ACLU LGBT Project
In response to Chelsea Manning’s disclosure that she is female, has been diagnosed with gender dysphoria, and will be seeking hormone therapy as a part of her transition during her incarceration, public statements by military officials that the Army does not provide hormone therapy to treat gender dysphoria raise serious constitutional concerns. Gender dysphoria is a serious medical condition in which a person’s gender identity does not correspond to his or her assigned sex at birth, and hormone therapy is part of the accepted standards of care for this condition.
Without the necessary treatment, gender dysphoria can cause severe psychological distress, including anxiety and suicide. When the government holds individuals in its custody, it must provide them with medically necessary care. The official policy of the Federal Bureau of Prisons and most state agencies is to provide medically necessary care for the treatment of gender dysphoria, and courts have consistently found that denying such care to prisoners based on blanket exclusions violates the Eighth Amendment of the Constitution.
Human Rights Campaign
Regardless of how she came to our attention, Pvt. Chelsea Manning’s transition deserves to be treated with dignity and respect. As she requested in her letter, journalists and other officials should use her chosen name of Chelsea and refer to her with female pronouns. Using the name Bradley or male pronouns is nothing short of an insult. Media, having reported on her wishes, must respect them as is the standard followed by the AP Stylebook.
As Pvt. Manning serves her sentence, she deserves the same thing that any incarcerated person does – appropriate and competent medical care and protection from discrimination and violence. The care she receives should be something that she and her doctors – including professionals who understand transgender care – agree is best for her. There is a clear legal consensus that it is the government’s responsibility to provide medically necessary care for transgender people and the military has an obligation to follow those guidelines.
What should not be lost is that there are transgender servicemembers and veterans who serve and have served this nation with honor, distinction and great sacrifice. We must not forget or dishonor those individuals. Pvt. Manning’s experience is not a proxy for any other transgender man or woman who wears the uniform of the United States.
Transgender people–like all people–deserve health care and are constitutionally protected in prison. Period. In fact the U.S. Supreme Court has previously ruled in Farmer v. Brennan on the right of transgender people to be free from cruel and unusual punishment while in prison which includes withholding medically necessary treatment.
“It would be a shame if the U.S. military prison system held itself to a lower standard than civil prisons. The Constitution requires that Chelsea Manning receive medical care at Ft. Leavenworth–to do otherwise would be a violation of the Eighth Amendment.”
In the 1994 seminal Eighth Amendment case involving a transgender plaintiff, Farmer v. Brennan, the court stated that “prison officials have a duty under the Eighth Amendment to provide humane conditions of confinement. They must ensure that inmates receive adequate food, clothing, shelter, and medical care.”
Just last year the U.S. Supreme Court declined review of a 6th Circuit decision in Fields v. Smith striking down as unconstitutional a Wisconsin law that barred medical care for transgender prisoners. Lambda Legal and the ACLU won that case on behalf of transgender prisoners.