More than six years after being released from prison, Chelsea Manning is opening up about what it was like to transition behind bars.
Manning is a former US Army analyst who was convicted of espionage for her role in leaking classified military information to WikiLeaks in 2010 and sentenced to 35 years in prison. In 2013, she came out publicly as a trans woman and began her transition while incarcerated.
"Prisons just don't prioritize medical care in prison, period," Manning said in an interview with NPR. Officials "just don't care. They're there to protect the prison, and the workers, the employees — not the inmates. They're not there to advocate for an inmate."
The bureaucratic struggle to get access to gender-affirming care made Manning's diagnosed gender dysphoria and existing mental health problems worse, she told the outlet. She only began receiving care after a lawsuit, though she acknowledged her legal team and knowledge of the system was a privilege, adding: "The average person doesn't stand a chance. That's the frank truth."
As the result of her 2015 lawsuit, Manning was the first person to receive gender-affirming health care while in military prison, per the ACLU. Despite her successes, many trans inmates still are only able to access gender-affirming care if they, too, sue for the right to access hormones or other therapies.
After serving seven years in prison, Manning's sentence was commuted by former President Barack Obama in 2017, though she was arrested and jailed again in March 2019 until March 2020 after she refused to testify before a grand jury related to a federal case against WikiLeaks.
During both terms in jail, Manning attempted suicide. She made a previous attempt in 2016, over what her representatives said was the government's denial of appropriate treatment for her gender dysphoria, Insider previously reported.
Manning did not immediately respond to Insider's request for comment.
Though her experience seeking trans health care while jailed was particularly troubling to her, "there needs to be a lot more robust protections for prisoners and prisoners' access to care in general, not just in terms of trans care," Manning told NPR. "Because that will immediately benefit a larger group of people who are being harmed, while also benefiting trans people."