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Federal Judge Calls Out BOP’s ‘Plinko’ Tactics, Orders Surgeon Found for Trans Prisoner’s Gender-Confirming Procedure

by Jacob Barrett

On April 18, 2022, after finding the federal Bureau of Prisons (BOP) “employed tactics similar to the game of Plinko on The Price is Right,” an exasperated federal judge demanded the agency produce a timeline for compliance with an earlier Preliminary Injunction (PI) ordering Gender Confirming Surgery (CGS) for a transgender prisoner.

The ruling by Judge Nancy Rosenstengel in the federal court for the Southern District of Illinois granted the request of prisoner Cristian Noel “Cristina Nichole” Iglesias, who has faced extreme obstacles in obtaining gender-affirming therapy while housed in BOP. [See: PLN, Mar. 2022. p.30.]

“For years, Cristina has fought to receive the health care the Constitution requires,” said her attorney, Joshua Blecher-Cohen of the American Civil Liberties Union (ACLU) of Illinois, the state where she was incarcerated at the time the suit was filed.

Calling the Court’s earlier PI “clear,” Rosenstengel said its “unambiguous demand” that BOP “not delay … regarding Iglesias’s request for GCS” was made “for a specific reason.”

“Iglesias is suffering from gender dysphoria, and time is running out,” the Judge said.

But months after that PI order in January 2022, with Iglesias’ Christmas release date nearing, she had still not seen a qualified surgeon. An annoyed Judge Rosenstengel said that BOP’s tactics were “turning into a game of ‘whack-a-mole.’” Recalling how the agency abruptly agreed at the end of January 2022 to recommend Iglesias for GCS, Rosenstengel said “it appeared the last of BOP’s moles had been ‘whacked.’”

“Then another one ‘popped-up,’” the Judge said, when it turned out the surgeon that Iglesias was booked to see on April 7, 2022, “does not even perform vaginoplasties.”

BOP argued that Iglesias’ impending transfer from her prison in Texas to a Florida residential re-entry center (RRC) counseled against an immediate, unqualified referral for GCS.

“The Court did not order a referral for surgery,” Rosenstengel shot back, “because ordering Defendants to refer Iglesias for surgery would have violated the [Prison Litigation Reform Act].”

Ultimately, the Court found that Defendants had “failed to evaluate Iglesias’s request for GCS.” In fact, Rosenstengel noted, “Dr. McLearen, who oversees [BOP’s Transgender Executive Council, or TEC], confirmed that the TEC did not evaluate Iglesias’s request” but rather “merely evaluated whether to recommend Iglesias to a surgeon for consultation for GCS.”

“[B]y laying out a pattern of oversight, misrepresentations of the law, misrepresentations of the record, disingenuous estimates in time to meet the Court’s discovery orders, and material errors,” BOP left the Court no choice but to modify the PI so as to require the agency to produce a timeline for Iglesias’ GCS and a list of all GCS-qualified U.S. surgeons who might perform the procedure. In addition, the Court ordered Defendants to show cause why they should not be sanctioned by April 28, 2022. See: Iglesias v. Fed. Bureau of Prisons, 2022 U.S. Dist. LEXIS 71002 (S.D. Ill.).

The Court later modified its show-cause date — twice — before appointing attorney G. Patrick Murphy of Murphy & Murphy LLC in Marion to serve as Special Master on July 15, 2022. On September 30, 2022, the parties submitted a joint status report to the Court that revealed Iglesias allegedly ran away from the RRC before her first scheduled consult for “facial feminization” surgery in August. After her recapture, her release date was recalculated to January 22, 2023. Meanwhile the agency said it obtained an appointment for the prisoner with a GCS surgeon for October 26, 2022.

By that point, Iglesias had also parted ways with Blecher-Cohen and was represented by attorneys James Esseks, Taylor Brown, and L. Nowlin-Sohl of the ACLU in New York, as well as Frank Battaglia and Shannon Lemajeur of Winston & Strawn LLP in Chicago and Angela M. Povolish of Feirich/Mager/Green/Ryan in Carbondale. See: Iglesias v. Fed. Bureau of Prisons, USDC (S.D. Ill.), Case No. 3:19-cv-00415.

About 1,200 BOP prisoners identify as transgender, though only a fraction of that number may suffer gender dysphoria that would require GCS. No position has been announced by the administration of Pres. Joseph R. Biden, Jr. (D), though Vice President Kamala Harris (D) was Attorney General of California when that state fought and ultimately conceded a legal battle granting the nation’s first GCS to a transgender prisoner, Shiloh Quine. [See: PLN, Apr. 2017, p.13.] Harris has since accepted “full responsibility” for putting up that fight and called for “better understanding” of the needs of transgender Americans. 

Additional sources: CNN, Washington Blade

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Related legal cases

Iglesias v. Fed. Bureau of Prisons

Iglesias v. Fed. Bureau of Prisons