Chelsea Manning Sues Federal Government for Gender Dysphoria Treatment

The lawsuit claims officials are withholding necessary medical care from Manning in violation of the Constitution.

The lawsuit claims officials are withholding necessary medical care from Manning in violation of the Constitution. Associated Press / YouTube

The federal government is denying Chelsea Manning the medical treatment necessary to treat her gender dysphoria in violation of her constitutional rights, the American Civil Liberties Union claims in a lawsuit filed in federal court on Manning’s behalf.

The lawsuit names Secretary of Defense Chuck Hagel and other Department of Defense and Department of the Army officials as defendants and details what Manning’s lawyers allege is a failure to provide necessary medical treatment for her gender dysphoria. Army doctors diagnosed Manning with the condition more than four years ago.

Manning is serving a 35-year prison sentence at the United States Disciplinary Barracks (USDB) at Ft. Leavenworth, Kansas, after leaking thousands of classified government documents to WikiLeaks.

Once Manning arrived at the Leavenworth prison, according to the allegations in the complaint, she submitted a formal request for an evaluation and treatment for gender dysphoria in accordance with World Professional Association for Transgender Health (WPATH Standards of Care), the leading authority on gender dysphoria.

The American Medical Association, the Endocrine Society, and the American Psychological Association all recognize WPATH Standards of Care as authoritative. The National Commission on Correctional Healthcare recommends that prisoners with gender dysphoria receive medical treatment that follows WPATH Standards of Care, and the Federal Bureau of Prisons administer hormone therapy to prisoners with gender dysphoria in their custody and house feminine-appearing prisoners in both men’s and women’s facilities.

Among the treatments recommended by WPATH Standards of Care: changes in gender expression and role that may involve living part-time or full-time in another gender role, consistent with one’s gender identity; hormone therapy; surgery; and accompanying psychotherapy or counseling. WPATH recommends against counseling or therapy as the sole treatment method.

Manning’s attorneys allege that during her initial appointment with Army officials to discuss her treatment options, she was told that Army policy limits treatment for gender dysphoria to psychotherapy and anti-depressant and anti-anxiety medication.

Army officials and doctors then had a series of communications where they admitted they were not qualified to care for Manning’s condition and expressed concerns about the effect Manning’s medical treatment—including hormone therapy—would have on the rest of the prison, according to the allegations in the complaint. From the complaint:

On October 15, 2013, Lt. Col. Keller sent a memorandum to Steve Lynch, former Deputy Director of the Army Corrections Command, regarding available treatment for Plaintiff at the USDB. In that memorandum, Keller wrote, “I see no way the USDB can provide a full course of therapy for Mr Manning’s Gender Dysphoria … because the USDB cannot house a female or highly feminized inmate. Permitting Mr Manning to live as female, much less begin to feminize his body, will create operational challenges as the inmate population respond to these changes.”

The U.S. military bans transgender people from serving, and defense department guidelines describe transgender as a “paraphilia” condition defined by “atypical” and “extreme” sexual behavior. In a May interview, Hagel said he was “open” to a review of the military’s ban on transgender service members but said the issue was more complicated than lifting the ban on gay and lesbians from serving because it “had a medical component to it.”

The federal government has authorized only “rudimentary level of gender treatment” for Manning.

Denying Manning the medically necessary treatment for her gender dysphoria violates the Eighth Amendment’s prohibition against cruel and unusual punishment, the American Civil Liberties Union (ACLU) charges in the lawsuit.

The complaint is accompanied by a motion for preliminary injunction demanding that Manning be provided hormone therapy, permission to follow female grooming standards, and access to treatment by a medical provider qualified to treat her condition.

“The government continues to deny Ms. Manning’s access to necessary medical treatment for gender dysphoria, without which she will continue to suffer severe psychological harms,” said Chase Strangio, attorney in the ACLU Gay Lesbian Bisexual and Transgender project and co-counsel on Manning’s case in a statement following the filing of the lawsuit. “Such clear disregard of well-established medical protocols constitutes cruel and unusual punishment.”

Manning is represented by the American Civil Liberties Union, the ACLU of the Nation’s Capital, the ACLU of Kansas, and civilian defense counsel David E. Coombs.