Chelsea Manning, the imprisoned Wikileaks leaker, issued a statement to NBC News last week saying the U.S. military, which had promised her sex-change surgery, is still refusing to provide it. Worse, the prison staff still calls her Bradley.
"This time last year, I publicly asked that I be provided with a treatment plan, to bring my body more in line with my gender identity," said Manning, an ex-Army private who used to go by Bradley, in the one-page statement. "Unfortunately, despite silence, and then lip-service, the military has not provided me with any such treatment."
Sex reassignment surgery is an important treatment option for people whose gender and sex don't match up, a situation diagnosed as gender dysphoria. For Manning, the problem is angered by Army-style rigidity and likely, from what her statement describes, bigotry. "For example," she writes, "in my daily life, I am reminded of this when I look at the name on my badge, the first initial sewed into my clothing, the hair and grooming standards that I adhere to, and the titles and courtesies used by the staff. Ultimately, I just want to be able to live my life as the person that I am, and to be able to feel comfortable in my own skin."
In 2013, the American Psychiatric Association updated its DSM entry on "gender identity disorder" to clarify that associating with one gender or another is not itself a disorder. "The critical element of gender dysphoria is the presence of clinically significant distress associated with the condition," they write. Military prison, where Manning is serving a 35-year sentence, seems to be aggravating that distress.
"Prisons — and especially military prisons — reinforce and impose strong gender norms, making gender the most fundamental aspect of institutional life," Manning said. "The U.S. Disciplinary Barracks restricts my ability to express myself based on my gender identity." Although she says she does not wish to be transferred to a different facility, Manning desperately wants to undergo the surgery.
In response to the NBC report on Manning's statement, the Army said privacy laws prevented it from talking about Manning's health. But they suggested that Manning first needed to go through a period of real life experience therapy, or the Real Life Test, which often precedes the sex reassignment operation. It's basically a trial run at living as the opposite gender. It's not clear how that would work in the barracks.
Here's the statement from the Army spokeswoman, Lt. Col. Alayne Conway: "The Department of Defense has approved a request by Army leadership to provide required medical treatment for an inmate diagnosed with gender dysphoria. I can't discuss the medical needs of an individual. In general terms, the initial stages of treatment for individuals with gender dysphoria include psychotherapy and elements of the 'real life experience' therapy. Treatment for the condition is highly individualized and generally is sequential and graduated."