Federal inmate seeks gender-affirmation surgery

A federal inmate in Texas is in the midst of contentious litigation, seeking gender-affirmation surgery and other services to treat her gender dysphoria. No federal inmate has received gender-affirmation surgery in America. But several state inmates have received the surgery. 

Cristina Nichole Iglesias, 47, is an inmate at a federal prison in Ft. Worth, Texas. She’s been incarcerated since 1994 and was diagnosed around that time as having gender dysphoria. She’s been requesting gender-affirmation surgery for about five years, according to court records.

Iglesias is being represented in the current litigation by the ACLU and several private attorneys.

Iglesias has suffered greatly as an inmate in male facilities prior to her transfer to Carswell Medical Center, a federal prison for women in Ft. Worth, a few months ago. Though she’s now incarcerated in a female prison, federal Bureau of Prison inmate-locator records still publicize her male birth name. Iglesias hasn’t obtained a legal name change, according to court records.

Iglesias has endured multiple physical, sexual and verbal assaults in male prisons. For example, inmates have exposed themselves to her, groped her and asked to see her breasts. In November 2019, Iglesias was raped by another inmate. The following year, she was held hostage by a cellmate. Authorities had to use force against the cellmate to secure Iglesias’ release, according to court records.

Prior to her transfer to Carswell, Iglesias was subjected to ongoing threats and taunts by prison staff and other inmates, according to court records.

“The Trump administration rescinded policy guidance intended to protect transgender prisoners and put in place a rule that makes placement decisions based on a person’s assigned sex at birth. This approach reversed the progress that had been made in finally recognizing the authentic existence of women who are transgender and the risks they face when housing them in men’s facilities,” according to a statement by the ACLU of Illinois.

In addition to gender affirmation surgery, Iglesias is seeking access to permanent hair removal. She’s also seeking a court order to ensure her safety.

John A. Knight, an attorney for Iglesias, issued this statement: “It’s long past time for the federal government to recognize the necessity of gender affirming health care for transgender people. While the U.S. Department of Justice has correctly stated that state correctional systems must stop enforcing blanket denials against providing transgender prisoners the medical care they need, it continues to enforce blanket bans in denying Ms. Iglesias and other transgender prisoners surgery and permanent hair removal.  We continue to hope that this case will finally put an end to the suffering the [federal Bureau of Prisons] has caused her and many others who are in federal custody by denying them gender affirming health care.”

The lawsuit, which was filed in April 2019, remains pending before U.S. District Judge Nancy J. Rosenstengel of the Southern District of Illinois.

On Oct. 29, Rosenstengel held a status conference and said an evidentiary hearing will be held at 9 a.m. Nov. 22.  Iglesias is expected to testify at the evidentiary hearing along with two physicians.

Rosenstengel said she’s not sure whether the Nov. 22 hearing will be conducted remotely or in-person. She’ll render a decision on that issue sometime prior to Nov. 22.

A spokesperson for the federal Bureau of Prisons declined to comment for this story.

The defendants include Michael Carvajal, who serves as director of the U.S. Bureau of Prisons, along with various BOP employees. The BOP is being represented by the U.S. Department of Justice, which also had no comment for this story.

Iglesias isn’t seeking any monetary damages. But her attorneys are asking for the BOP to be responsible for their reasonable court costs and fees, according to court papers.

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Tim Cwiek has been writing for PGN since the 1970s. He holds a bachelor's degree in history from West Chester State University. In 2013, he received a Sigma Delta Chi Investigative Reporting Award from the Society of Professional Journalists for his reporting on the Nizah Morris case. Cwiek was the first reporter for an LGBT media outlet to win an award from that national organization. He's also received awards from the National Lesbian and Gay Journalists Association, the National Newspaper Association, and the Keystone Press.