The Iowa Supreme Court ruled that the state's Medicaid program must cover sex reassignment surgery for transgender people.

The court ruled Friday that the Iowa Department of Human Services discriminated against two women by denying their Medicaid claims for transition-related care.

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“The ruling means that many transgender Iowans will be able to obtain life-saving medical care that they were unable to get in the past," said John Knight of the American Civil Liberties Union (ACLU), which represented the women.

The state argued that transition-related surgeries were not covered by Medicaid because they were "cosmetic, reconstructive or plastic surgery." It specifically banned "surgeries for the purpose of sex reassignment."

The decision upheld a lower court's ruling that the state's policy went against the state's civil rights act, which protects against gender-identity discrimination.

But the ACLU argued that the womens' medical providers determined the surgeries were medically necessary to treat their gender dysphoria.