It prohibits the funds from going to any organization that provides abortions, even though the money cannot be used for those procedures.

"This is a huge loss to the thousands of youth who would benefit from comprehensive and nonjudgmental sex education," which actually help to reduce abortions, Erin Davison-Rippey, state executive director of Planned Parenthood North Central States, said in a statement to the Register.