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, Kan.—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, Va.
"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.
Manning also won't be allowed to dress as a woman, as wigs and bras are not allowed. The soldier's gender dysphoria—the sense of being a woman in a man's body—coupled with the military convictions could leave Manning to face an isolated future, shunned by fellow inmates and transgender veterans on the outside who believe the leaks put Manning's comrades in danger.
It is not known whether Manning could be transferred to a female prison, though defense attorney David Coombs has said that was not the motive behind the Army private's statement Thursday asking to be referred to by feminine pronouns, signed "Chelsea E.
On NBC's "Today" show on Thursday, Coombs vowed to "do everything in my power to make sure that they are forced" to ensure Manning is provided with the hormone treatment, suggesting a lawsuit could be in the offing if the military doesn't comply. The American Civil Liberties Union, the Human Rights Campaign, along with other advocates, also say Manning should get the treatment.
Coombs didn't respond to telephone and email messages Friday from The Associated Press.
It's not clear whether Manning directly requested the therapy, which typically involves high doses of estrogen to promote breast development and other female characteristics, at Fort Leavenworth after arriving Thursday.
Fort Leavenworth spokeswoman Kimberly Lewis said Manning's prison processing would include meeting with medical and mental health staff and determining where the inmate will be assigned in the population. Manning was diagnosed with gender identity disorder by an Army clinical psychologist while serving in Iraq in 2010, and by a Navy psychiatrist who examined Manning last year, according to their court-martial testimony.
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 the soldier 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 the soldier's dishonorable discharge.
Fort Leavenworth staff has some leeway to segregate Manning for protection, though such isolation can be punishing, said Bridget Wilson, who practices military law in San Diego.
Even if the inmate is not segregated, the soldier 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 lesbian, gay, bisexual and transgender 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.
But former Army Lt. Dan Choi, a Manning supporter discharged for coming out as gay during the "don't ask, don't tell" era, said military LGBT advocacy groups would embrace Manning's quest if they could look objectively at the diplomatic duplicity and callousness toward civilian casualties the leaks exposed.
"I'm going to keep pushing, not just to the gay community but to all communities, because this is what the gay community should be about—must be about—is a declassification of your own closetedness, that is our main goal," Choi said in a telephone interview from Washington.
Associated Press writers Pauline Jelinek and Lolita Baldor in Washington and John Milburn in Topeka, Kan., contributed to this report.