Manning’s gender transition sets up legal showdown for life behind bars

[Emit]

Chelsea Manning is the first transgender military inmate to ask for hormone treatments, officials say, a request that could lead to a legal showdown over how – and if – the soldier convicted in the WikiLeaks case will be allowed to live as a female behind bars.

Current Pentagon policy dictates that transgender soldiers are not allowed to serve, and Manning won’t be discharged until being released from prison and all appeals are exhausted. Furthermore, the military does not allow soldiers to undergo hormone treatments while in the all-male prison at Fort Leavenworth, Kansas – though this is the first time officials have heard of a request for such treatment, said Maria Tolleson, a spokeswoman with the Army Medical Command in Arlington, Virginia.

“We’re just now dealing with the issue,” she said, adding it would be premature to say there has been any movement toward offering the care to all transgender inmates as a result of Manning’s case.

~snip~

As of last year, civilian federal prisons are required to develop treatment plans – including hormone therapy, if necessary – for inmates diagnosed with gender identity disorder, now called gender dysphoria.

Unlike military prisons, the policy also allows inmates who believe they are the wrong gender to dress and live accordingly as part of their individual treatment plans.

If the military refuses to provide the hormone treatment, Manning wouldn’t able to get it by other means until at least February 2020, the earliest she could be released on parole.

Transgender veterans can get help with hormone therapy and mental health counseling from the Veterans Administration after they leave the military. However, Manning would not be eligible because of her dishonorable discharge.

~snip~

http://www.lgbtqnation.com/2013/08/mannings-gender-transition-sets-up-legal-showdown-for-life-behind-bars/

[MillennialDem]

1. Denying hormones and hair growth is ridiculous and should fall under cuel punishment

Does Chelsea need hormones to live? No - but they are cheap, could be provided by donations, and are very cheap (roughly $1 a day, could be as low as $0.40 a day and as high as $3 a day though, depending on dosage).

Hair growth is free.

Moreover, gender transition (including hormones) is the MEDICALLY SOUND way to treat transgender individuals. It's settled science in the psychological/psychiatric community.

We don't deny prisoners who break bones treatment - even though said treatments are not required to live.

[Morning Dew]

2. "We don't deny prisoners who break bones treatment ..."

Don't give them ideas.

[Demo_Chris]

5. Ourt entire prison system fails this mental health standard. nt

[Demo_Chris]

3. Prisons provide the minimum medical care necessary to sustain life and heath...

And that, my friends, is a hell of a lot more than fifty-plus-million American's have access to.

[MillennialDem]

6. Hormones are necessary to maintain health in a transgender individual. Sadly, I argue with the other

point you are making

[Demo_Chris]

9. No, hormones are NOT necessary to maintaining heath in a transgendered individual...

Last edited Sun Aug 25, 2013, 08:30 PM - Edit history (1)

Chelsea will not die from a lack of hormones that serve no purpose but to enable a transition into a body she was not born with. her mental health here is no more relevant than the mental health of any inmate. She feels like she would be happier with a body that matches her mental image of herself, but then so does the inmate who needs plastic surgery for scars, or root canals for his or her teeth -- rather than having those teeth yanked from his or her head.

[MillennialDem]

11. I said MENTAL health, and yes they are. Also, inmates in federal prisons do receive root canals and

cleanings and fillings:

http://www.prisontalk.com/forums/showthread.php?t=148066

"My guy just had 2 root canals and cleaning, said it wasn't too bad considering it was "BOP" care. He's at Texarkana FCI (low)"

"I Have To Say I Received Great Care In Lexington. I Had A Cleaning About Every Six Months Several Fillings And A Root Canal. There Were Inmates Working With The Dentist. There Was Dental Sick Call 5 Days A Week For Quick Repairs Or Pulling A Tooth. I Suppose It Depends Where You Are At."

[Catherina]

13. You'e wrong. How about leaving this to medically qualified people?

Court cases, court rulings and some very tragic transgender deaths, contradict what you just wrote.

I can't believe you compared this to something as trivial as plastic surgery for scars, or a root canal.

[Demo_Chris]

15. Education me. Show me a study demonstrating PHYSICAL problems...

... Caused by a lack of gender reasignment therapy.

Don't tell me about Chelsea's mental health or that she would be happier. You don't know that, and so far as I know, she has never actually been evaluated to see if she is a candidate for this treatment. My (limited) understanding is that there is a whole lot more to it than just deciding on your own you would be happier as a female.

So make the case, show me the science, and I will be more than happy to admit that I am wrong.

NOTE: plastic surgery for scars is NOT trivial and I did not use it in this way. How someone looks can have a massive impact on their mental and emotional well-being.

[Catherina]

17. The first lesson is that medical problems aren't limited to the physical, the physiological

Gender dysphoria is very debilitating because physicians can't go in someone's head and start snipping away. They can only make the body match the brain instead.

You belong in your body, you feel perfectly comfortable there. Not everyone does. Some people who can't transition are so desperate they self-mutilate and hack off anatomical parts off because they're all wrong.

Those who are lucky enough undergo painful penectomies, vaginoplasties and mastectomies so they can finally experience the "normal" life they were meant to have. Can you imagine the never-ending mental torment of going through your entire childhood and young adult years in total distress because no one understands what you're going through, there's no support and you're repulsed by some of your body parts because they don't belong and you're missing others?

Others kill themselves.

I assume you're a male. Imagine hating your penis every waking day of your life because you can't identify with it.

Plastic surgery I used the phrase *something as trivial as plastic surgery* because you dismissed hormone therapy that way when you wrote: "like she would be happier with a body that matches her mental image of herself, but then so does the inmate who needs plastic surgery for scars, or root canals for his or her teeth".

If we can agree that some plastic surgery isn't trivial because "how someone looks can have a massive impact on their mental and emotional well-being", why doesn't that apply to gender dysphoria? Gender dysphoria is a zillion times more debilitating than having some bump on your nose. Suicide attempts among children are common, that's how bad it is. Among veterans, the suicide rate for it is over 4 times higher than the normal rate. 41% of the 6,450 transgender people interviewed for the 2011 National Transgender Discrimination Survey reported attempting suicide. The suicide rates are cut to 1/6th of that when people can get transition-related treatment.

Here, read this. This was written a while ago but it's simple to understand.

Gender Identity Disorder is a recognized medical condition by the American Medical Association and the American Psychiatric Association. It is considered a birth defect, which occurs about five weeks after conception. The brain does not match the physical sex of the body. This is also known as Transsexualism. There are males with female brains and females with male brains. The true incidence is unknown but is estimated to be one in one hundred thousand births. The reason for it is unknown but it is thought to be a biochemical mistake in the formation of the brain. The result is that the individual has the psychological and chemical brain of one gender but the body of the other. Persons with this disorder know from an age of 5 or 6, that they are different from other individuals of the same physical sex. Early on, they learn to hide it from all others, even their parents and siblings. They learn the skills and mannerisms of the gender that their body is but are aware that they think and feel different. They want to be of the opposite gender and often characteristically go to bed at night praying they wake up in the body that matches their mind. Many do not understand the difference until they see the anatomic difference between girls and boys. Puberty is very difficult because the body changes away from the way the mind expects.

Most individuals learn to cope and often act in a way that exaggerates their physical gender to compensate. Males with a female brain join the military or take up hazardous activities. All learn to hide it and never speak of it to another living soul for fear they will be considered crazy. Many internalize their feelings and eventually become moody, withdrawn, and despondent. No one else knows what he or she is going through. They are terrified others will find out about their secret.

At some point, the defense mechanisms and barriers that let the Transsexual function break down and it is impossible for the person to reestablish the shell that they have projected to others. This usually happens about ages 30 to 45. They develop what is termed Gender Identity Dysphoria. The term Dysphoria is Greek for “difficult to bear”. The discrepancy between what their mind and soul is and what they see in the mirror produces the Dysphoria. The symptoms are physical pain, agitation, and debilitating depression. Things that used to be meaningful diminish to extinction. The pain is like what is felt when a loved one dies. Eventually, the individual has to address the problem or become nonfunctional. Twenty percent attempt suicide. It is clearly not a choice one makes or wants. Many are angry they have the disease and can speak of it to no one. Often they do not understand the reason for their terrible feelings until they go through extensive psychotherapy. Not uncommonly, many therapists do not recognize what is happening to their clients, who are afraid to reveal their innermost feelings, for fear of rejection.

There is no cure, therapy, or medication to cure the Dysphoria once it breaks into the open. Treatment is directed towards options. The brain cannot be changed so the body image has to be altered. Some live part time in the gender of their mind and that may be sufficient. For most, about 99%, treatment is directed towards changing the body to match the mind. This involves hormonal therapy to match the brain, psychotherapy to deal with the stresses of transitioning from one gender to another, and eventually sex reassignment surgery. The Harry S. Benjamin Institute (now known as the World Professional Association for Transgender Health) determines the standards and protocols for treatment. It is a worldwide illness.

...

http://www.sarabecker.com/t/gender_identity_disorder%20letter.htm

I hope that helps.

[Demo_Chris]

18. Okay, well done! You made the case as far as I am concerned...

I am never embarrassed to admit that I am wrong. This is clearly a severe and debilitating condition that requires whatever care the experts believe is necessary. Again, well done.

[Catherina]

19. Thank you Demo_Chris

As a favor, if you'd help educate others that would be great.

One thing I forgot, and this is why the pronouns and the new name are so important, once someone takes that step, they need all the external support they can get to get through it. The name change is a big step, similar to when Muhammed Ali told people to stop calling him by his slave name (Cassius Clay) and use his new name only.

I can't think of anyone who's having to transition under such a bright spotlight, the way Chelsea is. And she's not in a supportive or understanding environment. While she was in pretrial detention, as Bradley, the guards kept calling her skivvies "panties". When the main guard was confronted about it, he said he called all the male underwear *panties*. Bullshit, no he didn't, not in the military. She's going to be ridiculed and mocked (on top of being hated for exposing so many dirty secrets). She doesn't need the dysphoria stress on top of it. If she's given the hormone therapy, it will balance things out for her and she'll be more stable to deal with the other crap. When my last roommate was doing her hormone therapy, she called it was the best anti-depressant ever. Chelsea will probably still get depressed because of where she is but at least with hormone therapy, and the relief that she's finally leaving that old self behind, she won't have that added stress.

[Demo_Chris]

20. The only "good" news so far as that goes is that she is unaware of any of this...

She's in prison, not surfing the net. The entire world could be cheering her on but she will only hear what the officers and her lawyers tell her.

[MADem]

4. Manning could apply for a transfer to a civilian prison. They might approve it, they might not.

Upside--she could apply for treatment.

Downside--civilian prisons are less safe. Military prisons are pretty safe; the atmosphere is calmer, more focused, and the inmates have more self-discipline, by and large. However, given Manning's crime, she might not feel terribly welcomed, even if she isn't harmed in any way:

Even if Manning is not segregated, she faces an isolated future because fellow soldier-prisoners may not look kindly upon Manning’s leak of more than 700,000 military and diplomatic records, Wilson said.

“Some of the most patriotic people you will ever meet are in military prisons,” she said. “They have more than one safety issue with Pfc. Manning.”

Manning also has found little sympathy among transgender veterans. Kristin Beck, a former Navy SEAL who began transitioning to life as a woman early this year, said on her Facebook page Thursday that “Manning is a tarnish on my dream” of equality for all.

The American Veterans for Equal Rights – an organization for LGBT services members and veterans – said in a statement it condemns the action of any soldier who would publicize information that could endanger service members’ lives.

http://www.lgbtqnation.com/2013/08/mannings-gender-transition-sets-up-legal-showdown-for-life-behind-bars/

[msanthrope]

14. Manning won't get to a civilian prison without a plea deal with the feds, and right now

she doesn't want to testify.

[Catherina]

7. She'll eventually win. Several courts have already ruled it's a violation of the 8th Amendment

to withhold this medically necessary treatment.


In the case of Ophelia Azriel De'lonta, a Virginia court ruled that witholding this medically necessary surgery was cruel and that it violated her 8th Amendment rights.

"In 1999, De'lonta filed a § 1983 lawsuit alleging that VDOC had instituted a policy that wrongfully prevented her from receiving GID treatment in violation of the Eighth Amendment. As in the instant case, the district court dismissed De'lonta's 1999 complaint for failure to state a claim. We reversed and remanded, holding that De'lonta's need for protection against continued self-mutilation constituted an objectively serious medical need under the Eighth Amendment and that De'lonta had sufficiently alleged VDOC's deliberate indifference to that need. De'lonta v. Angelone ("De'lonta I&quot , 330 F.3d 630, 634 (4th Cir.2003). The parties subsequently reached a settlement in which VDOC acknowledged De'lonta's serious medical need and agreed to provide continuing treatment."

http://www.leagle.com/decision/In%20FCO%2020130128117

and last year a federal judge ordered Massachusetts to provide and pay for a sex change operation for a Michelle Kosilek. She hasn't had the surgery yet but they were working on it. Michelle's case ran into a few complications Chelsea won't have.

Here's a layman's version of Michelle's case: http://www.huffingtonpost.com/2012/09/29/michelle-kosilek-ruling-transgender_n_1924424.html

There are a few other cases too where the courts ruled in favor.

[NV Whino]

10. Those rulings will certainly help her case, but

Military prison is not federal prison.

[Catherina]

12. That's the disparity Coombs vowed to overcome for her

Check this out from Federal Prisons memos

If a diagnosis of GID is reached, a proposed treatment plan will be developed which promotes the physical and mental stability of the patient. The development of the treatment plan is not solely dependent on services provided or the inmate’s life experiences prior to incarceration. The treatment plan may include elements or services that were, or were not, provided prior to incarceration, including, but not limited to: those elements of the real life experience consistent with the prison environment, hormone therapy, and counseling. Treatment plans will be reviewed regularly and updated as necessary.

Current, accepted standards of care will be used as a reference for developing the treatment plan. All appropriate treatment options prescribed for inmates with GID in currently accepted standards of care will be taken into consideration during evaluation by the appropriate medical and mental health care staff. Each treatment plan or denial of treatment must be reviewed by the Medical Director or BOP Chief Psychiatrist. Hormone therapy must be requested through the non-formulary review process, and approved by the Medical Director and /or Chief Psychiatrist. Consultation with the Chief of Psychology prior to such approval may be appropriate in some cases.

http://www.glad.org/uploads/docs/cases/adams-v-bureau-of-prisons/2011-gid-memo-final-bop-policy.pdf

I think "current, accepted standards of care" is where the military is going to run into problems because hormone therapy and surgery are listed as treatment in the DSM-V and the military will have to justify why they won't follow current, medical accepted practice and why military prisoners have fewer medical and amendment rights than federal prisoners. Especially since both are taxpayer-funded.

I know the military doesn't like to be dragged into the 21st century but sometimes it happens, especially in the case of LBTIQ rights and this is an extension of that.

[MADem]

21. The Kosilek case was appealed, so this issue isn't quite settled law, yet.

There should be a ruling any day now. It could very well be that this will end up at the Supreme Court. If MA doesn't get the ruling they want, they might well appeal, and the same for Kosilek.

Kosilek does not get a lot of sympathy in MA, as she is a convicted murderer who killed her wife while still living as Robert Kosilek. It was a rather gruesome strangulation with piano wire, the body dumped in a car in a mall parking lot in a quiet suburban area.

No shooting the messenger, now, that's just the prevailing view.

http://www.bostonglobe.com/metro/2013/04/02/appeals-court-hears-mass-inmate-sex-change-case/ydqBqn3CsGXAQMMsNbWxYO/story.html

She first sued the Department of Correction in 2000. Two years later, Wolf found that Kosilek was entitled to treatment for gender-identity disorder but stopped short of ordering surgery. Kosilek sued again in 2005, arguing that the surgery is a medical necessity.

In his ruling in September, Wolf found that surgery is the ‘‘only adequate treatment’’ for Kosilek and there ‘‘there is no less intrusive means to correct the prolonged violation of Kosilek’s Eighth Amendment right to adequate medical care.’’

Cohen said Kosilek, who turns 64 next week, has been living as a woman in an all-male prison throughout her incarceration, and corrects inmates and prison guards if they refer to her as a man.

‘‘She has been a model prisoner,’’ Cohen said.

The Department of Correction had argued that prison officials were concerned about protecting Kosilek from sexual assault if she were allowed to complete her transformation into a woman.

But Cohen told the court that Kosilek has received ­female hormone treatments and has lived at the state prison in Norfolk for more than 20 years ‘‘without incident.’’

McFarland, however, cited testimony from prison officials who said they were concerned about sending Kosilek back to the male prison after surgery. He disputed Wolf’s finding that the security concerns expressed by prison ­officials were ‘‘either pretextual or can be dealt with.’’

[Wash. state Desk Jet]

8. Legal showdown -Gee wiz

Maybe Manning has a plan-something like his testimony against Assange in exchange for hormone treatment .

[Yo_Mama]

16. What I'm confused about

is that I have the idea, from reading I did a long time ago, that transgender individuals transitioning medically (not all transgenders do) at treatment clinics go through a process in which first they receive a lot of counseling, and then they are guided through the process of living as a person of the other biological sex, and then the treatments begin. I got this idea from reading stories that medically transitioned persons had written.

If that is so, what of this is available to Manning in prison?

I can see if a transgender person had already navigated the first part of the process before going to prison that issues would be much simpler, but it seems to me that just being in prison poses several obstacles to starting the process. Prison is an abnormal environment. People here seem to be discussing this as if the average transgender person just wakes up one day, thinks "Hey, I'm a _____ (person of other gender), pops down for a doctor visit and is given hormones to start the process, and that doesn't seem to be the way it really works.