Convicted national security leaker Pvt. Chelsea Manning might get treatment for gender dysphoria in an unprecedented case that sheds new light on how the military treats transgender soldiers -- a small minority who serve invisibly for fear of reprisal.
Born male as Bradley Manning, she was convicted of sending classified documents to the anti-secrecy website WikiLeaks and sentenced in 2013 to the all-male federal prison in Leavenworth, Kansas, for 35 years.
Who is Bradley Manning?
But because transgender Americans are barred from serving in the armed forces, Department of Defense spokeswoman Catherine T. Wilkinson told ABC News at the time, "There is no mechanism in place for the U.S. military to provide hormone therapy or gender-reassignment surgery for inmates."
Now, just a week after Defense Secretary Chuck Hagel approved a request by Army leadership to evaluate potential treatment for inmates diagnosed with gender dysphoria, Manning may be transferred to a civilian prison, according to DOD.
Manning has asked for hormone therapy to live as a woman. Her request was the first ever made by a transgender military inmate and seemingly conflicted with long-standing policy. Manning cannot be discharged while serving her sentence.
During court martial and pre-trial hearings, Manning referred to herself using the female name Breanna. Her lawyers argued that her judgment had been clouded by a struggle with gender identity problems. Photos that Manning took of herself dressed as a woman were used as evidence.
Chelsea Manning fights to live as a woman.
Pentagon press secretary RDML John F. Kirby released this statement on the matter: "The secretary approved a request by Army leadership to evaluate potential treatment options for inmates diagnosed with gender dysphoria. No decision to transfer Pvt. Manning to a civilian detention facility has been made, and any such decision will, of course, properly balance the soldier's medical needs with our obligation to ensure Pvt. Manning remains behind bars."
But Mara Keisling, executive director of the National Center on Transgender Equality, said there is no dilemma, at least not in Manning's case, which, from the start, has been in violation of the Constitution for not accommodating her health needs in prison.
"Chelsea Manning came out just after being convicted, when the DOD instantly said there was no way she could get treatment," said Keisling. "We said, 'Yes, they will -- they are just wrong.' Now they have done an analysis and understand there is a Constitutional requirement to provide health care treatment for prisoners."
The 8th Amendment prohibits administering "cruel and unusual punishment" to prisoners. Keisling said NCTE "looks forward" to working with the Pentagon to "end these outdated rules that harm our military."
"This is health care we are talking about -- something the medical community is unified in believing is medically necessary treatment for a serious underlying condition. It's efficacious and necessary for many people -- and when a doctor says it's necessary for a prisoner, the warden has to provide the health care. They can't say no they won't treat diabetes or cancer or a broken leg."
Several court cases have affirmed the right to receive treatment for gender dysphoria in federal prisons.
A federal judge in 2012 ordered the Massachusetts Department of Corrections to provide sex reassignment surgery for Michelle Kosilek, a transgender woman serving a sentence for murder. He ruled that the state had violated the inmates' constitutional rights in denying the surgery.
In federal prisons, guidelines for housing of transgender inmates in sex-segregated facilities are regulated by the Prison Rape Elimination Law.
An estimated 15,000 transgender people are serving in the military, according to NCTE, according to a 2011 National Transgender Discrimination Survey.
"They can't even talk to a psychologist about this without being thrown out," said Keisling. "And the psychologists can't keep a secret. They have to report it out."
Transgender Leaker Chelsea Manning Could Get Transfer to Civilian Prison