In 2019, Cristina Iglesias filed a lawsuit that modified the course of therapy for herself and different transgender inmates in federal custody.
Iglesias, a trans girl who had been incarcerated for greater than 25 years, was transferred from a males’s jail to a ladies’s one in 2021. And in 2022, she reached a landmark settlement with the Federal Bureau of Prisons to obtain gender-affirming surgical procedure, which the company mentioned it had by no means supplied for anybody in its custody.
By the time she received the surgical procedure 10 months later, one other federal inmate had additionally obtained a process to align their physique with their gender identification. No different such surgical procedures for folks in federal custody are publicly documented, though some folks in state prisons have additionally obtained gender-affirming surgical procedure, together with at the very least five in Illinois and 20 in California inside a U.S. jail inhabitants that tops 1.25 million people.
Still, these procedures loomed giant within the 2024 presidential election. Political promoting for President Donald Trump and different Republicans included $215 million on anti-trans ads, in response to media monitoring agency AdImpact. One such advert declared that Democratic presidential nominee Kamala Harris supported “taxpayer-funded sex changes for prisoners,” and concluded, “Kamala is for they/them. President Trump is for you.” Some Democrats bemoaned the ads as having helped tip the election.
In the run-up to the Nov. 5 election, 55% of voters felt assist for trans rights had gone too far, in response to VoteCast, a survey by The Associated Press and companions together with KFF, the well being coverage analysis, polling, and information group that features KFF Health News.
On Inauguration Day, Trump issued a flurry of government orders that included a directive to bar federal spending on gender-affirming care in federal prisons and to “ensure that males are not detained” in federal ladies’s amenities.
“President Trump received an overwhelming mandate from the American people to restore commonsense principles and safeguard women’s spaces — even prisons — from biological men,” White House spokesperson Anna Kelly wrote in an e-mail. “Forcing taxpayers to pay for gender transition for prisoners is the exact sort of insanity that the American people rejected at the ballot box in November.”
But for Iglesias, 50, Trump’s order was a stunning reversal.
“It puts someone’s life in danger being in a men’s prison as a trans woman,” she mentioned from Chicago, the place she’s lived since her launch in 2023. “It’d be like putting sheep in a hyenas’ den.”
Iglesias mentioned she confronted emotional and bodily abuse from her father for her want to be feminine. When she was 12, she mentioned, he put a gun in her mouth after discovering her carrying her sister’s garments. Iglesias mentioned she ran away from dwelling, stole checks, vehicles, and jewellery, and ended up in jail.
Lockup was not enjoyable, Iglesias mentioned, nevertheless it was the primary place she received to be handled as a lady. So, she mentioned, she wished to remain. In 1994, she landed in federal jail after writing threatening letters to federal judges and prosecutors, in response to court docket filings. In 2005, information present, she pleaded responsible to sending a letter to British officers that she falsely claimed contained anthrax. She instructed investigators she hoped to get extradited.
“I was reading these things where they were allowing trans females to start living with females,” Iglesias mentioned.
She mentioned her outlook modified after the loss of life of her mom in 2010, which prompted her to get critical about having a life exterior of jail, and about bettering her life inside it.
She started requesting hormone remedy in 2011 and was authorized for it in 2015, in response to court docket information. The 2019 lawsuit that led to her switch to a ladies’s jail and her surgical procedure was initially handwritten and ready with the assistance of solely one other inmate.
An excerpt of Iglesias’ 2019 lawsuit that was initially handwritten and ready with the assistance of one other inmate. Iglesias was transferred to a feminine facility in 2021 and in the end gained a settlement from the Federal Bureau of Prisons in 2022 to obtain gender-affirming surgical procedure. (Cristina Iglesias’ 2019 court docket submitting)
“The lawsuit was the foundation for everything that I am today,” Iglesias mentioned. “For the first time in my life, instead of digging myself in these holes, I was digging myself out.”
Along along with her settlement, Iglesias received a commitment from the Federal Bureau of Prisons to create a timeline for contemplating different inmates’ requests for gender-affirming care, and to acknowledge everlasting hair elimination and gender-affirming surgical procedure as medically needed remedies for gender dysphoria — a medical condition during which the discrepancy between an individual’s gender identification and their intercourse assigned at start causes important misery.
In February, in response to Trump’s government order, the bureau issued new guidelines requiring jail staffers to discuss with inmates’ “legal name or pronouns corresponding to their biological sex,” and ending clothes requests “that do not align with an inmate’s biological sex.” The tips finish referrals for gender-affirming surgical procedure however permit inmates already receiving therapy, reminiscent of hormone remedy, to proceed.
However, in a lawsuit filed March 7, a trans prisoner alleged the hormone remedy she had been receiving since 2016 was stopped on Jan. 26.
Spokespeople for the bureau didn’t reply to requests for remark.
The bureau spent $153,000 on hormone remedy in fiscal yr 2022, its former director instructed Congress, 0.01% of its complete spending on well being care.
The new tips on trans inmates say that Trump’s government order “does not supersede or change” the duty to adjust to federal laws. But the manager order requires amending them to stop trans ladies from being housed in ladies’s prisons.
“It hurt my heart when I seen that because I do know other girls that are still in prison,” mentioned Iglesias, who spent greater than 25 years in male amenities. “Female prison is safe for a trans woman, and you can be who you are. You’re not penalized because you’re feminine.”
Iglesias hoped her landmark 2022 settlement with the Federal Bureau of Prisons that enabled her to get gender-affirming surgical procedure would set a precedent for different transgender inmates searching for care. Now, although, President Donald Trump has sought an finish to each gender-affirming medical look after federal prisoners and the position of trans ladies inmates in feminine federal amenities — each of which Iglesias had sought in her lawsuit. Iglesias says she is talking in opposition to the rollback for these nonetheless behind bars.(Laura McDermott for KFF Health News)
But requesting a switch to a facility matching inmates’ gender identification had not been easy, and few prisoners had been moved earlier than the order. A 2025 government court filing mentioned that federal prisons home 2,198 trans prisoners out of over 155,000 inmates. Of these, the submitting mentioned, 22 are trans ladies housed in feminine amenities, and one is a trans man in a males’s facility. Although courts have blocked makes an attempt to maneuver that small subset of trans prisoners after the order, a trans prisoner not included in these fits had been relocated, The Guardian information outlet reported.
A Department of Justice report from 2014 estimated that trans inmates in state and federal prisons have been 10 times as likely as different prisoners to report incidents of sexual victimization.
Iglesias mentioned she skilled such violence firsthand. Included in her swimsuit was a replica of a 2017 psychological report that mentioned Iglesias reported being the sufferer of sexual misconduct or abuse in 1993, 2001, 2013, 2015, 2016, and 2017. Later filings included allegations of getting been raped in 2019 and 2020, and a collection of rapes, threats, and other abuse in 2021 earlier than she was transferred to a feminine facility. Iglesias mentioned she confronted extra abuse than she formally reported.
“Just because you commit a crime doesn’t mean you deserve to have violence against you,” mentioned Michelle García, deputy authorized director of the ACLU of Illinois and one of many attorneys who in the end represented Iglesias.
Federal legislation requires all inmates to be protected against abuse. A 1994 Supreme Court decision acknowledged trans inmates as notably susceptible to assault. Regulations from the Prison Rape Elimination Act, handed unanimously by Congress in 2003, include specific provisions for trans inmates, together with permitting them to bathe individually from different inmates and requiring jail officers to contemplate their well being and security when deciding whether or not to accommodate them in male or feminine amenities.
Courts additionally have ruled that “deliberate indifference” to an inmate’s “serious medical needs” violates the Eighth Amendment’s ban on “cruel and unusual” punishments. The high quality of total medical look after federal prisoners has come under scrutiny amid reports of inmates going with out wanted medical care and preventable deaths.
Iglesias efficiently argued in court docket that gender-affirming surgical procedure was needed for her gender dysphoria. She was identified with what was then referred to as “gender identity disorder” quickly after getting into federal custody in 1994, in response to court docket filings. Her prognosis was up to date to gender dysphoria in 2015.
Iglesias’ court docket filings documented her having been assessed for the danger of suicide 33 instances and positioned on suicide watch 12 instances, in addition to an try at self-castration in 2009.
“Defendants are aware of Iglesias’s suffering, but have delayed her treatment without evaluating her medically,” the judge in her case wrote.
García referred to as the Trump administration’s focusing on of look after trans inmates merciless, pointless, and illogical.
“They’re not assessing the constitutional rights of people,” García mentioned. “They’re making choices because this is a vulnerable community that they can rally people behind to hate.”
Bram Sable-Smith:
brams@kff.org,
@besables
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