Transgender prisoner who fought for gender-affirming care for all inmates undergoes surgery

A transgender federal inmate who fought for four years to push the U.S. Bureau of Prisons to provide gender-affirming care to prisoners underwent surgery last week and is recovering, her attorneys said.

A federal judge in April 2022 ordered the bureau to ensure that Cristina Nichole Iglesias would get the gender-affirming surgery she’d sought throughout several years of litigation. At the time, Iglesias was in line to become the first-ever transgender inmate to receive gender-affirming surgery while in custody. Instead, another federal detainee became the first earlier this year, a development that civil rights advocates said became possible after Iglesias' cases put a spotlight on transgender prisoners' healthcare needs.

Iglesias' surgery was performed without complications on March 30, her attorneys said.

Just over 1,200 transgender individuals are estimated to be part of the federal prison population, but until recently none had ever received gender-affirming care while in custody.
Just over 1,200 transgender individuals are estimated to be part of the federal prison population, but until recently none had ever received gender-affirming care while in custody.

“We are pleased that Cristina has finally received the constitutionally-mandated health care she has sought for years, and that she is recovering well from the surgery,” said Taylor Brown, staff attorney for the American Civil Liberties Union’s LGBTQ & HIV Project. "We know her victory also is going to benefit other transgender people in BOP custody, changing their lives for the better.”

Iglesias is scheduled for facial feminization care in June, her attorneys said.

About 1,200 transgender individuals are estimated to be in the federal prison system, or less than 1% of the overall inmate population of about 159,000.

“This life-saving care for Cristina and others is the result of Cristina’s courage and fortitude,” said Michelle Garcia, the ACLU of Illinois’ deputy legal director. “What Cristina has done will benefit her and countless others for years to come.”

Who is Cristina Nichole Iglesias?

Iglesias pleaded guilty in 2005 to sending an envelope to British officials that she falsely claimed contained anthrax. At the time, she was in a federal prison and listed the detention center as the return address.

She ultimately received a 20-year sentence. Iglesias, now in a Florida facility, has been in the federal prison system since 1994, where until recently she was housed mostly in men’s facilities and subject to physical and sexual abuse.

Under the U.S. Constitution, federal prisons are required to cover costs of all necessary health care treatment for inmates.
Under the U.S. Constitution, federal prisons are required to cover costs of all necessary health care treatment for inmates.

According to court documents, Iglesias experienced gender dysphoria so extreme that she considered self-castration and was placed under suicide watch numerous times.

Federal prisons are required to cover costs of all necessary health care treatment for inmates under the U.S. Constitution. Gender-affirming care, especially in regard to youths, has come under increasing attack by lawmakers who say they’re concerned that people might make life-altering decisions they can later regret.

Proponents say prohibiting access to care can jeopardize individuals’ emotional and mental health and well-being and note that such care has been endorsed by dozens of medical groups, including the American Medical Association, Endocrine Society and the World Professional Association for Transgender Health.

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This article originally appeared on USA TODAY: Transgender federal inmate gets long-awaited gender-affirming surgery