A federal judge in Illinois has ruled that the U.S. Bureau of Prisons must find a qualified surgeon and develop a detailed timeline for when a transgender inmate can receive gender-affirming surgery.
U.S. District Judge Nancy Jo Rosenstengel, of the Southern District of Illinois, ordered the Bureau of Prisons to find a qualified surgeon who performs vaginoplasties so that Cristina Nichole Iglesias, a transgender prisoner, can obtain medically necessary gender-affirming surgery.
The 31-page order, issued last week, follows three years of litigation in which Iglesias sued to obtain gender confirmation surgery, but had her requests repeatedly rejected by the Bureau of Prisons.
Iglesias, who has been in federal custody for 28 years, was housed in men’s facilities for over two decades, where she experienced severe physical and sexual violence. She sued to be moved to a women’s facility and to receive gender-affirming surgery beginning in 2016. In May 2021, she became one of the few transgender people ever moved to a federal prison that aligns with her gender.
Rosenstengel had previously ordered the agency to provide the procedure last year, but the BOP has failed to make the necessary arrangements that would allows Iglesias to undergo the procedure.
In her ruling, Rosenstengel compared the BOP’s tactics to a game of “whack-a-mole,” in which the BOP sought to postpone any referral to a surgeon for months, and then created a series of excuses for why there were delays in connecting Iglesias with the care she requires.
She also directed BOP officials to appear in court to explain why they shouldn’t face sanctions for the repeated delays in connecting Iglesias with gender-affirming care.
The Bureau of Prisons has declined to comment on Rosenstengel’s most recent decision or whether it intends to appeal the order, citing a policy of refusing to comment on active litigation.
According to the ACLU of Illinois, Iglesias will become the first federal prisoner to ever receive gender confirmation surgery.
“I am hopeful that I will finally get the care I need to live my life fully as the woman I am,” Iglesias said in a statement provided to CNN. “[The] 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.”
“For years, Cristina has fought to receive the health care 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,” Joshua Blecher-Cohen, a staff attorney from the American Civil Liberties Union of Illinois, which represents Iglesias, said in a statement.
“We hope this landmark decision will help secure long-overdue health care for Cristina — and for the many other transgender people in federal custody who have been denied gender-affirming care.”
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