Friday, Aug. 23, 2013
I am Chelsea Manning: Reflections on a sexual transformation
By ERIC ADLER and MARK MORRIS
The Kansas City Star
Allison Ballard of Kansas City cant speak with authority as to why U.S. Army soldier Bradley Manning committed the WikiLeaks documents crime that led to a 35-year prison sentence at the Fort Leavenworth disciplinary barracks he entered Thursday afternoon.
But Ballard can speak to Mannings most recent personal concern: His desire for hormones in prison to continue on his transsexual transformation into a woman named Chelsea.
I wasnt really happy until I was able to start the process, said Ballard who, at graduation from Fort Osage High School in 2000, was known to classmates as a boy, Chris Ballard.
Then three years ago, Ballard, now 31, joined what experts say is a growing number of individuals in the Kansas City region who through counseling, hormones and, for some, the surgical removal or modification of sex organs have become part of the transsexual community.
Caroline Gibbs, the licensed counselor who helped Ballard make her transition, since 2006 has built a practice at her Transgender Institute on Ward Parkway, helping close to 200 individuals make the transition from male to female or female to male.
Some local clients, she said, are as young as age 6. One grandfather, looking to turn female, is 73.
Guess how many people we have in our support group for young F-to-Ms? asked Gibbs, meaning children ages 11 to 18 wanting to change from female to male.
Sixteen, she said.
On Wednesday, the court-martial that sentenced Manning to 35 years also stripped him of his rank as a private first-class and deprived him of military benefits as penalties for handing over more than 700,000 secret government documents to the WikiLeaks website.
Mannings defense lawyers raised the issue of the stress caused by Mannings gender identity during the sentencing phase of his court-martial. Psychiatrists testified that the soldier, now age 25, was being treated for gender identity disorder, a diagnosis that the American Psychiatric Association last year renamed gender dysphoria.
In a 2010 interview with the online version of Wired magazine, Manning referenced the deep dissatisfaction he had with his own gender.
On Thursday, he made a bid to continue his transition to female through a statement read by NBCs Today show anchorwoman Savannah Guthrie.
As I transition into this next phase of my life, I want everyone to know the real me. I am Chelsea Manning, I am a female, the statement said.
Given the way that I feel and have felt since childhood, I want to begin hormone therapy as soon as possible. I also request that starting today, you refer to me by my new name and use the feminine pronoun.
The Army has said that it unlikely to happen. It does not provide hormones for sexual transformation. Manning has not requested or indicated that he wants sexual reassignment surgery performed to remove or modify sexual organs. Not all transsexual people get the surgery, as it is expensive and few surgeons perform the operations.
The Army, nonetheless, also does not provide it.
Hell have to do it after hes released, Kansas City defense attorney John Osgood, a Vietnam Army combat veteran who also worked as an Army lawyer and judge, said of Mannings preference to become female. I dont think theyre medically or legally obligated to do it, based on what I know about the law.
Unless Manning was already taking hormones, he said, the soldier shouldnt expect the disciplinary barracks to begin treatments there.
Courts around the country, however, have ruled that hormone therapy for inmates can be a legitimate medical treatment. Arbitrarily refusing them can violate the constitutional ban on cruel and unusual punishment. The American Civil Liberties Union said it would support Mannings pursuit of appropriate health care and lawful treatment while at Fort Leavenworth.
This is an untested area, said Chris Slobogin, professor of law and psychology at Vanderbilt University. Generally, prisoners and other incarcerated individuals only have a constitutional right to treatment to prevent deterioration. If Manning could show that without hormone treatment his psychological or physical condition will worsen, he might have a case.
In 2012, a Massachusetts federal judge ordered the state to provide taxpayer-funded sex-change surgery to an inmate serving a life sentence for murder. Since then, however, the judge warned the inmate that she could lose her chance for the surgery because she had violated court-ordered confidentiality rules.
But in the friend or foe culture of the military, gender recognition usually is treated as a straightforward, physical matter. It is particularly true in institutions such as prisons where the sexes are rigidly segregated.
A sex-change operation automatically disqualifies one from enlisting in the U.S. Army. And a diagnosis of transsexual gender identity disorder merits discharge, according to the Armys Medical Standards for Appointment, Enlistment or Induction in the Military Service.
Lt. Col. S. Justin Platt, an Army spokesman at the Pentagon, said no soldier would receive hormone therapy or sex-reassignment surgery from the Army. But Platt said all prisoners at the disciplinary barracks are treated equally regardless of sexual orientation.
All inmates are considered soldiers, he said, 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.
Prisons generally make accommodations for transgender inmates, but usually on safety and security grounds rather than for any perceived medical need.
Gibbs, the counselor, said there are multiple misconceptions about transsexuals. Prime among them is the notion that all transsexuals are gay.
A transsexual person can be lesbian, gay, bisexual, straight or asexual, like anybody else, she said. Homosexuality and lesbianism refers to who a person is attracted to erotically and romantically. It is totally separate from ones gender identity.
Individuals who become transsexual most often are identified medically as experiencing a profound gender dysphoria, or deep unhappiness with their gender.
It means, Gibbs said, that they have been born with a condition that is hard-wired. It is not a choice, by any means. It is not something that is learned. It is, in fact, like there are two people in one body. There is the shadow self that shows on the outside. And the authentic self that nobody in life can see.
Ballard, the Fort Osage graduate, said she understands Mannings experience. For years, she said, she avoided mirrors because the image of the man in the mirror did not jibe with the female she knew herself to be.
The camera, I avoided like the plague, Ballard said.
The consequences for people who deny, or are unable to successfully change, their own gender identity can be psychologically and emotionally devastating. Many come to hate the person they see on the outside. Attempted suicides are not uncommon.
To make the transition, counseling comes first. Then medications are taken. They include estrogen for men who are transitioning to women and testosterone for women transitioning to men. Both sexes also take medications to reduce levels of their own naturally occurring sex hormones.
While some transsexuals choose to have surgery, not all do. The procedures are expensive, between $20,000 and $25,000 for male-to-female surgeries and upwards of $80,000 for female-to-male surgeries.
Ballard has not had the surgery, she said, although it is something she is considering.
Exactly what will happen regarding Mannings medical future is hard to predict, as rumblings of legal action to compel the Army to begin hormone therapy already have begun.
In releasing Mannings statement to NBCs Today show, lawyer David Coombs said he would do everything in my power to make sure his client received hormone treatment.
Osgood, who said hes sympathetic to Mannings situation, said that to prevail, lawyers would have to prove that prison officials were deliberately indifferent to the soldiers medical needs, a much higher legal standard than merely being negligent.
Still, Osgood mused that Mannings lawyers could be trying to draw enough attention to their clients position that any indifference that prison officials express would have to be deliberate.
This may be a creative defense in this case, Osgood said.