Transgender in Iowa: Know Your Rights!

Transgender people are entitled to equal treatment in every aspect of employment.

• Potential employers may not ask about gender identity during interviews.
• If a dress code is gender-specific, you must be permitted to dress consistent with your gender identity.
• You should have access to workplace restrooms consistent with your gender identity.
• You are also protected against coworker harassment. Notify your employer in writing if this occurs.
• In addition to violating the Iowa Civil Rights Act, workplace discrimination against transgender people violates a federal law covering “sex” discrimination (Title VII).
• Employer-provided health insurance must not exclude coverage for medically necessary gender-affirming surgery. In fact, in an April 2022 decision, the Iowa Supreme Court upheld a $120,000 jury award and found that the State had unlawfully discriminated against a former transgender employee by providing an employee health insurance plan that denied coverage for medically necessary gender confirmation surgery. 

Students, teachers, and staff may not be discriminated against on the basis of gender identity.

• ICRA applies to all K-12 schools, public and private, except bona fide religious institutions.
• The Iowa Safe Schools Law requires all such institutions to adopt policies that prohibit anti-gender identity harassment and bullying.
• Discrimination based on gender identity or sex stereotyping at a school or college receiving federal funding may also violate federal law (Title IX).

You may not be denied access to the premises of a public accommodation or any of its goods or services on the basis of your gender identity.

• A public accommodation is any place or service that offers goods or services to the public at a price (whether privately or publicly owned) or that receives government subsidies or tax support. Examples include stores, restaurants, hotels, gyms, doctor’s offices, hospitals, social service agencies, public parks, public transportation, and Medicaid.
• The ICRC maintains that under ICRA, people must be allowed to use public restrooms consistent with their gender identity, regardless of sex assigned at birth.

The Iowa Civil Rights Act prohibits discrimination in most private health care services and employer-provided healthcare insurance coverage. This means that you cannot be refused insurance coverage or medical care based on your gender identity. This includes denial of coverage for “gender incongruent” care like a trans man’s Pap smear.

Both public (government) and private employer-provided health insurance must not exclude coverage for medically necessary gender-affirming surgery.

Iowa Medicaid

For a very long time, Iowa Medicaid—a type of government insurance—specifically excluded coverage for medically necessary gender-affirming surgery. After years of litigation and legislative changes, the state has decided not to appeal a court decision finding that the exclusion violated the Iowa Constitution, and Iowa Medicaid is currently covering this needed care. 

For more details on Iowa Medicaid coverage for transgender Iowans, click here.

Employer-provided health insurance 

Private insurance, usually offered through an employer, also must comply with the Iowa Civil Rights Act's nondiscrimination requirements in health care benefits.

Many private insurance plans cover surgery and other treatments when medically necessary for gender dysphoria. Inquire with your insurer about your options, and if coverage is not available, consider asking your employer to update its plans, and if necessary, filing a complaint with the Iowa Civil Rights Commission for discriminatory health care insurance benefits at work. 

Contact the ACLU for assistance with health care and insurance coverage.

You may not be treated differently with respect to any aspect of the purchase or rental of residential property, or in home loans or property insurance, on the basis of your gender identity.

• ICRA covers almost all housing, including shelters, but has limited exceptions for religious institutions and for owner-occupied buildings of two or fewer units (and houses in which four or fewer rooms are available for rent).
• Sellers and brokers may not discriminate in advertising or showing properties.
• Anti-trans housing discrimination may also violate the federal Fair Housing Act as “sex” discrimination.

A bank or lender may not discriminate on the basis of gender identity.

This might include refusing to enter into a consumer credit transaction; imposing onerous or unfavorable terms or conditions on a loan; or refusing to offer credit life or health and accident insurance because of your gender identity.

In general, ICRA’s gender identity protections do not apply to bona fide religious institutions that have bona fide religious requirements.

What does this mean? Just because an institution is religious in nature does not mean it may discriminate on the basis of gender identity. However, it may be exempt under ICRA if it is run for the sole purpose of furthering a religious goal, and the institution says discrimination is necessary to achieve some specific religious purpose.

In Iowa, you may change your legal name by filing a petition in court. By submitting that court order and other documentation, you can change the name and gender marker on other documents, including your birth certificate, driver’s license or non-operator’s ID card, Social Security documents, passport, citizenship and immigration documents, financial records, etc.

For a detailed how-to guide on changing your name and gender marker on your identification in Iowa, see "The Iowa Guide to Changing Legal Identity Documents," University of Iowa LGBTQ Health Clinic (2024). Available here.

Iowa law does not include "gender identity" within its hate crimes provisions, but under federal law, crimes targeting transgender people may be subject to federal prosecution and greater penalties.

There is little Iowa-specific law on this issue, but federal law requires prisons and jails to make individualized decisions about where trans prisoners can be safely housed. Denial of medical care for gender dysphoria may violate the U.S. and Iowa Constitutions.