Judge orders first gender-affirming surgery for transgender inmate in federal custody

An Illinois judge this week ordered the Bureau of Prisons (BOP) to find a qualified surgeon to provide the first-ever gender-affirming operation for a transgender inmate in federal custody.

Judge Nancy Rosenstengel in the U.S. District Court for the Southern District of Illinois ruled in her order the BOP must provide Cristina Nichole Iglesias with a surgeon who can perform the gender-affirming surgery by December, when Iglesias’s sentence ends.

The American Civil Liberties Union of Illinois, which is representing Iglesias, on Wednesday hailed the ruling as a major victory for transgender rights and more than 1,200 transgender inmates in federal custody.

“We hope this landmark decision will help secure long overdue healthcare for Cristina,” said staff attorney Joshua Blecher-Cohen said in a statement.” And for the many other transgender people in federal custody who have been denied gender-affirming care.”

Iglesias, who identifies as transgender, has been in federal custody for the past 28 years for threatening to use a weapon of mass destruction against the British government.

She is currently at a BOP residential reentry center in Florida and has been fighting for gender-confirming surgery since 2016.

In December, the federal court ordered the BOP’s Transgender Executive Council (TEC) to provide a recommendation on the surgery. After missing a court deadline, the TEC recommended Iglesias for the surgery one month after she moved to the Florida facility, but slipped in a number of conditions, including good behavior.

Despite the recommendation, Iglesias has yet to receive the surgery or have a proper appointment and consultation for it.

Rosenstengel accused the BOP of delay tactics and playing a game of “whack-a-mole” with Iglesias, saying one problem was surfacing after another. The judge is weighing possible sanctions against the defendants.

In one example, the judge criticized federal officials for scheduling an appointment with a surgeon who cannot perform a proper gender-affirming operation.

“The order was clear. The Court ordered BOP to not delay its decision,” Rosenstengel wrote in her court order. “The unambiguous demand was made for a specific reason. Iglesias is suffering from gender dysphoria, and time is running out.”

Under the new ruling, BOP must provide a timeline to the court for providing Iglesias with gender-affirming surgery and must file updates every Friday until a surgeon is secured and a surgery is scheduled.

While states have funded and approved such surgeries, a federal inmate has yet to receive the operation.

Attorneys for Iglesias argue it’s important their client receives the surgery while in federal custody because the operation is just as pertinent as any other medical procedure, which wouldn’t be delayed until a sentence is finished or an inmate is released.