Scarce Transgender Care Options for Manning

     FT. MEADE, Md. (CN) - Though evidence has shown that Bradley Manning has considered living as a woman, the prison likely to hold the WikiLeaks source for decades confirmed that it does not provide hormone therapy or sex-reassignment surgery to inmates.
     Manning's gender identity has been a prominent feature of his court-martial for the biggest intelligence leak in United States history. The young soldier shared hundreds of thousands of documents with WikiLeaks, including battlefield reports from Iraq and Afghanistan, diplomatic cables from around the world, profiles of Guantanamo detainees and footage of airstrikes that killed civilians.
     Before his detection, he confided in Internet chats with ex-hacker Adrian Lamo, "i wouldn't mind going to prison for the rest of my life, or being executed so much, if it wasn't for the possibility of having pictures of me... plastered all over the world press... as [a] boy."
     His desire to be known as a woman apparently shifted as trial approached.
     On July 24, 2012, his supporters at the Bradley Manning Support Network released the following statement: "Everything we know from Bradley Manning's friends, family, and legal defense team, is that he wishes to be referred to as Brad or Bradley until he's able to get to the next stage of his life."
     For Manning, whom prosecutors want to put behind bars for 60 years, that next stage may be a long way away. His lead attorney David Coombs has indicated that Manning will likely serve his sentence in Ft. Leavenworth, Kan. The military judge presiding over his case, Col. Denise Lind, will announce on Wednesday how long Manning will remain there.
     Ft. Leavenworth spokeswoman Kimberly Lewis told Courthouse News that treatment for transgender inmates does not extend beyond psychiatric care.
     "All inmates are considered soldiers and are treated as such with access to mental health professionals, including a psychiatrist, psychologist, social workers and behavioral science noncommissioned officers with experience in addressing the needs of military personnel in pre- and post-trial confinement," Lewis said in an email. "The Army does not provide hormone therapy or sex-reassignment surgery for gender identity disorder."
     A growing number of federal judges have ruled that rejecting such treatment for transgender prisoners constitutes cruel and unusual punishment.
     Indeed, the jurisdiction of the Maryland courtroom where the WikiLeaks source has been tried is subject to a 4th Circuit decision from Jan. 28 this year guaranteeing the possibility of sex-reassignment surgery for all federal inmates in Maryland, Virginia, West Virginia, and North and South Carolina.
     The Chicago-based 7th Circuit ruled similarly in 2011, striking down a Wisconsin law banning such medical care. A Boston federal judge granted surgery to a convicted wife-killer last year, and the 1st Circuit is currently mulling that decision on appeal.
     Manning, however, is being held in a military prison in Ft. Leavenworth, out of reach for all of these jurisdictions.
     Lauren McNamara, a transgender woman who testified on Manning's behalf, seemed surprised when told about the military prison's policies, which she called an "extraordinary problem."
     "I don't think people understand what hormone-replacement therapy does," she said. "This is something that's the best anti-depressant, anti-anxiety drug I have ever been on."
     Manning has been diagnosed with and received medication for both conditions.
     "Denying people access to this treatment just because they're in prison is simply inhumane," added McNamara, who wrote about her court-martial testimony about her Internet chats with the young soldier in "The Humanity of Private Manning."
     "Can you just imagine not giving someone, say, blood pressure drugs in prison when they needed them," she asked. "But because this has become some politicized notion of identity and choice and so on, and people act as though this were a controversial thing, rather than a medical condition, they think it's okay to deny people this."
     At this point, Manning wishes to maintain privacy about his gender identity.
     "Bradley has indicated that he's not interested in publicly addressing this issue," his support network wrote last year, in their only statement on the matter.
     They did not immediately return a request for comment Tuesday.
     McNamara, a staunch advocate for transgender rights, respects that choice.
     "This is a very private, very personal thing, and this is something for each person to understand about themselves at their own pace," she said. "We have no obligation to make this clear for others as we figure this out for ourselves."
     Despite their client's personal privacy on the topic, Manning's advocates have made his transgender exploration a pivot point of the WikiLeaks source's legal defense and public outreach. His lead attorney David Coombs entered a picture of his client dressed as a woman into the court record, along with an anguished email Manning sent to his superior about his gender identity.
     The subject line said: "My problem."
     The treatment of transgender prisoners is in fact an understudied problem throughout the United States, though statistics about their plights are hard to come by.
     A 2009 study of California prisoners found that 59 percent of male-to-female transgender prisoners have been sexually assaulted in all-male prisons, and a shocking zero percent trusted their guards to protect them.
     The brochure for U.S. Disciplinary Barracks at Ft. Leavenworth indicates that 57 percent of the prisoners there were confined for sex-related offenses in 2011. The prison keeps no demographics on their number of transgender detainees.
     In commenting on the case of a Virginia inmate who won the right to surgery, Lambda Legal's deputy legal director, Hayley Gorenberg, said in an interview early this year that a significant number of transgender inmates deprived of medical care attempt to castrate themselves.
     The statistics about this phenomenon are hard to come by, she added.
     Also hard to pin down are the numbers of transgender inmates in military jails. Lt. Col. J. Todd Breasseale, a Department of Defense spokesman, said that the Pentagon does not track prisoner demographics.
     After the repeal of Don't Ask, Don't Tell, the Pentagon has tried to clean up its image regarding transgender armed service members, even while officially banning them from serving under so-called "medical" restrictions.
     Under a recent executive order, Veterans Affairs must provide "culturally and clinically competent care" to lesbian, gay, bisexual and transgender former service members. The Pentagon even hosted an LGBT Pride Month celebration this year, with the "T" included.
     In a surprising turn, Manning's prosecutors have even argued in court that the WikiLeaks source's gender dysphoria diagnosis should not have stopped his deployment, taking a position against the Army's existing regulations.
     Retired Army Col. James Pritzker's Tawani Foundation recently awarded the University of California's Palm Center $1.35 million to establish a Transgender Military Initiative investigating the topic.
     Palm Center director Aaron Belkin had this to add about the treatment of transgender troops in prison: "Without addressing the specifics of one case or another, it would nevertheless be a sad day if the military denied necessary medical treatment to a prisoner."