Chelsea Manning has been approved to start hormone replacement therapy while serving her thirty-five year prison sentence at Fort Leavenworth, according to the Associated Press.
After a tentative plan to transfer Manning to a civilian prison to undergo hormonal treatment was denied by the Bureau of Prisons, the AP reported that US Secretary of Defense Chuck Hagel approved a plan allowing her access to “rudimentary” treatment for her gender dysphoria.
The specifics of the treatment Manning will be allowed were not disclosed, but her attorney, David Coombs, told press he is “optimistic” that she will have access to hormone replacement therapy, one of the standard treatments used in the beginning stages of gender confirmation. According to the World Professional Association for Transgender Health (WPATH)’s Standards of Care, “hormones are often medically necessary for successful living in the new gender. They improve the quality of life and limit psychiatric co-morbidity, which often accompanies lack of treatment.”
Coombs told the AP, “It has been almost a year since we first filed our request for adequate medical care. I am hopeful that when the Army says it will start a ‘rudimentary level’ of treatment that this means hormone replacement therapy.”
Should the Army fail to provide Manning with the treatment, which has been declared medically necessary by her doctor, Coombs said he intends to take “appropriate legal action to ensure Chelsea finally receives the medical treatment she deserves and is entitled to under the law.”
If Manning is allowed to begin transitioning while in a military prison, it will be a historic first. Though civilian prisons can provide inmates with gender identity treatment, at present military prisons are not able or willing to do the same, as transgender people are still barred from the military.
Manning cannot be discharged until she has completed her thirty-five year prison sentence, but the military treating her for her gender dysphoria would mean violating a long-standing policy, and it has argued that it does not have the medical expertise to treat her as a result. (The obvious solution of hiring someone who does has not been addressed.)
Currently, transgender people are barred from serving openly in the US military. The Advocate noted that if Manning is given access to gender confirmation treatment, it “could have great significance for other transgender members,” because “successfully treating Manning’s gender dysphoria while she remains in military custody would prove that the military has the capability of providing care to trans people.”
Shortly after Manning came out as a transgender woman on August 22, 2013, prison spokesperson Kimberly Lewis stated “The Army does not provide hormone therapy or sex-reassignment surgery for gender identity disorder,” in an email to Courthouse News. In the eleven months since then, officials with the Department of Defense have been consistent in claiming that the Army is unable and/or unwilling to provide appropriate transition-related treatment for Manning.
When the Pentagon began looking into transferring her to a civilian prison to allow her to undergo hormonal treatment, her lawyer said such a move would force her to choose between medically necessary treatment and her safety. Coombs wrote, “Whether the Pentagon likes it or not, Chelsea is a military service member and responsibility for her falls on the military.
“Chelsea has been asking for medical treatment from the military for the past ten months. So far, the military has outright ignored her requests. The military absolutely needs to revisit its ‘policy’ on transgender medical care and adapt it to 21st century medical standards. It cannot continue to bury its head in the sand any longer.”