“We sentence people to incarceration. We do not sentence them to untreated medical conditions. We don’t sentence them to untreated gender dysphoria just as we don’t sentence them to untreated kidney failure, untreated infections, or anything else of the sort.” – Lauren McNamara, a noted LGBT activist, while appearing on CNN’s “The Lead.”
Chelsea Manning, formerly known as Bradley, has been through a lot—from being held in solitary confinement and tolerating treatment later ruled “cruel and unusual” at Quantico to being incarcerated for more than three years before her case went to trial. Now she is being asked to endure yet another injustice: being denied transitional medical care to treat her gender dysphoria.
Manning’s case is certainly complicated, and her transgender status undeniably contributed to public perceptions of the trial. Many activists both inside and outside the LGBT community have voiced support for Manning, even going so far as to help fund her defense. But those ignorant to the details of what it means to identify as transgender have questioned the legitimacy of Manning’s claim, and also agreed with the sentiment that American taxpayers should not be responsible for funding her transition care.
Extensive research preceded this column. I have followed Manning’s trial and have read statements from her, her legal representation and many LGBT lawyers and activists. I will try to give the clearest and most respectful explanation of Manning’s condition possible, but I do not presume to speak for her or the trans* community as a whole. I acknowledge that trans* issues can be difficult to navigate. That said, an issue being confusing or controversial for the general public does not give us a right to ignore it, nor does it excuse the historic pattern of transphobia in the United States. From both a personal and legal standpoint, we are obligated to treat transgendered people equally. To illegitimate Manning’s condition or to suggest that she is not entitled to medical care is ridiculous.
Recently, the medical community has taken steps to try to destigmatize transgendered status, including by changing the name of the underlying medical condition from “gender identity disorder” to “gender dysphoria.” Gender dysphoria is the condition of experiencing or expressing a gender that does not match the biological gender (or sex) you were assigned at birth, according to the Diagnostic and Statistical Manual of Mental Disorders. Transitional medical care, including hormone replacement therapy and sexual reassignment surgery, is considered valid treatment for gender dysphoria.
Many transgendered people attest that they were aware of their gender identity from a young age, and that seems to be true for Chelsea Manning as well. She recently issued a statement to her supporters saying: “I want everyone to know the real me. I am Chelsea Manning, I am a female. Given the way I feel and have felt since childhood, I want to begin hormone therapy as soon as possible.” Additionally, it was revealed during her trial that she had sent a picture of herself dressed in a blonde wig and lipstick to a supervisor in the army and captioned it “my problem.” Manning sent the picture in 2010, which suggests her struggle with gender identity is not a new development.
There are people who will still suggest that Manning coming out as transgendered is a ploy to get her released from prison, to garner attention or to make an excuse for her crimes. Those people demonstrate a fundamental misunderstanding of not only what it means to be a transgendered person but also of our justice system. Being transgendered will not get you released from prison or even (necessarily) transferred to a different facility. And no one would pursue transitional medical care lightly — it is a serious commitment that physically alters your body chemistry and your appearance. Those who request it have considered it carefully and use it to correct a medical condition. Manning’s offer to pay for her transitional care herself, should the Army refuse to pay, demonstrates the seriousness of her convictions.
Currently, Manning is being held at Fort Leavenworth in Kansas. A representative from the prison has stated that the facility would not provide trans treatment beyond psychiatric support because the Army does not provide hormone therapy or sex-reassignment surgery for gender dysphoria. Manning was diagnosed with gender dysphoria by two Army behavioral health specialists prior to her trial, but now Fort Leavenworth is insisting on re-examining her medical files.
It should be obvious that refusing treatment to Manning is a violation of her Eighth Amendment rights, which safeguard against cruel and unusual punishment, but if it is not, there is legal precedent to support such a claim. In 2010, a settlement reached in the case Adams v. Federal Bureau of Prisons held that it was not sufficient to supply hormone treatments to a transgender inmate at the level they had been administered prior to incarceration. Treatment should be built on and continued throughout the sentence. In 2012, a transgender inmate named Michelle Kosilek in Massachusetts was granted the right to sexual reassignment surgery after the judge determined that it was the “only adequate treatment” and “that there is no less intrusive means to correct the prolonged violation of Kosilek’s Eighth Amendment right to adequate medical care.”
The fact that Chelsea Manning may be denied transitional medical care due to the Army’s outdated policies, which are based on flawed understandings of LGBT people, is a travesty. Regardless of what some may think of Manning or the crimes she committed, we as a country cannot condone denying her treatment.
Ashley Spinks is an Opinion columnist for The Cavalier Daily. Her columns run Mondays.
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