An Illinois judge set a new legal precedent this week when she ordered the Federal Bureau of Prisons to secure a sex-change operation for a transgender prisoner.

Judge Nancy Rosenstengel of the U.S. District Court for the Southern District of Illinois on Monday ruled that the BOP must find a qualified surgeon to perform vaginoplasty on inmate Cristina Nichole Iglesias, a gender dysphoric male who identifies as female.

Iglesias, who is serving a 20-year sentence for making a weapons of mass destruction threat against the British government, has been fighting in court for several years for the right to have a sex-change operation.

“I am hopeful that I will finally get the care I need to live my life fully as the woman I am,” Iglesias said in a statement. “BOP has denied me gender-affirming surgery for years — and keeps raising new excuses and putting new obstacles in my way. I am grateful that the court recognized the urgency of my case and ordered BOP to act.”

In December, the court instructed BOP's Transgender Executive Council to provide a recommendation on the surgery. The council missed the court's deadline, and only made a recommendation that Iglesias go forward with the sex-change surgery after including several conditions, including good behavior.

During that time and until now, Iglesias has not received the surgery.

Rosenstengel said BOP was playing a game of "whack-a-mole" with the prisoner, improperly delaying the surgery. She ordered the bureau "to show cause why it should not be held in contempt" for violating the courts previous orders.

The ACLU of Illinois hailed Rosenstengel's ruling as a major victory for transgender rights and for more than 1,200 transgender prisoners in federal custody.

“For years, Cristina has fought to receive the healthcare 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,” said attorney Joshua Blecher-Cohen. “We hope this landmark decision will help secure long overdue healthcare for Cristina—and for the many other transgender people in federal custody who have been denied gender-affirming care.”

Iglesias has been in federal custody for 28 years and currently resides in a BOP halfway-house in Florida. Iglesias' attorneys say BOP has been aware that he identifies as a woman he arrived in federal custody in 1994.

"Since then, she has been denied basic medical care to treat her gender dysphoria and was housed in men’s facilities for over two decades, where she experienced severe physical and sexual violence," the ACLU said. "In May 2021, this lawsuit resulted in Ms. Iglesias being one of the few transgender people ever moved to a federal prison that aligns with her gender. Ms. Iglesias has been seeking gender-affirming surgery since at least January 2016."

Iglesias will be the first federal prisoner to receive a sex-change operation while in custody, opening the door for others to follow.