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Federal court orders Bureau of Prisons to schedule inmate’s gender-affirming surgery

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The federal Bureau of Prisons (BOP) on Wednesday was ordered to immediately secure a qualified surgeon so that a transgender prisoner, Cristina Nichole Iglesias, can receive gender-affirming surgery.

Th ACLU of Illinois said that the federal court’s order follows three years of litigation in which Iglesias sought this medically necessary surgery but faced repeated delay. The court’s latest order requires BOP to provide a detailed timeline for Iglesias’s surgery, including undertaking a nationwide search to identify a qualified surgeon.

“I am hopeful that I will finally get the care I need to live my life fully as the woman I am,” said Iglesias in a statement. “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 stated that 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 Iglesias receives surgery and recovers before her sentence ends in December 2022. These reports will continue until 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 Iglesias’s litigation, including violations of previous judicial orders.

“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 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 has ever yet received gender-affirming surgery. The ACLU said that with this court order, Iglesias is expected to be the first.

Iglesias has been in federal custody for 28 years and currently lives in a BOP residential reentry center in Florida. BOP has known that 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 Iglesias being one of the few transgender people ever moved to a federal prison that aligns with her gender. She has been seeking gender-affirming surgery since at least January 2016.

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.

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