US Bureau of Prisons recommends inmate undergo historic gender affirmation surgery

The US Bureau of Prisons may yet approve a Texas inmate’s request to become the first to undergo gender affirmation surgery while in federal custody, according to documents obtained by The Hill.

The Office’s Transgender Executive Council (TEC) recommended that Cristina Iglesias, 47, receive the sex reassignment surgery, according to documents filed Monday in U.S. District Court in Southern Illinois. The Justice Department and US attorneys further wrote that if certain conditions were met, including good behavior, it would refer Iglesias to a surgeon a month after the inmate transitioned to another facility in March.

“Thus, assuming she does not engage in behavior that would preclude her continued placement in a women’s facility and further assuming that no other reason develops that would make gender confirmation surgery inappropriate, the TEC expects the Complainant to be referred to a surgeon in a timely manner,” the documents read.

The move comes as a surprise given that last week the TEC missed a court deadline requiring a notice of approval, leading Iglesias and his legal team to assume he was denying the transaction.

But the recommendation comes with conditions. The Bureau won’t approve the surgery until after Iglesias transitions to a halfway house in Florida in the spring. Court documents also argue that Iglesias should continue to be monitored before approval, citing that the inmate has “demonstrated significant difficulty adjusting to life with women in a correctional setting.”

Edwin Yohnka, director of communications and public policy for the American Civil Liberties Union (ACLU) of Illinois, which represents Iglesias, said the team would meet with his client in the coming days to discuss the terms of the TEC.

“I think it’s important that they recognize the need for Cristina to have surgery,” he said. “But continued further delay, I think, is cause for concern.”

Iglesias is a natural born man held in prison since 1994 for terrorism. In May, Iglesias was transferred to Federal Medical Center Carswell in Fort Worth, a women’s facility, as one of the first federal inmates to be reassigned to another facility because of her gender identity.

Iglesias has been suing the Bureau since 2016, arguing that the surgery is as relevant as any other medical intervention a federal prisoner would receive while in custody.

Yohnka said that although Iglesias’ sentence ends at the end of the year, it was important that she had the surgery while in federal custody.

“The idea that time would be up just doesn’t seem satisfying,” he said. “We wouldn’t do this with other health care, we wouldn’t say – ‘Don’t do procedure X’, even if it was necessary and necessary – just because you’re going to be out in a year.”

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