Wednesday, August 28, 2013

Chelsea Manning and the Big Picture

I've been taking in and digesting a lot of material over the last week or so about the Chelsea (nee Bradley) Manning and the complex matrix of her crime, her trial, her treatment, and her condition. The complexity of the situation is staggering and, even for one as verbose as myself, defies a straightforward assessment.  There's a really good book to be written here, by one connected enough to gather the facts. Sadly, the book we get probably won't be that book.

I'm not going to attempt to go into any sort of deep analysis of the progression of events, rather I'll link you to the best thing I've seen written on the subject. but what i do want to do is step around the superstructure that's already been erected over the various interlocking elements of this story and look for a moment at the broader implications for the trans community which could potentially grow out of Manning's situation.

However, in order to do that I do need to review the most specific salient points to lay the factual foundation for my comments. Manning is 25 years old, and joined the Army just before her 20th birthday. she almost washed out of boot camp (a discharge order was created, then revoked) and there were red flags about her suitability for the service throughout her enlistment and even before. Other writers have well covered the argument that Manning should never have been IN the Army, let alone have access to sensitive information.

Alongside that, the situation in the Army, vis-a-vi security, retention, and the DADT policy all can be faulted in various ways for the nexus of events which led Manning to have the access she had. Whatever one's view of her crimes, and the motivation behind them, one has to be blind to believe that Manning "beat the system" and cleverly outsmarted anyone. There are truckloads of culpability backed up in a row here. As we all know, Manning chose to transmit to the site Wikilinks a huge document dump of classified information. However, the Army testifies that no life has been lost, or is expected to be, due to Manning's actions.

I shall, in this writing, take no position on the action to reveal the documents. It is not the purpose for which I've created it. Rather, my interest is in the implications which might be drawn from the situation as it now stands. Chelsea Manning was a self-identified transsexual* having reportedly revealed this to more than one other person, well before the "espionage" event. Though there's some evidence that she viewed herself as a gay male for her early adult years.  This no doubt comes as a shock to many people who get their information from the nightly news or other mainstream media because they've treated that bit of established fact is if it were a pile of nuclear waste that they dare not touch.

Likewise, both before the Incident and after, the Army refused to deal in a head-on way with this reality. the did not discharge her when she outed herself (as DADT would require at the time) nor did they offer her significant care to attempt to deal with her distress, nor have they treated their prisoner as a woman in any regard or, indeed, in a way which constitutes recognizing the particular needs of a trans inmate. Some will no doubt scoff at the close timeline between the willingness to reveal gender dysphoria, and the crime being committed, but there's no visible evidence of lack of sincerity about her GD situation.

Now, with her lawyer having boldly proclaimed Chelsea's wishes on national TV, most feign shock and surprise and a "where did this come from?" attitude and propose to begin the conversation of what should be done with her - a conversation that rightly should have been long held by this point.  Even here, as she is facing a 35 year sentence, at least eight of which she'll serve in Ft. Leavenworth (which is a military prison, separate from the Leavenworth Federal prison for civilians), the situation hasn't gotten less complex at all, just taken on a new dynamic.

The controversy now bears considerable resemblance to the ongoing legal battle in Massachusetts concerning the claims of convicted murderer Michelle Kosilek that part of her essential medical health treatment includes Gender Reassignment surgery (GRS - also known by various other labels). In that state, government lawyers for the prison system vociferously fight to deny the treatment, which a U.S. district judge says is her civil right. That case is now before the First Circuit U.S. Court of Appeals.

Kosilek's legal case is, in some respects, more cut and dried in that there's no moral mitigation for her crimes (committed while still living as a man) but those details are not really relevant to the point I feel needs to be addressed. The central point of controversy here, and the one sure to spark the indignant outrage of a large segment of the population, is common to both these cases as well as several others: Is the prison obliged to expend taxpayer funding for the treatment of Gender Dysphoria (the sole effective treatment being transition)?

This question provokes outrage even from some in the trans community itself. It is not uncommon to see the sentiment expressed something like this: "Why should a convicted murderer (or whatever the crime) be privileged to have their treatment paid for while I, a law abiding citizen, can't afford mine?!"

As one of those who cannot afford a great many aspects of treatment, I completely sympathize with this instinct. It parallels, of course, the anger many non-trans people feel on the issue (if they are aware of it) because many people will argue that a convicted criminal should receive only the most basic health care intervention - or none at all. Many people are really invested in the "make them suffer" paradigm. I won't try to persuade anyone who holds that view to change it. The over-riding reality is, that the courts do not hold that view. There's a long legal history now of the courts firmly coming down on the side of providing prisoners with a full slate of health care ruling that to fail to do so violates the 8th Amendment. That is thoroughly established legal precedent and all the howls of protest won't change it. So the question of Manning's treatment, and Kosilek's and the rest of the trans persons who are incarcerated HAS to be discussed within that context.

It's clear, to logically thinking observers who are not biased against the interest of trans people that the answer to their requests for transitional treatment MUST be "yes." Why? Because upon that question turns the whole concept of whether transitional treatment is recognized at large as a legitimate medical expense. As opposed to cosmetic or elective procedures.  I don't need to tell you that, while some city policies and a few major employers (such as Microsoft and Disney to name just two) have updated their coverage to include trans related care, the vast majority of insurance policies, including government insurance (though this may change soon) excludes trans-related treatment from covered options. The decision makers in the insurance industry often take their cues from the courts, and court rulings upholding treatment for Kosilek and others benefit all insured trans people by establishing the official position that the care is legitimate.

The law-abiding trans person who protests Kosilek's surgery, or Manning's treatment, spites themselves because all of us are in better standing before the insurance industry when those rulings happen. To be clear, the courts are not making this "right" up out of whole cloth either, but these decisions reflect the consensus of the medical, scientific, and psychological professional communities. It is from THOSE professionals that the court draws guidance. But insurance companies will spurn that guidance until they are forced to do differently, either by the  client purchaser, or by the court.

I have no real answer for the cis-person who says "feed em bread and water and let them suffer" except to say that you'll need to take your position to the court and argue with them. but for the trans person who resents the possibility that manning will eventually get transitional treatment in prison - STOP IT! Every time you voice that view what the cis-person hearing you says is "Oh? so it IS elective treatment after all? You don't HAVE to have it? Thought so." Please do not surrender your legitimacy and your credibility in a pique over the perceived imbalance of the prisoner's treatment. Ultimately, we are closer to being covered - each of us - every time a court rules in favor of someone like Manning. It's true that Manning, being a prisoner of the Army, is under a different set of rules but the Army, too, os bound not to violate the civil rights of their prisoners.

Consider this chain of events:
>Kosilek (and others) get court ordered treatment;
>>Manning sues, based on that precedent, and the courts affirm that it's a matter of civil rights (equality before the law) that Manning get treatment as directed by her doctors;
>>>Trans civilian sues insurance company demanding coverage, citing the foregoing court decisions as precedent and wins. Bam. Trans exclusions in private and public insurance policies are dismantled; Including, for instance, medicare.
>>>>Trans service members, citing manning, are armed to appeal the military's unfair policy towards trans service members, including but not limited to health care.

I, for one, calculate the price her to be well worth it. And before someone begins to bemoan the cost of that treatment, consider that in Kosilek's case, the projected cost of mental health care treatment ongoing into the future exceeds the cost of the surgery by a wide margin. consider too, that the state has now incurred enough expense fighting her operation that they could have paid for around 100 such operations. GRS, when medically indicated, is in fact a cost-effective treatment for an incarceration of any significant length.

As for Manning, the point has been made that a 25 year old person can surely wait 8 years for surgery. indeed, in the abstract that is true. Manning has not yet indicated an intention to even pursue a surgical treatment while incarcerated. I can testify to the burden and necessity of long waits, as I began my transition five years ago and would be stunned if I've obtained that surgery within the next three. I'm insanely jealous of acquaintances I've had who had the money to go from start to finish in 2 years and sometimes less. Nevertheless, we must not lose site of the principle at stake here. If Manning's treating physicians agree that GRS is indicated and necessary treatment, then I want to see her get it. Not because she can't wait but because WE can't wait.



*Regarding my use of the word "Transsexual": I recognize that in some circles within the trans community, there's a lot of debate about the proper use of these labels. for my fuller exposition on that subject, see my previous post Transgender 101, but suffice to say in this space that while many would like to push the word transsexual into the dustbin, I hold the view that it is perfectly reasonable to distinguish between the transgender person who is born with a condition which they have no choice and and which is only fully resolved by transition, from the transgender person who for whatever reason lives in a way that is inconsistent with traditional gender expectations. in short, what I am and what a drag queen are is not the same thing (transsexuals who also do drag notwithstanding) yet both are considered "transgender." I will not compromise the argument that we need more specificity and clarity than that. I am not a separatist, nor do I hold either as superior to the other. but they are distinct and we should not whitewash that.

So whenever you see me write about the broader spectrum of trans issues, I'll readily say "transgender", but when the subject is a person who is engaged in, wishes to be, or has completed a physical modification of their body in order to align it with their brain sex, or an issue related specifically to that process, I'll be using the word "transsexual" - deal with it.

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