Army Pvt. Chelsea Manning poses for a photo wearing a wig and lipstick in this undated photograph released by the U.S. Army.  (AP Photo/U.S. Army, File)

Attorneys for Army Pvt. Chelsea Manning said last week they will sue the Defense Department if officials do not immediately provide
gender dysphoria treatment for the soldier, who is serving time in a military prison for leaking classified documents to the
anti-secrecy Web site WikiLeaks.

Manning, who joined the Army as a man and previously went by the first name Bradley, asked for the treatment nearly a year
ago after announcing publicly that she identified as a woman. Last month, Army officials indicated publicly they would begin
a rudimentary level of treatment.

But the American Civil Liberties Union, which has taken on this aspect of Manning’s case, say they have received no such commitment from Army officials, and that the failure to provide the treatment constitutes cruel and unusual punishment.

“The Army’s continued indifference to Ms. Manning’s serious need for medical treatment, despite the recommendations of the
Army’s own medical providers, is causing her to experience serious distress, anxiety and other physical and psychological
symptoms,” the attorneys said in an Aug. 11 letter, advising officials they will take legal action if measures to provide
treatment are not in place by Sept. 4.

Wayne V. Hall, a spokesman for the Army, declined to comment except to reiterate in an e-mail that “the Secretary of Defense
has approved a request by Army leadership to provide required medical treatment for an inmate diagnosed with Gender Dysphoria.”
He said he could not comment on the medical needs of an individual, citing privacy, and said he had no knowledge of the lawsuit

Manning is being held at the maximum-security military prison at Fort Leavenworth in Kansas, among male inmates. Doctors have
recommended a treatment regimen that includes hormones as well as accommodations that permit an “outward expression of her
female gender,” said Chase Strangio, an ACLU staff attorney.

For instance, Strangio said, Manning has requested that she be allowed to grow out her hair and have access to certain grooming
products used by women. Those requests have been denied, Strangio said.

Army officials had at one time considered shifting Manning to the civilian federal prison system, which is more accustomed
to dealing with transgender inmates and often accepts medical transfers from military prisons. But the Bureau of Prisons denied
the Army’s request, according to media reports.

Though cases like this are rare, courts have previously found that transgender inmates have a right to transgender-related

Earlier this year, a federal appeals court panel upheld a lower court’s decision that Michelle Kosilek, a convicted murderer
in Massachusetts taking hormones to transition to a woman, had a right to obtain a sex-change operation. The panel cited in
its opinion the Eighth Amendment, which forbids cruel and unusual punishment.