Now, as to why I feel I need to share this now.
The answer is that Chelsea Manning’s desire to transition has been in the news a great deal the last couple of days. Attitudes towards her situation are made incredibly complicated by peoples’ opinions about her actions and the recent outcome of her trial... and those ideas about transgender issues that people are forming now based on her situation are going to have an impact on the lives of many trans people for years to come.
This is not what this post is about, but for the record: I do not feel that Private Manning’s actions are supportable, and I believe that the verdict of her trial was fair, and that the sentence handed down was fair. I expect that she will serve her time as required by the law, and that this is the just outcome for her actions.
Nevertheless, she is a human being. And, as I said before, the ideas formed about trans people by folks who hear about her situation will have an impact on many many other trans peoples’ lives. (And there are a lot more of us than most people may believe. See this article from Lynn Conway for some analysis of the prevalence of transgenderism in the United States.)
I should be clear that I do not speak for all trans people—these feelings can be intensely personal. I am simply doing my best to broadly cover the situation.
So, let’s begin. First, the facts about Chelsea:
Chelsea Manning is transgender. This is absolutely not news to people who’ve followed the trial. It was widely known in the transgender community, and there was some debate over the right way to speak of her, until her lawyer shared her wish that she be referred to by her old name and pronouns. There was some speculation that this might have been out of a desire to avoid complicating things during the trial, but the trans community respected this wish once it was known, because we know how important these things are.
Before the action which made her infamous, Manning shared this information with her superiors in a piece of email which included a photo of her presenting as a woman. The standard policy of the U.S. military regarding transgender people is that they may not serve, and that if a servicemember is discovered to be transgender they should be separated from the military. She continued to serve and was discourage from seeking official recognition of her condition because her unit was understaffed. This information was detailed during the sentencing of Private Manning.
Before her trial began, Manning was officially diagnosed as having gender dysphoria. (Literally: a bad feeling caused by gender.)
Now that her trial has concluded and she has been sentenced, Manning has publicly stated that she now wishes to be known as Chelsea Manning and to be referred to by female pronouns, and that she would like to begin hormone therapy.
People who are not familiar with gender dysphoria who heard that Chelsea was transgender before her announcement may have been surprised by it—but the trans community certainly was not, because we know how serious gender dysphoria is, and that it pretty much never goes away.
Now, the things that I feel people need to understand:
Since Chelsea made her announcement, there’s been a lot of talk in the press. Some press outlets have refused to use her new name and pronouns... and this really upsets trans people a lot. Why? Because this is a matter of basic respect: If someone is unwilling to do this minor thing, it indicates that they don’t believe that someone is being truthful about their personal feelings. Further, when it’s in a public context like this, it suggests to other trans people that their experience is being dismissed as well. This is really, really upsetting.
Adding to that upset is the fact that the most place most of us see this sort of treatment of transgender people is in reports of their murder. It is typical for a news outlet to report on the murder of a trans person using their old name and pronouns, and digging up a picture of them pre-transition... even if they haven’t gone by that name or looked at all like that for a decade or more. That’s an incredibly disrespectful thing to do, particularly to someone who most likely was murdered because they were trans.
And, of course, when this sort of thing is done in a widely public way, it suggests to people who don’t know better that this sort of behavior is acceptable (which it is not). To people who don’t care it provides an excuse for bad behavior. (Well, CNN is doing it!)
Most of us have experienced people intentionally “forgetting” and using our old names and pronouns when they are upset with us. This is an extremely crappy thing to experience.
Because of this, it is very important to us that other trans people be referred to by the name and pronouns they request, no matter what we think of them personally.
Whenever this sort of thing comes up, there’s a lot of talk about the cost to the taxpayer, and should we be providing this sort of “optional” treatment to people who are in prison.
First and most importantly: Prisoners are wards of the state. They are prohibited from caring for themselves, therefore the state must provide for their needs. Among these needs is medical care. What medical care is necessary is a matter for doctors to decide, not prison administrators, not politicians, not the general public. If a doctor in the state’s employ says “this treatment is recommended for the health of this patient”, then that patient needs to get that treatment.
That’s true for diabetes. That’s true for heart problems. That’s true for depression. And, it’s true for hormone therapy and even reconstructive surgery.
The doctor is going to measure the necessity of the care against the cost, and against the time the patient is going to be in prison. And, they’re going to make the best decision they can based on their professional understanding.
(For reference, the American Medical Association, the Americal Psychological Association, the American Psychiatric Association, the American Association of Pediatrics, and many many other professional organizations world-wide recognize only one effective treatment for gender dysphoria: transition.)
So, what is it going to cost? Well, in Manning’s case, she’s asked to begin hormone therapy. My own personal hormones are probably about the same as what she would receive.
They cost me $15 a month.
They’re not unusual medications, they’re not complicated. They’re quite safe, and they’re commonly available.
Surgery is more expensive—but not every transgender person requires surgery to treat their dysphoria, and many will spend years waiting and saving up for it. If a doctor says that it’s indicated, it still needs to be done, because that’s the law of the land and the ethical thing to do. But it’s not something that’s going to happen all the time.
And for the record, there’s already legal precedent that it is in fact required in the scenario that it’s necessary for the health and safety of the prisoner when the prisoner is incarcerated for life. Amortized across the entire life of a person, the cost is not much at all.
Again: In the end, it doesn’t matter if a prisoner is a reprehensible terrible person or not: we don’t torture prisoners by depriving them of medical care. If the consensus of doctors is that treatment is indicated, that’s what needs to happen.
Finally: Why do other trans people care about this? Well, mainly because it reflects on all of us. We need you to understand what being transgender is like, at least enough to sympathize with our needs. When people attempt to pass laws that put trans peoples’ lives in danger by forcing them to go into the wrong restrooms, we need your help. When we meet you on the street, we need your understanding. When someone cuts into us with vicious slurs based on our appearance, we need to know that there are more people out there who don’t feel that way.
So, we need you to understand Chelsea Manning’s situation, because she is a human being. Because the hundreds of other transgender inmates in the U.S. who are deprived of proper treatment and who are placed in danger by being put into the wrong facilities and being mistreated by guards are human beings.
Because some day, you’ll meet one of us, like you have today, and we need you to treat us like we’re people.
Thanks, and sorry for being so long-winded. (I wrote... a lot more, but realized that would be way too much.)