CHICAGO — For the first time in its history, the federal Bureau of Prisons (BOP) has been ordered to immediately secure a qualified surgeon so that a transgender prisoner, Cristina Nichole Iglesias, can receive gender-affirming surgery. The federal court’s order follows three years of litigation in which Ms. Iglesias sought this medically necessary surgery but faced repeated delays, denials, and deception from BOP. The court’s latest order requires BOP to provide a detailed timeline for Ms. Iglesias’s surgery, including undertaking a nationwide search to identify a qualified surgeon.
Earlier in Ms. Iglesias’s case, the district court issued the first-ever decision ordering the federal Government to evaluate a transgender prisoner for gender-affirming surgery. BOP then recommended Ms. Iglesias for gender-affirming surgery in January 2022, but sought to postpone any referral to a surgeon for months. The court’s order this week requires BOP to immediately locate a qualified surgeon and begin the process of scheduling Ms. Iglesias’s gender-affirming surgery.
“I am hopeful that I will finally get the care I need to live my life fully as the woman I am,” said Cristina Iglesias. “BOP has denied me gender-affirming surgery for years—and keeps raising new excuses and putting new obstacles in my way. I am grateful that the court recognized the urgency of my case and ordered BOP to act.”
The court’s ruling responds to BOP’s pattern of delays, noting that Ms. Iglesias “is suffering from gender dysphoria, and time is running out.” Chief Judge Nancy Rosenstengel ordered BOP to make weekly reports to the court that lay out a timeline to ensure Ms. Iglesias receives surgery and recovers before her sentence ends in December 2022. These reports will continue until Ms. Iglesias’s surgery occurs and will allow the court to monitor BOP’s compliance.
The court also ordered high-level officials from BOP and the Department of Justice, including the Principal Deputy Assistant Attorney General, to appear at a hearing and justify federal government officials’ repeated misconduct during Ms. Iglesias’s litigation, including violations of previous judicial orders. As one example, Judge Rosenstengel noted that BOP spent seven weeks promising to set up a surgical consult for Ms. Iglesias, then knowingly sent her to a doctor who does not perform the surgery she needs.
“For years, Cristina has fought to receive the healthcare the Constitution requires. The court’s order makes clear that she needs gender-affirming surgery now and that BOP cannot justify its failure to provide this medically necessary care,” said Joshua Blecher-Cohen, an ACLU of Illinois staff attorney who represents Ms. Iglesias. “We hope this landmark decision will help secure long overdue healthcare for Cristina—and for the many other transgender people in federal custody who have been denied gender-affirming care.”
While BOP has more than 1,200 transgender people currently in its custody, no federal prisoner—past or present—has ever yet received gender-affirming surgery. With this court order, Ms. Iglesias is now expected to be the first.
Ms. Iglesias has been in federal custody for 28 years and currently lives in a BOP residential reentry center in Florida. BOP has known that Ms. Iglesias is transgender since she first arrived in federal custody in 1994 and identified as a woman. Since then, she has been denied basic medical care to treat her gender dysphoria and was housed in men’s facilities for over two decades, where she experienced severe physical and sexual violence. In May 2021, this lawsuit resulted in Ms. Iglesias being one of the few transgender people ever moved to a federal prison that aligns with her gender. Ms. Iglesias has been seeking gender-affirming surgery since at least January 2016.
Ms. Iglesias is represented by a legal team that includes counsel from the ACLU of Illinois, the American Civil Liberties Union, Winston & Strawn LLP, and Feirich/Mager/Green/Ryan.