[4/20/22] – U.S. Bureau of Prisons Ordered by Federal Judge to Find a Surgeon for a Transgender Inmate’s Gender-Affirming Surgery

On Monday, April 18th, 2022, a federal judge in Illinois ruled that the U.S. Bureau of Prisons (BOP) has to find a qualified surgeon to perform a gender-affirming surgery for Cristina Nichole Iglesias, a transgender inmate. According to CNN, the district court had previously ordered the BOP to evaluate Iglesias for the surgery, but the BOP sought to postpone the referral for a surgeon for months. Chief U.S. District Court Judge Illinois Nancy Rosenstengel, compared the BOP’s tactics to Plinko, a game on The Price is Right. The ruling will require the BOP to provide the Court with a timeline that describes the preparation of what the BOP and NaphCare, a provider for correctional healthcare services, must do to ensure that Iglesias is ready for the surgery and a timeline for Iglesias’ recovery. In addition to that, the BOP is required to provide the Court with a list of all surgeons in the U.S. who are qualified to perform the gender-affirming surgery, who are willing to work with the BOP and NaphCare, and who have the availability to fit Iglesias in for the surgery so that she recover by December 2022. 

In a statement, Iglesias’ attorney Joshua Blecher-Cohen of the American Civil Liberties Union (ACLU), said that “For years, Cristina has fought to receive the health care the Constitution requires. The court’s order makes clear that she needs gender-affirming surgery now and that BOP cannot justify its failure to provide this medically necessary care.” Blecher-Cohen hopes that the landmark ruling will “help secure long overdue health care for Cristina and for the many other transgender people in federal custody who have been denied gender-affirming care.” According to the ACLU, there are more than 1,200 transgender people currently held by the U.S. Bureau of Prisons. Iglesias, who has been in federal custody for 28 years, is slated to be the first federal prisoner to receive the gender-affirming surgery.

Instructors, click on the link below to download this week’s lecture for use in your classroom. The deck contains a writing prompt, a debate question, as well as other assessment questions.



  • Writing: Explain the significance of the Court’s ruling in Cristina Nichole Iglesias’s case.
  • Debate: According to Iglesias’ attorney Joshua Blecher-Cohen of the ACLU, the ruling will help secure long overdue health care for many transgender people in federal custody. Do you believe that this ruling will truly bring changes to the way that transgender inmates are cared for in prison?
  • Poll: Transgender inmates should not be denied gender-affirming care. (Agree or Disagree).
  • Short Answer: Discuss the requirements that the U.S. Bureau of Prisons and NaphCare are required to meet following the ruling.  

Cover Image: iStock/Cunaplus_m.Faba

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