Judge Nancy Rosenstengel in the U.S. District Court for the Southern District of Illinois ruled Cristina Nichole Iglesias is entitled to the surgery before her sentence ends.

Iglesias is serving a 20 year federal sentence after sending a letter issuing death threats and filled with a powdery substance claimed to be Anthrax to the Foreign and Commonwealth Office in London.

The Bureau of Prison’s Transgender Executive Council (TEC) recommended Iglesias for the procedure in December but with conditions. Iglesias was required to move to a halfway house in Florida and be monitored as a report noted the inmate has “demonstrated significant difficulty adjusting to living with women in a correctional setting”.

The ACLU, which is representing Iglesias, cheered the ruling.

“We hope this landmark decision will help secure long overdue healthcare for Cristina,” said staff attorney Joshua Blecher-Cohen. ”And for the many other transgender people in federal custody who have been denied gender-affirming care.”

Under the judge’s order, BOP must file updates on its progress every Friday until a surgeon is secured and the procedure is scheduled.