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March 12, 2019 (LifeSiteNews) – Iowa must allow gender-confused residents to obtain “gender-reassignment” treatments at taxpayer expense, the Iowa Supreme Court ruled Friday.

The case stems from a discrimination suit against the state Department of Human Services by Eerieanna Good and Carol Beal over its classification of transition-related surgeries as “cosmetic, reconstructive or plastic surgery,” and administrative code excluding “surgeries for the purpose of sex reassignment,” The Blaze reports.

The plaintiffs got a district court to agree that such surgeries were “medically necessary,” spurring state health officials and Assistant Attorney General Matthew Gillespie to appeal.

“This case is not about transgender Iowans at all,” Gillespie argued, but rather the treatment in question was for physical or psychological purposes, and that the Iowa Constitution contained no mandate to cover all services. Gender-reassignment procedures can cost anywhere from $20,000 to $100,000.

“The department has a limited number of funds, he said. “We're limited in what we can cover and what we can do,” he said.

Nevertheless, the state Supreme Court upheld the district court ruling, with Justice Susan Christensen writing that to exclude the procedures from Medicaid “discriminates” against transgender Medicaid recipients in Iowa. She noted that an amendment to the Iowa Civil Rights Act of 2007 specifically added “gender identity” as a protected criteria, and that Medicaid already covers certain cosmetic or reconstructive surgeries for other purposes, such as “Revision of disfiguring and extensive scars resulting from neoplastic surgery” or “Correction of a congenital anomaly.”

The Iowa Department of Human Services has so far declined to comment, but a spokesperson for the attorney general’s office implied that the matter is unlikely to be appealed.

“As the ruling showed, this case presented a difficult question involving individual rights and the state’s interests,” Lynn Hicks told the Des Moines Register. “This issue was a first for Iowa’s courts, and we thank the court for its guidance and for resolving this issue.”The Iowa Supreme Court is no stranger to left-wing rulings; last summer, it ruled that Iowa cannot make women wait 72 hours before obtaining abortions, despite the U.S. Supreme Court having upheld 24-hour waiting periods.