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MADISON — A federal judge has ordered Wisconsin to pay for the gender reassignment surgery for two transgender Medicaid recipients, including a Baraboo resident.

Cody Flack, 30, and Sara Ann Makenzie, 41, filed a lawsuit in April, saying a state rule denying coverage for surgeries to treat gender dysphoria violates the Affordable Care Act and their right to equal protection, the Milwaukee Journal Sentinel reported. The state rule that excludes coverage for undefined “transsexual surgery” was adopted in 1996.

U.S. District Judge William Conley granted a preliminary injunction Wednesday barring enforcement of the rule. He suggested the injunction could be expanded to include any transgender Medicaid patient whose doctor recommends the surgery.

“The likelihood of ongoing, irreparable harm facing these two individual plaintiffs outweighs any marginal impacts on the defendants’ stated concerns regarding public health or limiting costs,” Conley said in the 39-page order.

Flack, of Green Bay, could get his surgery in two or three weeks, said attorney Rock Pledl. He said Makenzie, of Baraboo, may have to wait a few months because of her status on the paperwork process with an HMO.

Flack, who has cerebral palsy, uses a motorized wheelchair and relies on Supplemental Security Income for the disabled as his sole support. He first identified as a boy at age 5, according the lawsuit.

Makenzie also is disabled and relies on Supplemental Security Income. She has been living as a woman since 2012.

“This is tremendous,” Pledl said of the ruling.

The state’s Medicaid has a budget of about $9.7 billion to cover about 1.2 million eligible residents. An estimated 5,000 enrollees are transgender.