Why The Military Should Be Prepared To Offer Chelsea Manning Hormone Therapy


Fort Leavenworth PrisonPfc. Chelsea Manning (née Bradley Manning) announced Thursday that she identifies as transgender, prompting many conversations about transgender identities and the fate of transgender people in prison. Manning’s circumstances in this regard are unique, as she will be serving her time at Fort Leavenworth, a military prison, which released a statement clarifying it “does not offer sex reassignment or hormone therapy for the inmates housed at the facility.”

Even after the repeal of “Don’t Ask, Don’t Tell,” a transgender identity still disqualifies an individual from military service. Military regulations consider a transgender identity a medical disorder, even though psychiatrists no longer use the word “disorder” to describe such identities. Thus, any active duty servicemember who came out as trans would be booted from the military, much as gays and lesbians were under “Don’t Ask, Don’t Tell.”

But Manning was convicted of crimes by a military court, and she has been sentenced to serve time in a military prison. In fact, Fort Leavenworth is the only military prison for servicemembers sentenced to 10 or more years of confinement. Thus, her fate is bound to that of the military even though her identity would otherwise disqualify her from continued military service were she not a prisoner. This is a situation the military prison system has likely never encountered.

Still, there is also precedent that could — and arguably should — work in Manning’s favor. The Veteran’s Administration has extended many benefits and protections to transgender veterans, including the right to access trans-related healthcare and a process for changing one’s gender records. In particular, the health benefits stipulate that hormone therapy should be covered if the “appropriate health care professional determines that the care is needed to promote, preserve, or restore the health of the individual and is in accord with generally-accepted standards of medical practice.”

The same standard should apply to Manning. It remains unclear what her doctors have said or might yet say about how best to respond to her gender identity. If they recommend that her mental health and general well-being are dependent upon her ability to begin physically transitioning with the use of hormone therapy, the military will have to reconsider its policy. As the American Civil Liberties Union has pointed out, denying Manning treatment that her doctors have prescribed could raise “serious constitutional concerns,” such as violations of her right of equal protection and/or her freedom from cruel and unusual punishment.

Pentagon spokesman George Wright echoed the prison’s statement that inmates cannot receive surgery or hormone therapy, but proclaimed that they “are treated equally regardless of race, rank, ethnicity, or sexual orientation.” To be treated “equally,” Manning would have to receive all prescribed healthcare just as other prisoners do. If she is selectively prevented from that right, it would constitute pure anti-transgender discrimination on the military’s part.