Former Oklahoma Soldier Chelsea Manning To Begin Gender Treatments

National security leaker Chelsea Manning can get initial treatment for a gender-identity condition from the military after the Bureau of Prisons rejected the Army's request to accept her transfer from Fort Leavenworth, Kansas, to a civilian facility.

Defense Secretary Chuck Hagel has approved the Army's recommendation to keep the Army private in military custody and start a rudimentary level of gender treatment, a defense official said Thursday. Defense officials have said the Army doesn't have the medical expertise needed to give Manning the best treatment.

The initial gender treatments provided by the military could include allowing Manning to wear some female undergarments and also possibly provide some hormone treatments.

The decision raises a number of questions about what level of treatment Manning will be able to get and at what point she would have to be transferred from the all-male prison to a female facility.

In May, Manning's lawyer, David Coombs, had contended that civilian prisons were not as safe as military facilities. In a statement, he had said, "It is common knowledge that the federal prison system cannot guarantee the safety and security of Chelsea in the way that the military prison system can."

Coombs told The Associated Press on Thursday that he was encouraged that the Army will begin medical treatment.

"It has been almost a year since we first filed our request for adequate medical care," Coombs said. "I am hopeful that when the Army says it will start a 'rudimentary level' of treatment that this means hormone replacement therapy."

If hormone therapy is not provided, he said he will have to take "appropriate legal action to ensure Chelsea finally receives the medical treatment she deserves and is entitled to under the law."

Manning, an Army private from Crescent, Oklahoma has been diagnosed with gender dysphoria, the sense of being a woman in a man's body. The Army tried to work out a plan to transfer Manning to a federal prison where she could get better treatment.

Officials said Thursday that federal authorities refused the proposal. Officials spoke on condition of anonymity because they were not authorized to discuss the matter publicly by name.

The Army sends an average of 15 to 20 prisoners a year to civilian prisons. But Manning's appeals have not been exhausted, she's still in the military and her case is of national security interest. Those are factors that normally could prevent a transfer.

According to a complaint filed by Manning, she asked that a treatment plan consider three types of measures: "real life experience," a regimen in which the person tries dressing and living in the new gender; hormone therapy, which changes some physical traits such as breast and hair growth; and sex reassignment surgery. Manning has not publicly said whether she wants surgery, and the proposed plan was not released.

Manning's treatment request was the first by a transgender military inmate, and it set up a dilemma for the department over how to treat a soldier for a diagnosed disorder without violating long-standing military policy.

The former intelligence analyst was sentenced in August for six Espionage Act violations and 14 other offenses for giving WikiLeaks more than 700,000 secret military and State Department documents, along with battlefield video, while working in Iraq in 2009 and 2010.

After the conviction, Manning announced the desire to live as a woman and legally changed her name to Chelsea Elizabeth Manning from Bradley Edward Manning.

Manning cannot be discharged from the service while serving her 35-year prison sentence.