Chelsea Manning sues Chuck Hagel. But came this out of the blue?
A timeline:

- Though she was assigned male at birth, from a young age, Ms. Manning felt different from her male peers and was
teased and bullied for being effeminate.
Since then, her gender dysphoria diagnosis has been confirmed multiple times by Army medical providers and civilian experts:

- May, 8, 2010 She was first diagnosed with gender dysphoria by Capt. Michael Worsely, an Army psychologist in Iraq

- May, 27, 2010 After her arrest for unlawful disclosure of classified information Ms. Manning was transferred from Iraq to Camp Arifjan, Kuwait where she was again diagnosed with GID by military doctors.

- May/June 2010 While in confinement at Camp Arifjan she was placed on suicide watch because she contemplated ways to remove her testicles and even planned to commit suicide in a moment of extreme distress
.
- April 22, 2011, Ms. Manning was diagnosed a third time with GID during her Rule 706 Board.

- August, 22, 2013 With her court-martial and sentencing final, Ms. Manning decided to come out publicly about her female gender identity and her desire to begin treatment as soon as possible. In response to her public announcement the Department of the Army announced through a USDB spokesperson that it was the Army’s policy not to provide hormone therapy to treat gender dysphoria.

- August 2013 Shortly thereafter, during a routine treatment and risk assessment, when Ms. Manning inquired about treatment options for gender dysphoria, she was informed by John Lesniak, Chief, Assessment Division DTP, that it was USDB and Army policy to limit treatment for gender dysphoria to psychotherapy and anti-depressant and anti-anxiety medication.

- August 28, 2013, Ms. Manning again requested a mental health evaluation and treatment for gender dysphoria by submitting a Department of Defense (DD) Form 510 to Lieutenant Colonel Nathan Keller, the Director of Treatment Programs at the USDB.

- September 2013, Dr. Ellen Galloway, Chief of the Mental Health Division at the USDB, evaluated Ms. Manning and diagnosed her with gender dysphoria again.

- October 1, 2013 Dr. Galloway’s diagnosis was reviewed and confirmed by Dr. Patrick Armistead-Jehle, another Army psychologist.

- October 15, 2013, Lt. Col. Keller sent a memorandum to Steve Lynch, former Deputy Director of the Army Corrections Command (ACC), based in Washington, D.C., regarding available treatment for Ms. Manning at the USDB. In that memorandum, Lt. Col. Keller noted that treatment for gender dysphoria is governed by the WPATH Standards of Care but said “I see
no way the USDB can provide a full course of therapy for Mr Manning’s Gender Dysphoria …because the USDB cannot house a female or highly feminized inmate. Permitting Mr Manning to live as female, much less begin to feminize his body, will create operational challenges as the inmate population respond to these changes.”
He recommended possible “stop-gap” treatment options that he identified as “at best stop-gaps [that] will not meet the need.” Those options included weekly therapy at the Transgender Institute in Kansas City or supervision of Dr. Galloway by the Transgender Institute.

- October 16, 2013 Dr. Galloway also sent a memorandum to Steve Lynch, ACC regarding treatment available at the USDB for Ms. Manning. She advised that the ethical principles of psychologists mandate that psychologists
only provide services within the scope of their competence and that she does not have the expertise to develop a treatment plan or provide treatment for individuals with gender dysphoria.

- November 1, 2013 Dr. Malone recommended psychotherapy and real life experience – a term used to refer to outward changes to gender expression and role to be consistent with one’s gender identity – as the minimal acceptable therapeutic interventions.

- November 25, 2013, Dr. Galloway finalized a treatment plan for Ms. Manning
based on recommendations made by Dr. Ricky Malone, whom she described as an expert provided by the Western Region of the Army Medical Department, and sent it to the Army Corrections Command. The plan recommended that Ms. Manning receive weekly psychotherapy with Dr. Galloway to address issues specific to gender dysphoria and to receive treatment in the form of the real life experience by being provided with female underwear and sports bras. The plan also noted that it is likely that additional interventions will become necessary such as hormone replacement therapy (HRT) or gender reassignment surgery.

- January 5, 2014, Ms. Manning submitted another DD Form 510 to the Directorate of Treatment Programs requesting a status update on her care, but never received a response
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- January 21, 2014, Ms. Manning submitted a request for redress to Col. Ledwith, the Commandant at the USDB at the time, and Capt. Byrd, her commander at the Personnel Control Facility in Fort Sill, Oklahoma pursuant to Army Regulation (AR) 27-10 and Article 138, Uniform Code of Military Justice (UCMJ).

- No response to her Request

- January 21, 2014, Ms. Manning also submitted a comparable request for treatment in accordance with WPATH protocols through the Office of the Inspector General. That request went from the Office of the Inspector General, United States Army Combined Armed Center, Fort Leavenworth, Kansas to the Western Regional Medical Command and ultimately to the Office of the Surgeon General for the Army.

- Ms. Manning never received a response to that request.

- March 4, 2014, she submitted a UCMJ Article 138 complaint of wrong
against both Col. Ledwith and Capt. Byrd for their failure to implement a treatment plan in accordance with the WPATH Standards of Care

- May 7, 2014, Plaintiff learned through her civilian defense counsel that her Article 138 complaint of wrong had been deemed deficient on March 19, 2014, on the grounds that 1) Col. Ledwith was not her commanding officer; and 2) Capt. Byrd lacked the authority to approve the treatment plan.

- April 2, 2014, Ms. Manning submitted a request to the DTP for permission to follow the hair and grooming standards for female prisoners as part of her treatment for gender dysphoria.

- April 23,2014 A Kansas judge granted a request to formally change the name from Bradley Edward Manning to Chelsea Elizabeth Manning. The Army did not oppose the name change, Army spokesman George Wright said.

- 14 May 2014 Attorney David Coombs learned for the first time that the Pentagon considered transferring Chelsea Manning to the Federal Bureau of Prisons. This news came via a leak of information to the AP and was the only information they have heard regarding Chelsea's medical treatment in 10 months. The Army will start a rudimentary treatment, an official said.

- May 29, 2014 Chelsea Manning sought permission to file her complaint against the Commandant of the USDB.

- July 3, 2014, that request was denied.

- July 17, 2014 Defense Secretary Chuck Hagel has approved the Army's recommendation to keep Manning in military custody and start a rudimentary level of gender treatment, a defense official said. Officials spoke on condition of anonymity because they were not authorized to discuss the matter publicly by name.

- July 23, 2014 having received no response to her April 2, 2014 request, she renewed that request to the DTP but never received a response to either request
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- August 11, 2014 Ms. Manning sent a demand letter to Defendants

- August 20, 2014, approximately six weeks after Defendants became aware that Ms. Manning was being represented by counsel regarding her health care Dr. Galloway wrote a memorandum recommending that Plaintiff be provided with female undergarments.
- that was provided shortly thereafter.

- August 22, 2014 Chelsea Manning send a Statement Statement for Public Release Subject: My Treatment Request–One Year Later

- August 27, 2014, Ms. Manning met with Dr. Randi Ettner, an expert in the diagnosis and treatment of gender dysphoria that she retained. Dr. Ettner confirmed Ms. Manning’s gender dysphoria diagnosis and concluded that her condition was moderate to severe. She noted that Ms. Manning is experiencing symptoms of anxiety, depression and hopelessness because she is not receiving necessary treatment for her gender dysphoria. Because gender dysphoria intensifies over time, the longer an individual goes without
treatment, the greater the risk of severe harms to her health, Dr. Ettner noted.

- September 3, 2014, Col. Erica Nelson, the Commandant of USDB, sent a letter to Ms. Manning’s counsel responding to the demand letter. She stated that Ms. Manning’s psychotherapy was expanded sometime after July 18, 2014 to include therapy for gender dysphoria and that she “has also been permitted to begin the ‘real-life experience’ treatment by being issued female undergarments, specifically female underwear and sports bras.”

- Yet, despite her well documented diagnosis and the medical consensus about the proper treatment protocols for this condition, the Defendants have denied Ms. Manning urgently needed and medically necessary treatment for her gender dysphoria.

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