Chelsea Manning decision points to shift in views on transgender health care

New York Army officials have approved hormone treatments for the male-to-female transition of Chelsea Manning, the transgender soldier convicted of espionage in 2013 after sending classified government documents to WikiLeaks, the Defense Department confirmed on Thursday.

Official approval to begin hormone treatments for Ms. Manning, formerly Pfc. Bradley Manning, who is currently in the Forth Leavenworth Army prison, marks a first for the Defense Department, which does not permit open transgender individuals to serve in the military, and had not previously provided transition-related health care in the past.

But the Armys approval of Mannings hormone therapy is part of a rapid and wide-ranging shift in how the nation sees transgender people and their health needs. Health providers and insurance companies across the nation, as well as the federal government and civil courts, have begun to reevaluate previous bans on sex-transition treatments, which have long been seen as elective procedures, like cosmetic surgery, that were done for personal, subjective reasons.

In past few years, however, the nations medical and psychological professions have increasingly shifted to considering transition therapy, in some cases including sex-reassignment surgery, medically necessary treatments of a condition referred to as gender identity disorder.

Though the idea of providing public funds for such treatments remains politically controversial, the nations health care structure has been changing.

In February, 2013, the Veterans Health Administration approved all medically necessary care for intersex and transgender veterans, including hormone therapy, mental health care, as well as pre-operative and post-operative care following sex-reassignment surgery. The VA does not provide such surgery, however.

Last year, the Obama administration ended the 33-year-old ban on Medicare coverage for both transition-related care and sex-reassignment surgery.

Weve had some really significant gains in the last few years, says Dru Levasseur, director of the Transgender Rights Project for Lambda Legal, a New York-based lesbian, gay, bisexual, and transgender civil rights group. And we see a growing number of states that are passing these private insurance bulletins that say that insurers cannot discriminate in the provision of health care for transgender people.

In 2012, Oregon became the first state to tell private insurers to pay for transition procedures deemed medically necessary. Other states, including California, Colorado, Connecticut, Vermont, as well as the District of Columbia have done the same.

At the same time, much of corporate America has embraced more inclusive insurance coverage for transgender people now included as a part of the Human Rights Campaigns influential corporate equality index scores.

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Chelsea Manning decision points to shift in views on transgender health care

Chelsea Manning Will Receive Hormone Therapy Following Suit

Chelsea Manning, the Wikileaks leaker formerly known as Bradley Manning, is finally getting the hormone treatments shes been demanding for months.

In September of last year Manning sued the US Department of Defense, claiming she had been denied access to medically necessary treatment in connection with a gender disorder.

She brings this action to compel defendants to treat her serious medical needs consistent with their obligation under the Constitution, said the lawsuit. Mannings lawyers claimed that lack of hormonal treatment would cause Manning to suffer continued pain, depression and anxiety and that she is at an extremely high risk of self-castration and suicidality.

Manning and the ACLU said that the military was stalling.

Now, after many months, theyve caved. USA Today obtained the internal memo, which grants Manning the medically appropriate and necessary treatments.

After carefully considering the recommendation that (hormone treatment) is medically appropriate and necessary, and weighing all associated safety and security risks presented, I approve adding (hormone treatment) to Inmate Mannings treatment plan, wrote Col. Erica Nelson in the memo.

The American Civil Liberties Union, who has represented Chelsea Manning, applauded the decision.

We are thrilled for Chelsea that the government has finally agreed to initiate hormone therapy as part of her treatment plan, said Chase Strangio, an attorney with the ACLU. This is an important first step in Chelseas treatment regimen and one that is in line with the recommendations of all of her doctors and the basic requirements of the Eighth Amendment.

Still, its not a total victory. According to Strangio, the officials at Leavenworth are still refusing to let Manning grow her hair out a step in her transformation that he describes as critical.

In August of 2013, Pvt. Chelsea (then Bradley) Manning was sentenced to 35 years in prison for supplying WikiLeaks with 700,000 classified documents in 2010. Manning was found guilty on charges under the Espionage Act, the Computer Fraud and Abuse Act, and the code of military justice but was spared the charge of aiding the enemy, the most serious of all the charges. If convicted of that crime, Manning could have faced up the 90 years behind bars.

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Chelsea Manning Will Receive Hormone Therapy Following Suit

Chelsea Manning has gender hormone therapy approved

The decision came after a lawsuit was filed in September in US District Court for the District of Columbia. It alleged Manning was at a high risk of self-castration and suicide unless she received more focused treatment for gender dysphoria, the sense of being a woman in a man's body.

The Army was providing some treatment but not enough, according to the lawsuit, including psychotherapy from a mental health specialist who lacked the qualifications to treat gender dysphoria. The Federal Bureau of Prisons and many state and local corrections agencies administer hormone therapy to prisoners with gender dysphoria, but Manning is the first transgender military prisoner to request such treatment.

"Such clear disregard of well-established medical protocols constitutes cruel and unusual punishment," ACLU attorney Chase Strangio said in September. Outgoing Defense Secretary Chuck Hagel had approved medical treatment in August, but it hadn't started by the time the ACLU filed the lawsuit.

The 26-year-old former intelligence analyst was convicted in August 2013 of espionage and other offenses for sending more than 700,000 classified documents to WikiLeaks while working in Iraq.

Transgender people are not allowed to serve in the U.S. military, but Manning can't be discharged from the service while serving her prison sentence.

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Chelsea Manning has gender hormone therapy approved

Chelsea Manning one step closer to making transition to a woman

In this undated file photo provided by the U.S. Army, Pfc. Chelsea Manning poses for a photo wearing a wig and lipstick. AP Photo/U.S. Army, File

WASHINGTON -- Hormone treatment for gender reassignment has been approved for Chelsea Manning, the former intelligence analyst convicted of espionage for sending classified documents to the WikiLeaks website.

Defense Department officials said Thursday that the hormone therapy was approved Feb. 5 by Col. Erica Nelson, commandant of the U.S. Disciplinary Barracks at Fort Leavenworth, Kansas, where Manning is serving a 35-year sentence.

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Bradley Manning, the army private who leaked government secrets, made a surprising revelation by saying he wants to become a woman and be called ...

The treatment would enable the Army private formerly known as Bradley Manning to make the transition to a woman. Manning changed her legal name in April 2014.

The officials were not authorized to discuss the matter publicly and spoke on condition of anonymity. The memo approving Manning's hormone treatment was first reported by USA Today.

Calls to military officials at Fort Leavenworth weren't immediately returned.

The decision came after a lawsuit was filed in September in U.S. District Court for the District of Columbia. It alleged Manning was at a high risk of self-castration and suicide unless she received more focused treatment for gender dysphoria, the sense of being a woman in a man's body.

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Chelsea Manning one step closer to making transition to a woman

Manning to get hormone therapy

Story highlights "This is an important first step in Chelsea's treatment regimen," her legal counsel says Manning, whose former first name was Bradley, had filed a lawsuit over the issue But she's still not allowed to grow her hair like other female prisoners, the ACLU says

The prisoner formerly known as Bradley Manning, and once held to be male, said in August 2013, the day after her court sentencing, that she is female. Just over a year later, it emerged that she had filed a lawsuit in federal court claiming she "has been denied access to medically necessary treatment" for her gender disorder.

The commandant of the Fort Leavenworth Disciplinary Barracks in Kansas, where Manning is serving her sentence, issued a memo on February 5 authorizing the addition of hormone therapy to Manning's treatment, USA Today reported Thursday.

The memo cited a recommendation that the therapy was "medically appropriate and necessary."

The news was welcomed by Manning's legal counsel in the lawsuit.

"We are thrilled for Chelsea that the government has finally agreed to initiate hormone therapy as part of her treatment plan," said Chase Strangio, an attorney with the American Civil Liberties Union. "This is an important first step in Chelsea's treatment regimen and one that is in line with the recommendations of all of her doctors and the basic requirements of the Eighth Amendment."

But Strangio said that the approval of the therapy was only a partial victory.

"The military continues to refuse to let Chelsea grow her hair like other female prisoners, a critical part of her treatment plan that has been recognized by her doctors," he said.

Also, the delay in getting the hormone treatment "came with a significant cost to Chelsea and her mental health," Strangio said.

At the time of her 2013 announcement that she planned to live as a woman, Manning asked for support and said she wanted to begin hormone therapy as soon as possible.

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Manning to get hormone therapy

Chelsea Manning to get hormone therapy

The U.S. Army has agreed to provide hormone therapy for Chelsea Manning, the soldier serving a 35-year prison sentence for leaking a huge trove of classified documents.

The prisoner formerly known as Bradley Manning, and once held to be male, said in August 2013, the day after her court sentencing, that she is female. Just over a year later, it emerged that she had filed a lawsuit in federal court claiming she "has been denied access to medically necessary treatment" for her gender disorder.

The commandant of the Fort Leavenworth Disciplinary Barracks in Kansas, where Manning is serving her sentence, issued a memo on February 5 authorizing the addition of hormone therapy to Manning's treatment, USA Today reported Thursday.

The memo cited a recommendation that the therapy was "medically appropriate and necessary."

The news was welcomed by Manning's legal counsel in the lawsuit.

"We are thrilled for Chelsea that the government has finally agreed to initiate hormone therapy as part of her treatment plan," said Chase Strangio, an attorney with the American Civil Liberties Union. "This is an important first step in Chelsea's treatment regimen and one that is in line with the recommendations of all of her doctors and the basic requirements of the Eighth Amendment."

Not allowed to grow hair

But Strangio said that the approval of the therapy was only a partial victory.

"The military continues to refuse to let Chelsea grow her hair like other female prisoners, a critical part of her treatment plan that has been recognized by her doctors," he said.

Also, the delay in getting the hormone treatment "came with a significant cost to Chelsea and her mental health," Strangio said.

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Chelsea Manning to get hormone therapy

Army Approves Hormone Therapy for Chelsea Manning

The U.S. Army has approved hormone therapy for Chelsea Manning, who was convicted of leaking national security secrets to Wikileaks, defense officials told NBC News late Thursday.

Private Manning revealed her gender identity as a transgender female after being convicted and sentenced to 35 years in the military prison at Leavenworth in July 2013.

According to the officials, since Manning has been clinically diagnosed as a transgender and is confined to the military prison, the Army is obligated to provide and pay for her hormone treatments just as if she was confined to a civilian federal prison.

The hormone therapy development was first reported by USA TODAY.

Manning, formerly known as Bradley Manning, became the first military inmate to ask for treatment for gender dysphoria. She asked for a treatment plan that would consider three measures: dressing and living as a woman, hormone therapy and possible surgery.

In July 2014, Defense Secretary Chuck Hagel approved an Army recommendation to begin the early stages of gender reassignment, including counseling and approval to dress as a woman, officials said.

First published February 12 2015, 4:15 PM

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Army Approves Hormone Therapy for Chelsea Manning