The legislation is mainly about gender-affirming medical procedures, but would seem to rope in counselors also.
Gender-affirming treatment -- seemingly including mental health counseling that affirms "the minor’s perception of, the minor’s gender or sex, if that appearance or perception is inconsistent with the minor’s sex [at birth]"-- would seem to be a professional code violation enforceable by any state officer or licensing board if it leads to surgery or use of hormones.
[I'm unclear if there is a professional board violation if the counseling does not support or lead to further medical treatment. But Medicaid won't pay for it.]
So, what happens to an Iowa counselor who dares any gender dysphoria counseling if the client later gets hormone treatments or surgery out-of-state?