Trans woman could be first American in federal prison to receive gender-affirming surgery

A trans woman currently incarcerated in Texas could become the first American to receive gender-affirming surgery while in federal prison.

Cristina Iglesias, 47, is a trans woman who has been incarcerated in Texas’ Federal Bureau of Prisons (BOP) for 27 years.

Iglesias made prison officials aware that she was transgender when she was first sent to prison, in 1994, and has been working to access gender affirmation surgery since 2016.

Just last year, after she launched legal action against the BOP, she was finally moved to a female facility after suffering “severe physical and sexual violence”, according to the ACLU of Illinois, which is representing her.

She alleges that the BOP is violating her rights under eighth amendment, which prohibits “cruel and unusual punishment”, but not allowing her to undergo necessary gender affirmation surgery.

Finally, on 27 December, Chief Judge Nancy J Rosenstengel issued a decision in the US District Court for the Southern District of Illinois.

Rosenstengel ruled that the BOP’s Transgender Executive Council must evaluate Iglesias for gender affirmation surgery, and that it must complete the evaluation before 24 January.

If both the council and the BOP’s medical director approve the surgery, then the BOP must produce a detailed plan for it to go ahead, including a timeline of preparation for the surgery, a list of possible surgeons, and a timeline for the trans woman’s recovery.

While a few trans inmates in state prisons have been approved for the surgery, the decision marks the first time in US history that an federally incarcerated trans person will be evaluated for gender affirmation surgery, and could see Iglesias become the first person ever to access the life-saving surgery from within the federal prison system.

Cristina Iglesias and her legal team hope her case will set a precedent for other trans folk in prison

John Knight of the ACLU of Illinois, who represents Cristina Iglesias, said in a statement: “For years, Cristina has suffered greatly from the denial of appropriate healthcare and the constant threats to her life while in BOP detention.

“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.

“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.”

Iglesias herself told the Dallas Morning News in a statement: “I am happy to have had the chance to tell my story and am hopeful that other transgender people will benefit from my case.”