DES MOINES, Iowa (AP) — Two transgender women are suing an Iowa state agency, arguing the state’s ban on Medicaid coverage for sex reassignment-related medical services violates the state constitution.

The Des Moines Register reports that Carol Ann Beal of northwest Iowa and EerieAnna Good of the Quad Cities filed the lawsuit Thursday, saying the ban by the Iowa Department of Human Services violates patients’ rights to equal protection.

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Iowa’s Medicaid code bans sex reassignment surgeries, saying they’re “cosmetic, reconstructive or plastic surgery.”

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Rita Bettis is the legal director of the American Civil Liberties Union of Iowa, which is representing the women. She says the ban is unfair because transgender patients aren’t covered for some surgeries that non-transgender Iowa residents are, such as mastectomies.

The department declined to comment on the lawsuit, citing pending litigation.

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