Bradley Manning faces legal and social difficulties as transgender

Bradley Manning, the US soldier sentenced this week for leaking 700,000 classified documents to WikiLeaks in the biggest breach of secret data in the country's history, could soon be entangled in another legal showdown.

Unlike the court-martial Manning faced for leaking the data, the next challenge could play out in federal court over a far different issue: sexual identity.

Manning's announcement on Thursday of wishing to live as a woman named Chelsea raised unprecedented legal questions over whether the Army will provide the female hormone therapy Manning wants to undergo, not to mention questions over how life will unfold as a transgender military inmate.

"The prime issue concerns the manner in which Chelsea Manning will be treated in prison, and whether she will have the same access that all prisoners have to treatments that are prescribed to her," said Michael Stillman, executive director of the Transgender Legal Defense ~~amp;amp; Education Fund in New York.

"Will the prison in which she is housed allow her doctors to treat her the same way they allow them to treat other prisoners?" he asked.

Manning, 25, was sentenced to 35 years at Fort Leavenworth, Kansas, which houses military prisoners about 25 miles north of Kansas City, Kansas.

At Fort Leavenworth, Manning will have access to mental health professionals, including a psychiatrist, psychologist, social workers and behavioral science specialists, according to an Army spokeswoman.

But she said the Army did not provide hormone therapy, which is what Manning would seek, or gender-reassignment surgery.

"I'm hoping that Fort Leavenworth will do the right thing and provide that," Manning's attorney, David Coombs, said on the "Today" show. "If Fort Leavenworth does not, then I'm going to do everything in my power to make sure that they are forced to do so."

Neal Minahan, a Boston lawyer who won a federal court decision in 2011 for his client to receive hormone therapy in a Massachusetts state prison, said federal judges have consistently knocked down bans on such therapy.

"What is very clear is that prisons cannot do exactly what Leavenworth is doing in saying that there is a blanket ban on hormone therapy as a matter of policy," he said.

But while Manning's first step would be getting a doctor's prescription for the treatment, the soldier will likely face years getting legal approval in the courts, Minahan said.

Manning's lawyers argued during the sentencing phase of the court-martial that the soldier suffered from gender identity disorder. Coombs said on Thursday that Manning has had feelings of being female since childhood.

The American Psychiatric Association in its newest diagnostic manual replaced "gender identity disorder" with "gender dysphoria" to remove the stigma associated with the diagnosis and avoid what it said was the incorrect indication that gender nonconformity was a mental disorder.

Prescribed treatments for gender dysphoria can range from hormones, which typically affects breast development and other secondary sex characteristics, to facial feminization and genital surgery.

Challenging the Army's policy on hormone therapy could have long-term broader benefits, said Jennifer Levi, director of the Transgender Rights Project at Gay ~~amp;amp; Lesbian Advocates ~~amp;amp; Defenders, or GLAD.

In the Massachusetts case, she said, the ruling not only knocked down the policy but also helped launch training for prison staff.

"It's that kind of training and education that I think ultimately changes the ways people view the transgender experience," Levi said. "As there's more understanding of the medical condition, there's more humanity that is extended to people who experience it."

Coombs said he was not worried about Manning's safety in a military prison since inmates there were first-time offenders who wanted to complete their sentences and get out.

Still, experts said transgender inmates tend to be vulnerable or targeted, and steps taken to protect them can be punitive, such as segregation or isolated cells. Fort Leavenworth is an all-male prison. Female military prisoners are housed at the Naval Consolidated Brig Miramar in California.

A spokeswoman for the United States Disciplinary Barracks at Fort Leavenworth did not immediately respond to a request for comment on the Manning case.

"The worst case scenario is that she's going to experience harassment or abuse in prison as a result of being transgender," said Stillman, of the Transgender Legal Defense ~~amp;amp; Education Fund. "That abuse might or could include the withholding of medical treatment.

"It's hard for people who haven't been diagnosed with gender dysphoria to understand quite how severe it can be to have treatment withheld," he said. "It can have profoundly debilitating effects on people."