Chelsea ManningCommunityThe Dissenter

Chelsea Manning Sues Pentagon for Denying Her ‘Urgently-Needed’ Medical Care for Gender Dysphoria

How Chelsea Manning sees herself

Chelsea Manning has filed a lawsuit against the United States Defense Department and the Department of the Army for denying her medical care for her gender dysphoria. It seeks a preliminary injunction requiring the Pentagon to provide “clinically appropriate treatment.”

While deployed as an intelligence analyst in Iraq, Manning provided WikiLeaks with around a half million classified documents, which exposed details of the Iraq and Afghanistan wars, including war crimes like torture and summary executions. She is currently serving a 35-year prison sentence at Fort Leavenworth after being convicted of Espionage Act violations and other offenses on July 30, 2013.

She has spent more than a year trying to convince the Pentagon to provide her access to hormone therapy, but they have ignored her requests or insisted on denying her access to treatment—an alleged violation of her Eighth Amendment rights under the US Constitution.

The lawsuit [PDF] accuses the Pentagon of prohibiting her “from expressing her female gender by growing her hair and otherwise following female grooming standards.” It says she is “experiencing escalating distress and is at serious risk of severe and imminent harm, including resorting to self-surgery (auto-castration) or suicide, because this medically necessary treatment is being withheld.”

It was filed in the US District Court for the District of Columbia by David Coombs, a military defense attorney who argued her case when she was court-martialed, and lawyers from the American Civil Liberties Union.

“Despite my repeated efforts to follow each and every procedure to pursue medical treatment,” Manning states in a declaration to the court [PDF], “I am not receiving hormone therapy or permission to follow to the hair, cosmetics, and nail grooming standards consistent with my female gender.”

“On August 20, 2014, approximately six weeks after my attorneys put in a request for my medical records from the USDB, I was informed that I would be issued sports bras nd female underwear. I received those items shortly thereafter but I have not been permitted follow female hair length and other female grooming standards that would allow me to outwardly feminize my appearance. And I have not been provided hormone therapy.”

She adds, “Because I have not been treated with hormones or given permission to outwardly express my female gender by growing my hair and receiving permission to follow the other female grooming standards, I am becoming increasingly stressed, anxious and depressed.”

“Instead of feeling more like the woman I want to express myself as being, I feel like I am just a ‘man in a bra,’ and I feel as though I am slowly being poisoned by the testosterone that my body produces.”

“It has now been more than four years since I was first diagnosed with gender dysphoria, a condition that I have struggled with my entire life,” she explains. “It has been more than a year since I first requested treatment consistent with the [World Professional Association for Transgender Health Standards of Care for the Health of Transsexual, Transgender and Gender-Nonconforming People] at the [US Disciplinary Barracks (USDB)].”

“My treatment request is, and has been, my highest priority since arriving at the USDB – even more than the appeal of my conviction and thirty-five year sentence. If my requests for medical treatment are ultimately denied, I do not believe I will be able to survive another year or two – let alone twenty to thirty years – without treatment.”

Manning recounts all the steps she has taken to obtain medical care.

She arrived at the USDB on August 22, 2013, and immediately requested that the Army provide her with a “mental health assessment and treatment plan consistent with the standards for treating gender dysphoria.”

That same day John Lesniak of the Chief Assessment Division conducted a “series of interviews and evaluations to assess” her “treatment needs and risk for sexual victimization based on the fact” that she is transgender, effeminate and have “a slight build.” Lesniak informed her treatment would be limited to psychotherapy, such as “anti-anxiety and anti-depressant medication.”

On September 12, Manning saw Dr. Ellen Galloway, who is the Chief of the Mental Health Division. For two weeks, Galloway conducted “psychological tests and one-on-one interviews.” She reviewed documentation detailing how Manning had been diagnosed with gender dysphoria and what she needed for treatment. The records came from Dr. David Moulton, a defense forensic psychologist who extensively evaluated her between August 2011 and August 2013 and also testified at her trial.

Galloway informed Manning on October 1 that she “met the criteria for a diagnosis of gender dysphoria” and would be diagnosed with the condition. Then, a few weeks later, Manning was interviewed by Colonel Ricky Malone, a forensic psychiatrist from Bethesda, Maryland, who produced an assessment to help establish a treatment plan.

By November 25, Galloway notified Manning that a treatment plan was completed and had been sent to the US Army Western Regional Medical Command (WRMC) and US Army Corrections Command (ACC) and US Army Office for the Surgeon General for approval.

When January came and it had been more than a month since Manning had heard anything about her treatment, she became “anxious and fearful.”

“I continued to meet with Dr. Galloway regularly to discuss my mental health,” Manning shares. “During these meetings, I expressed my ongoing distress over not being provided with treatment for gender dysphoria. Dr. Galloway repeatedly told me that the requests were being reviewed at various commands, then later she informed me that the requests were at ‘the highest levels,’ and ultimately, that decisions related to my health care would be decided by the Secretary of Defense.”

Manning requested “permission to follow hair and grooming standards for female prisoners” on April 2. She asked for “female-specific issued clothing” and “female health and grooming items.” She heard nothing and submitted a request again on July 23.

On August 21, she submitted a request to the Army for “permission to use the female hair grooming, cosmetic and nail grooming standards” in the military as part of her “medically supervised treatment for gender dysphoria.” No response to this request has been received.

Efforts to obtain redress for her request for treatment have been rebuffed. One commander, Major General James McDonald of Fort Sill, found her complaint “deficient.” A request filed with the US Army Office of the Judge Advocate General (OTJAG) was denied. One captain in her chain of command who one would think could take action claimed he had no authority to implement her treatment plan.

Manning submitted a complaint to the Office of the Inspector General of the WRMC on January 30. It declined to take any meaningful action.

Meanwhile, as gender treatment has been repeatedly denied, Manning was successful in changing her legal name to Chelsea Manning. The district court of Leavenworth County, Kansas, approved her petition for a name change on April 23.

Lieutenant Colonel Nathan Keller, who is the Director of Treatment Programs at the USDB, wrote in a memorandum on October 15, 2013, that he saw no way the USDB could provide a “full course of therapy for Mr. Manning’s gender dysphoria…because the USDB cannot house a female or highly feminized inmate. Permitting Mr. Manning to live as female, much less begin to feminize his body, will create operational challenges as the inmate population respond to these changes.”

“Stop-gap” measures were proposed by Keller, like “weekly therapy at the Transgender Institute in Kansas City or supervision of Dr. Galloway by the Transgender Institute.” (Galloway later informed the ACC she lacked the expertise to treat Manning.)

On August 27, 2014, Manning saw Dr. Randi Ettner, who concluded her condition was “moderate to severe.” She recommended hormone therapy be “initiated immediately” and that Manning be permitted to “outwardly express her female gender by growing her hair and following the grooming standards applied to female prisoners.”

As the lawsuit argues, her claim that the Pentagon and Department of Army is “withholding necessary medical care in violation of the Eighth Amendment is extremely strong on the merits.” She will “suffer irreparable harm” if this is “permitted to continue.”

“To the extent defendants may claim safety concerns related to housing a female or feminized prisoner, they cannot substantiate such concerns given that [Manning] is never left alone with other prisoners outside the presence of one or more staff members and is under constant surveillance.”

It is in the public interest to uphold the Constitution and prevent “avoidable injury to individuals held in government

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Kevin Gosztola

Kevin Gosztola

Kevin Gosztola is managing editor of Shadowproof. He also produces and co-hosts the weekly podcast, "Unauthorized Disclosure."