Cristina Iglesias, Who Helped Secure Gender-Affirming Surgery in Prisons, Is Finally Living For Herself

Chalffy/Getty Images

It took years of activism behind bars and a four-year-long lawsuit, but Cristina Iglesias finally got gender-affirming surgery in March 2023. I’d long been familiar with Iglesias’ name thanks to her historic lawsuit against the federal Bureau of Prisons (BOP) that forced the federal government to, for the first time, provide an incarcerated trans person with gender-confirmation surgery. (Iglesias was set to be the first incarcerated person to receive this kind of surgery, but another woman ended up getting surgery first, crediting Iglesias’s lawsuit.) .

Iglesias’s journey to this win was a hard one. She first started requesting surgery in 2016, alongside transfer out of the men’s prisons where she had been held since her arrest. For three years she continually requested the procedure, only to be told the matter was still under consideration. In April 2019 Cristina filed a lawsuit, which she worked on by herself until the case was taken on by the American Civil Liberties Union (ACLU), the ACLU of Illinois, and two private firms. In April 2022, they sent her to a surgeon for the supposed purpose of being evaluated for vaginoplasty; when Cristina arrived at the office, she was crushed to learn the physician did not even perform the procedure. Later that month, District Judge Nancy Rosenstengel compared the BOP’s tactics in delaying care to “a game of ‘Whac-A-Mole” and threatened the government with sanctions for the second time. In May 2022, Iglesias and her attorneys reached a comprehensive settlement, in which the agency agreed to provide her with surgery as well as other medically necessary gender affirming procedures, including breast augmentation and facial-feminization surgery. According to the ACLU, the BOP also agreed to implement changes that would benefit the more than 1,200 trans people in its custody. Cristina finally underwent surgery in March 2023.

Iglesias’ experience reveals the federal government's continued and overt efforts to deny medically necessary care to incarcerated people, even as the Justice Department publicly advocated for trans prisoners on the state level.

In January 2024, shortly after her release from BOP custody, Cristina and I were able to connect over Zoom. At a time when gender-affirming care is under attack across the country, Iglesias’ story is about a historic win — and the transformative power of fighting to obtain care that can make you feel whole.

This interview has been edited and condensed for clarity.

Aviva Stahl: Could you tell me a little bit about yourself before you got locked up? Who were you as a kid?

Cristina Iglesias: [At the age of 12] I ran away from home. I started stealing money from my parents, stealing cars. It led me to a life of crime. And I was frequenting gay clubs and I was cross dressing, it was very, very different back in those days. And so when I got a taste of the prison system, fast forward a little bit, I was treated as a female [while at a male facility]. I was accepted as a woman. I was able to have a boyfriend. I wanted to stay in prison and I know that sounds so f*cked up. But that's the truth. And I was in such a bad place that I was literally sabotaging myself, writing threatening letters to stay in prison.

AS: Did your activism start around the time you were diagnosed with gender dysphoria?

CI: Honestly, it was probably around a little bit after my mom passed away in 2010. I was actually in a supermax facility in Florence, Colorado. I spent three years there [for writing threatening letters].

I kept my word to my mom because she literally told me, please get out of there. My mom was very supportive. She was my rock. It killed her to know that I was there. And she made me promise before she passed away, that I would not give up and I would come home. After she died I programmed like hell to get out of there. It was after leaving the ADX [the prison in Colorado] that I really started focusing on trying to get treatment [for gender dysphoria].

AS: Tell me what that looked like - what did it take to fight for that care?

CI: I had to go through psychology because I was dealing with gender dysphoria. I've always had psychologists who've been supportive of my transitioning. They would go to the warden, and they would get me approved for foundation to cover up the shade look [facial hair regrowth], nail polish, girls perfume, stuff of that nature. At every institution you had to start all over again to get things from the commissary. It was very difficult.

But that stuff was only a Band-Aid. The bigger picture was getting hormones. Once I got on hormones, then I had to continuously fight to get treated as a woman, for example pat searched by a female [corrections officer]. You have to apply for an exception for that to happen.

A lot of the new transgender prisoners were not aware of how to even apply for the pat search, or they would get denied because of the bullsh*t. I helped them navigate it.

The big filing in my case started when I was at the end of my rope. I started seeing state inmates getting surgery. I said, “Why is the BOP not doing that?” A friend of mine told me, “Girl, you're a fighter.” So I filed paperwork. And I could not stop once I started. I just kept going and going, using their own policies against them — going to sick call to request laser hair removal and other treatments, filing paperwork continuously, exhausting my administrative remedies — laying the groundwork that could make the lawsuit a success.

AS: Over the course of your lawsuit, in May 2021, you were finally moved to a women’s prison. Can you tell me about that transition? Was it what you expected?

CI: After [I got approved for transfer] by the Transgender Executive Council,... I was in the SHU for like a week. I was going through it, like 'Oh my God, are the women going to accept me, or how's it going to be?' Because at that point I'd done 20-some years with men.

Women were more accepting, they were more curious, there was less violence, and I was able to just blend in them. There were a few times where it was awkward. But for the most part, besides the peeping toms trying to see if I had a penis or not, it was okay. In female prisons, they have the mom, the grandma, the aunts, the family tree thing, whereas in the men's prison, we don't do that. So I had a prison daughter — had four actually — and I had a trans son. But I still felt inadequate because I didn't have a vagina.

And the steps that I had to go through — like wearing Maxi pads, two pairs of panties, tucking, just to make sure that no one's seeing anything. That was also disconcerting

AS: After so many years of fighting came your settlement and this huge legal win — one that enabled you to get surgery and has already made it possible for others to obtain gender-affirming care. What does it mean to you to be a trailblazer?

CI: I guess I was a trailblazer with helping some other people get surgeries and open the doors for that possibility to happen in the Federal Bureau of Prisons. But I also really wanted to touch base on something that I've come to reflect. I don't want to sound selfish, but I helped myself, mainly. And that's something I had never done in the past as far as I was my worst enemy. I built these walls and I basically buried myself. And throughout the lawsuit, I was able to help me as an individual. I remember having to tell my story in front of Judge Rosenstengel and tell her the steps that I had to make, and how I had to tuck and the things I had to do to shower and how dirty it felt. And that's something that I could never do with a therapist. But I did it to ensure my lawsuit was successful.

When I came back to the Metropolitan Correctional Center in Chicago after having my surgery, that’s when it really started to hit me that I have a vagina and that no one can take that away from me. And from that point on I was able to really start healing. All the years of torture and trauma that I had in my life, I started letting go.

AS: We’ve talked about these valuable changes you’ve helped bring about in the BOP, what that’s meant for other trans people behind bars. But I'm sure there are people that you also lost along the way. You mentioned a friend — could you tell me about her?

CI: I met [my friend] in 1994. We were almost the same age, she was like me — a girl. I wrote a threatening letter and I had to go to court to get sentenced. And on my way back, I found out that she had killed herself in the SHU. And it was because she was struggling with receding hairline. It resonated because she was my best friend.

[She] was catty but she was also very sweet. She was older than me by a year but she taught me some ropes that I didn't know because I was new to prison. One of the things she taught me was that I had to forget the free world. Because it would make my time go hard. And that was the hardest thing.

AS: Over the past couple of months you were released, you’re living in Chicago, you moved into your own place - so many big changes! How does it all feel?

CI: Honestly, it feels amazing. This is the first time in my life I’ve lived on my own. It’s a work in progress. It didn't come furnished, so I had to furnish it. I had to buy a plunger, a toilet brush — stuff I’ve never had to do before.

I’m on probation. I don't have to answer to people everyday, I have the freedom to go to the city when I want. It’s the most freedom I’ve had in decades.

I went to an all LGBTQ play — basically a skit and with all LGBTQ actors — and it was a charity thing, you paid $20 and you could interact with the whole cast.

That’s something I've never been able to do in my adult life. Now I can. It’s kind of amazing but I also have to pinch myself, is this really happening? It’s a dream.

Originally Appeared on Teen Vogue