Federal Judge Rules Transgender Inmate Must Have Access To Gender-Affirming Surgery

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The ruling by Judge Nancy Rosenstengel of the U.S District Court for the Southern District of Illinois paves the way for Cristina Nichole Iglesias, the plaintiff in the case, to become the first ever federal inmate to receive gender-affirming surgery.

A federal judge has ruled that the U.S Bureau of Prisons (BOP) must allow a transgender inmate access to gender-affirming surgery.

The ruling by Judge Nancy Rosenstengel of the U.S District Court for the Southern District of Illinois paves the way for Cristina Nichole Iglesias, the plaintiff in the case, to become the first ever federal inmate to receive gender-affirming surgery. It comes after three years of litigation, during which time Iglesias’ legal representatives allege that the BOP frequently delayed or denied gender-affirming treatment despite previous court orders to do so. 

“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 released by ACLU Illinois, who represented her in the case. “BOP has denied me gender-affirming surgery for years – and keeps raising new excuses and putting new obstacles in my way.”

She added, “I am grateful that the court recognized the urgency of my case and ordered the BOP to act.”

Iglesias has been seeking gender-affirming surgery since at least 2016, according to ACLU Illinois. A prior ruling in her case required that the BOP provide a surgical consultation for her; however, the BOP stalled and, when officials did set up a consultation, it was with a practitioner who did not perform the surgery Iglesias required, as noted by Judge Rosenstengel in her ruling

“[T]hroughout this litigation the [BOP] has employed tactics similar to the game of Plinko on The Price is Right,” the justice wrote. “Now, the BOP’s tactics are turning into a game of ‘whack-a-mole.’ Indeed, it appeared the last of BOP’s moles had been ‘whacked.’ Then another one ‘popped-up.’ This time BOP represented it had an appointment with a surgeon for a consultation of gender confirmation surgery on April 7, 2022, but the surgeon does not even perform vaginoplasties.” 

Rosenstengel has ordered that the BOP provide a timeline for Iglesias to receive gender-affirming surgery before her sentence ends in December. She has also ordered federal officials from the BOP to appear at a hearing to justify the bureau’s repeated delays in getting Iglesias access to treatment.


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