(Follow-up to Part II)
“We sentence people to incarceration. We do not sentence them to untreated medical conditions. We don’t sentence them to untreated gender dysphoria just as we don’t sentence them to untreated kidney failure, untreated infections, or anything else of the sort. When the government takes on inmates and incarcerates them, it becomes responsible for their medical care. And this condition from a medical and scientific perspective is no different from any other medical condition that requires treatment. And increasingly from a legal perspective as well. Civilian courts have found in almost all cases that prisons are required to provide hormone therapy and increasingly surgery as well. Not to do so is considered cruel and unusual punishment under the Eighth Amendment.”
— Lauren McNamara, an activist and friend of, and former defense witness for, Chelsea Manning, explaining why hormone therapy is a medical necessity for trans people and why Chelsea ought to be treated in prison
The third perspective to which I alluded on Saturday (quite honestly, this was a busy week for me, so there’s why it took me so long to update) is the one McNamara speaks of in the above quote. Having fact-checked her on this, I found in an extensive source referenced in Part II ample evidence to suggest not only that gender dysphoria is responsible for considerable struggles in the lives of many individuals, but also that the most effective treatment is transitioning. While the extent to which any given trans person would be best off transitioning varies, common elements of this process include hormone replacement therapy, SRS, and — most critically — integration into the authentic gender identity in a way that maximizes comfort with the self. As far as none of this causes unethical harm to the transitioning person or to others, the need for acceptance of trans people and demolishing of the myths surrounding transgender issues is undeniable.
Where, then, does this leave Private Manning? Currently, the prison in which Manning resides offers no more than psychiatric assistance for gender dysphoria as part of inmate health care. This may sound reasonable enough on paper, but the problems are twofold. First, as noted in the aforementioned source, the sort of therapy that is standard practice for military inmates is not nearly as effective as the remedies prescribed almost unanimously by psychological journals (e.g. the AJP). The former methods, which tend to focus more on eliminating the desire for elements not conforming to the norms of the birth sex (analogous to ineffective “pray away the gay” tactics), are as relatively inefficient as if we treated PTSD with Freudian psychoanalysis.
Second, these facts lead inevitably to the conclusion McNamara reaches: that the government has no more right to deny trans people any necessary treatment than it does to preclude mental health care for sufferers of depression. For many, as is medically demonstrated, dysphoria manifests as a form of depression and should be treated as such in urgency.
Why, many ask, should the people’s tax dollars go toward funding this treatment for a person at least a fair deal of the country considers a traitor? For the same reason taxes go toward any other sort of prisoner medical care: inmates are not legally allowed to pursue their own private health care, thus, as the system currently runs, they can only rely on the government’s provisions of such services. The alternative is to add unnecessary physical and mental suffering to the sentence, which is indeed “cruel and unusual punishment under the Eighth Amendment.” Those who take issue with this policy are doing just that; it has nothing to do with the rights of trans inmates specifically.
To close this post, consider this graphic:
In far too many — not all, but enough for us to care — cases, a lack of acceptance of trans people wreaks damage on multiple levels. Families are broken, jobs are lost or precluded to begin with, discrimination is imposed at every turn, physical and sexual abuse is endured, and lives come to tragic ends. This is a real problem, and it is not inevitable. The vast majority of that which plagues the trans community begins in the attitudes, speech, and actions of you and me. For those who are denied respect solely on the basis of their gender identities, in honor of Suicide Awareness Week, we ought to do better. Manning was once one of the youth described above, and her case brings light to the need for a paradigm shift in our overwhelmingly cissexist society.