ABOVE: Photo via U.S. Federal Bureau of Prisons.
A federal judge in Illinois ruled that the U.S. Federal Bureau of Prisons (BOP) must evaluate a trans woman incarcerated in Texas for gender-affirming surgery – a first of its kind ruling that could improve the treatment of trans prisoners across the country.
In the ruling issued on Dec. 27 in the U.S. District Court for the Southern District of Illinois, Chief Judge Nancy Rosenstengel ruled that the Transgender Executive Council (TEC) within the BOP must evaluate a request from Cristina Nichole Iglesias – a 47-year-old trans woman who has been in custody for more than 27 years – for gender-affirming care by Jan. 24.
If the TEC recommends Iglesias for gender-affirming care, the BOP’s medical director must assess Iglesias within 30 days and report to the court about progress on locating a surgeon.
If the TEC decides not to recommend Iglesias for surgery, they must provide a detailed explanation to the court.
“For years, Cristina has suffered greatly from the denial of appropriate healthcare and the constant threats to her life while in BOP detention,” said John Knight, LGBTQ project director at the American Civil Liberties Union (ACLU) of Illinois. “Cristina has fought for years to get the treatment the Constitution requires. The court’s order removes the unnecessary hurdles and delays BOP has repeatedly constructed to prevent her from getting the care that she urgently needs.”
Iglesias has been seeking gender-affirming care since at least January 2016.
According to the ACLU of Illinois, the BOP has known Iglesias is a trans woman since she first arrived in prison in 1994. Yet, she was “denied basic medical care to treat her gender dysphoria and was housed in men’s prisons for more than two decades, where she experienced severe physical and sexual violence.”
The ruling adds that BOP staff has “failed to protect her.”
In her ruling, Rosenstengel writes: “Iglesias has been on suicide watch multiple times while in BOP custody and has attempted self-harm. Iglesias has and will continue to endure mental and physical harms because of the BOP’s mistreatment of her gender dysphoria.”
Previously, the lawsuit resulted in Iglesias being transferred to a federal prison that aligns with her gender. According to the ACLU of Illinois, she is one of the few transgender prisoners ever moved to the correct prison.
The court also found that the BOP’s unwritten criteria for delaying Iglesias’ transfer to a female facility and its denial of gender-affirming care were “forbidden post hoc justification[s] created in response to litigation.”
In an email to the Los Angeles Blade, the BOP declined to comment on the specifics of the ruling. However, a spokesperson did say, “The BOP’s team of subject-matter-experts provide a wide range of gender-affirming accommodations based on comprehensive and individualized assessments. These accommodations can include gender affirming surgical referral when deemed appropriate.”
“We hope that the order directing BOP to move forward will result in medically necessary and long overdue healthcare for Cristina—and, in time, for the many other transgender people in BOP’s custody who have also been denied surgery and other much-needed gender-affirming care,” Knight said.
According to the ACLU of Illinois, there are currently 1,200 transgender prisoners in federal custody. To date, no prisoner has ever received gender-affirming surgery from the BOP.
