MILWAUKEE — Two Wisconsin residents who want gender reassignment surgeries say in a federal lawsuit they're being discriminated against by the state because the agency that administers Medicaid won't approve their procedures.

The lawsuit filed Monday argues their refusal of service amounts to a violation of the Affordable Care Act's provision barring discrimination based on gender identity.

The lawsuit from 30-year-old Cody Flack, a transgender man, and 41-year-old Sara Ann Makenzie, a transgender woman, challenges a 1997 state regulation that deems "transsexual surgery" as medically unnecessary and therefore not Medicaid-eligible.

Wisconsin is among 10 states that prohibit Medicaid coverage for sex reassignment surgery, according to the lawsuit. Another 18 and the District of Columbia do provide coverage for those procedures under Medicaid. The remaining states don't have stated policies on the matter.