This Is What Happens When the Secretary of Defense is in Charge of Your Medical Care

When Chelsea Manning was sentenced to 35 years in prison on August 21, 2013, she was immediately worried that she would be denied desperately needed medical care for gender dysphoria.

So far, her worst fears of suffering without treatment have come true.

Every decision about her care goes from her doctors, all the way up the chain of command to the Secretary of Defense, who is notably not a doctor or a prison administrator. Even the Army's own providers admitted that her treatment is moving at a "glacial pace."

But the Constitution does not permit medical care to be provided sluggishly when it is urgently needed. And for Chelsea, the care is critical and the consequences for withholding it are dire.

Chelsea was first diagnosed with gender dysphoria, a serious medical condition, more than four years ago. When she arrived at the United States Disciplinary Barracks (USDB) at Fort Leavenworth, Kansas, over a year ago, the first thing she did was request treatment for gender dysphoria, including hormone therapy and permission to follow grooming standards for female prisoners, such as growing her hair.

Shortly thereafter she was again diagnosed with gender dysphoria, and a treatment plan was developed by Army medical providers in November of 2013. This seemed promising, and Chelsea was hopeful that the Army would follow the clear medical protocols for treating gender dysphoria.

Unfortunately, it soon became clear that Chelsea's medical treatment would be governed not by doctors but by Washington officials and be dictated not by medicine but by politics.

After a failed attempt to transfer Chelsea from the USDB into the federal Bureau of Prisons, the Associated Press reported on July 17, 2014, that Defense Secretary Hagel had approved "rudimentary" treatment for Chelsea's gender dysphoria. After the ACLU, the ACLU of Kansas, and Chelsea's civilian defense counsel David Coombs sent a letter to DOD and Army officials on August 11, 2014, demanding that she receive treatment, we learned just how "rudimentary" this treatment would be. On August 20, the Army provided Chelsea with female underwear and sports bras, but it continued to withhold hormone therapy and prohibit her from growing her hair and otherwise following the grooming standards for female prisoners.

Treating severe gender dysphoria with sports bras is like treating a gunshot wound with a Band-Aid. Such inadequate treatment sends the message to Chelsea and the rest of the world that the Army is not taking her health needs seriously.

People with gender dysphoria should not be forced to suffer without treatment because government officials don't take their medical needs seriously. As the American Medical Association recognizes, without treatment, gender dysphoria can lead to "distress, dysfunction, debilitating depression … suicidality and death."

Chelsea, like so many transgender women in prison, is experiencing the unrelenting anguish of being denied life-saving treatment. As Janet Mock wrote after Chelsea came out as transgender last year, "[w]e … all, whether we've been charged with a crime or not, whether we are popular or unpopular, whether we are loved or unloved, whether we are understood or stigmatized, deserve safe, quality, knowledgeable healthcare."

Today we are heading to court to demand that the government treat Chelsea Manning's serious medical condition and fulfill its obligation under the Constitution.

The days of government discrimination in providing healthcare for transgender people are numbered. It is the bravery of our clients like Chelsea, Andrea Fields, and Ophelia De'lonta who stand up to this injustice that will make the world safer and more just for the rest of us.

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Why is this considered such an urgent matter. Manning lived as a male her whole life. I understand she may want this therapy, and it may be appropriate for the public to foot the bill, but I don't understand the furor over the government's deliberate approach to the matter. Please spend the ACLU's money on things that matter.


I work very hard for the money I earn only to have 30% of what I make taken by the government!!
To have this money that I WORK FOR spent for female treatment procedures for a male TRAITOR to this country is an insult to me and every American who pays taxes.
If you want this absurd treatment carried out, then I suggest the ACLU pay for it.


Bradley Manning has a penis. That makes him a man, whether he or the ACLU likes it or not. My tax dollars should not pay for anything besides a cell and food for this guy. I was much less offended by what he is accused of thanhis insistence that taxpayers pay for so called treatment.
If he is in such denial of the fact that he was born male that he feels compelled to kill himself, so be it. Whatever anatomy you have at birth is what you are, the same as what color your skin is determines your race. Get over it!

Anonymous paramedic

Well you wouldn't believe how many people think they're a doctor or paramedic. One even made the statement that because he watches a reality show about Emergency Medicine that makes him a doctor. He said he's watched so many episodes that he considers himself to have a doctor's knowledge of Emergency care.
I watch the same show, so I asked him when the vital sign machines start beeping repeatedly what does it mean? He had no clue; they've never said on the show that beeping vital sign machines indicate the vital sign in question has gone out of range and that the patient needs the attention of professionals.

I hope the show has a disclaimer somewhere, if it's going to make people like THAT think they're doctors because they watched so many episodes of Trauma: Life in the ER.
I'm a paramedic but also work in the ER which, where I live, is called a Trauma 1 Center. They leave out little unimportant bits of information that people who work in the field know of because they've gone to school and worked in ER for their intern. The regular public doesn't know anything a doctor on the show hasn't told them.
But they think they know everything, and that's one reason I DISlike Internet. Looking something up online or watching a reality show doesn't make you a professional in Emergency Medicine.
I would be furious if the Secretary of Defense thought he knew ANYthing about health care. IMO he barely comprehends his OWN job, why's he strutting around thinking he understands health care?

John Smith

I'm a long time member of the ACLU and have tried to post to this discussion before this. My post was very respectful but took issue with the ACLU's involvement in this lawsuit at this time. I'm disappointed that the moderators were apparently not willing to have a dissenting opinion voiced. Pretty sad, ACLU.

Common Sense

Since his condition is not life threatening, than it is cosmetic and the Military has no obligation to provide it.

David M

I do believe he can deal with this when his time is up ..... we are not obligated to pay for his "selective" surgery. How many times to people fairly bitch and moan about the cost of health-care yet turn around and expect the system to pay for stuff that should not be paid for.


To the person who said "Bradley Manning has a penis, that makes him a man."

What does it make them when they're born with both organs? A penis and a vagina? It's happened before. It means something went out of control in the development of the fetus.
Ordinarily people call it a hermaphrodite.

I think it's dumb that people decide a man or woman on the basis of physical appearance alone and entire ignore the brain of the person.
If they don't feel like a man (or woman) what are YOU going to be able to do to change that?

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