According to the DSM-5, a manual published by the American Psychiatric Association to diagnose and classify mental disorders, those whose gender at birth is “contrary to the one they identify with will be diagnosed with gender dysphoria.”
The former term, “Gender Identity Disorder” was replaced with “Gender Dysphoria” as a more neutral diagnosis of emotional distress over one’s gender. This was a revolutionary decision for the transgender community who is often still stigmatized and discriminated against in schools, workplaces and their daily lives.
Today, transgender Americans are able to access necessary hormone therapy and sex-reassignment surgery, even including most prisoners.
After a 2010 lawsuit, the U.S. Bureau of Prisons reformed their regulations from not only allowing transgender prisoners to continue their treatment after being incarcerated and to start treatment while already incarcerated if determined necessary by a doctor.
This is why many people are puzzled as to why the Army released a statement saying that it “does not provide hormone therapy or sex-reassignment surgery for gender identify disorder” after Pfc. Manning stated that she would like to begin hormone therapy.
“It seems odd that the Army would make a determination on Manning’s healthcare needs before they’ve even had an assessment [on Manning’s health],” says Masen Davis, the Executive Director of the Transgender Law Center. “Manning has the right to access necessary medical care while she is in prison, which may include estrogen. That should be determined by a doctor and the patient, not by bias.”
“It is illegal in the U.S. to withhold legitimate medical treatment from prisoners,” says Mara Keisling, the founding Executive Director of the National Center for Transgender Equality. Many argue that gender dysphoria is not a legitimate disorder and therefore treatment should not be given to those who have broken the law. They believe that it is a luxury that Manning lost when she broke the law.
“The reality is that every credible medical organization has recognized gender identity disorder as a legitimate medical condition, and that the appropriate standard of care includes hormone therapy and surgery,” says Jennifer Levi, Director of the Transgender Rights Project for the Gay and Lesbian Advocates and Defenders. Even in prison you have the right to be treated for both physical and emotional harm and distress.
Transgender advocates believe that the Army’s decision to deny Chelsea Manning access to hormone therapy will likely be challenged, as it very well should be.
The issue of gender identity is still a new concept in mainstream society and is one that we as a society are still learning how to deal with.
It has been over a week since Chelsea Manning (formerly Bradley Manning) was sentenced to 35 years in prison for releasing 700,000 documents to the infamous WikiLeaks website.
During the trial Manning came out as transsexual who has long considered herself as a woman. Now that she is free from what she described as the “hyper-masculine” environment of the military, she wishes to start hormone therapy.
This has turned into yet another media circus because military prison policy “does not provide hormone therapy or sex-reassignment surgery for gender identity disorder,” (NBC).
The problem with this scenario is that Chelsea Manning didn’t make her choice when she was free but after she was incarcerated. A law-abiding person should be entitled to alter their body in any way that helps them achieve their desired lifestyle, but jail is not the appropriate place for such choices to be a made. Jail is an institution of consequence, a place where the results of past choices have led to the forfeiture of certain freedoms.
It would be one thing if Manning was already being treated and required medicine to maintain her health, but to start the process now is a luxury beyond the rights of an inmate.
While confined, she becomes a burden of the people and her choices must be weighed against the other concerns facing society.
Although Manning has offered to pay for the therapy, other cases have led to the state paying for treatments. Using tax money for a non-essential purpose is insulting to the other areas of government and society that lack proper funding. By paying for the hormone treatments of a criminal, we essentially deny the opportunity of a child to receive better educational materials or a dangerous road the chance to be repaired.
The real shame of this case is that society’s lack of understanding, regarding the transgender community, could very well be the reason Manning felt the need to expose a historically divided institution like the US military. His actions not only harmed our country’s security but also deprived the country of an intelligent young person, who is now sitting in jail through taxpayer money. It is hard not to think that a little compassion and understanding might have avoided these results.
While Manning’s fate has already been decided, the lessons learned from her case can hopefully provide a pathway to a future where a person’s perception of gender is not an internal war but a supported personal choice.