Three years after she was sentenced to 35 years in prison, the most pressing question about Chelsea Manning is not whether she’s a traitor or a hero. It’s whether she’s a human being.

Two months ago, the former WikiLeaks source tried to kill herself, later citing a “lack of care for [her] gender dysphoria” as the motivating factor. Five days ago, she announced the start of her hunger strike with a simple plea: “I need help. I am not getting any.”

Manning, who came out as transgender shortly after her 2013 sentencing, has been particularly vocal about the fact that the United States Disciplinary Barracks (USDB) is requiring her to adhere to male hairstyle standards. As part of her hunger strike, Manning says she will “refuse to voluntarily cut or shorten [her] hair in any way,” which would likely vex USDB officials.

In a court brief filed last November, the Department of Justice claimed that “making an exception” for Manning’s hair would “pose a significant security risk, and would undermine the USDB’s important military mission.”

But at the heart of the conversation around the length of Manning’s hair is a sobering question: If the United States can’t even treat transgender people humanely outside jail, what hope do transgender prisoners have?

According to ACLU staff attorney Chase Strangio, who represents Manning, transgender prisoners may be a bridge too far for a government that has supported trans rights in other arenas.

“Although the federal government has argued outside of the prison context that transgender women are women and transgender men are men, when it comes to treatment in custody, our government seems to believe it is just to strip away one’s core humanity as part of the punishment of incarceration,” Strangio told The Daily Beast.

In response to inquiries about Manning’s hair and her hunger strike, a U.S. Army spokesperson told The Daily Beast, “The U.S. Disciplinary Barracks at Fort Leavenworth monitors the health and welfare of individual inmates to ensure procedures are pursued to preserve life.”

Like Manning, most transgender prisoners in the U.S. are held in facilities that correspond to the gender they were assigned at birth unless they have undergone sex reassignment surgery (SRS). Military officials did, however, grant Manning access to hormone therapy last February after an ACLU lawsuit. The following month, an Army appeals court ordered military officials to stop referring to Manning as male.

This puts Manning in the awkward position of having had her gender recognized in some official capacities, but not others.

According to the DOJ’s November 2015 court brief, Manning is permitted to receive psychotherapy for her gender dysphoria, speech therapy, hormone therapy, female undergarments, and “subdued cosmetics.” But somehow, allowing her to have hair longer than 2 inches would compromise “prison-security and military values at the USDB,” the DOJ claimed.

The DOJ’s brief attempted to justified this discrepancy by arguing that Manning is “housed in a male facility for male military inmates” and is therefore “not similarly situated to female inmates who are housed in facilities for female military inmates.”

But the logic that placed Manning in a male facility in the first place is the same logic that has been used to deny medical treatment to prisoners like her for decades.

As a Lambda Legal FAQ states, seven circuit courts have recognized gender dysphoria as a legitimate medical condition. Most major medical associations—including the American Medical Association, the American Psychiatric Association, and the American Psychological Association—agree. But despite recent court victories for transgender prisoners, U.S. prison officials still “commonly block the access of incarcerated people to transition-related health care,” as Lambda Legal notes.

To date, for instance, no transgender prisoner has ever been able to receive SRS while still in detention, even though medical associations have long recognized its potential necessity depending on the patient. (Michelle-Lael Norsworthy, the first trans prisoner set to receive SRS after a 2015 court ruling, was paroled before the procedure could take place.)

Surgical procedures aside, physicians who treat transgender people also recognize that hair can be of vital importance for their patients—as it is for many cisgender people.

Clinical psychologist and World Professional Association of Transgender Health (WPATH) board member Dr. Randi Ettner, who evaluated Manning, said in a court filing that “she should be immediately permitted to outwardly express her female gender through grooming standards that permit her to grow her hair.” And in a section on transgender children, the WPATH Standards of Care highlight the potential significance of “having a hairstyle that reflects gender identity” during transition.

That doesn’t mean that every transgender woman needs long hair nor that every transgender man wants short hair. But as the ACLU noted in an October 2015 court complaint, Manning reportedly “feels like a freak and a weirdo—not because having short hair makes a person less of a woman—but because for her, it undermines specifically recommended treatment and sends the message to everyone that she is not a ‘real’ woman.”

Dr. Ettner has also stated that “the refusal to permit [Manning] to consolidate her female gender through the outward expression of her femininity causes her to suffer extreme pain, depression, and anxiety,” according to the ACLU.

The DOJ waved away these concerns in its November brief by observing that Dr. Ettner’s evaluation of Manning had taken place “over fourteen months ago” and by arguing that a “vague allusion to a potential future risk of harm is insufficient to establish that Manning is currently suffering an objectively serious deprivation.”

After Manning’s suicide attempt, however, it may become more difficult to argue that the risk of harm is “vague.” In the wake of that attempt, Manning has not yet been permitted to grow out her hair—hence the hunger strike—but she could face additional charges for trying to kill herself.

“Rather than treat Chelsea, the government has continued to deny her the necessary care that their own doctors have recommended and then, when Chelsea made the decision to end her life, they punished her for that as well,” Strangio told The Daily Beast.

For her part, Manning has tried to shift public focus away from her 2013 conviction for leaking government documents to the fact that she is, above all, a person.

“The bottom line is that I am only human,” Manning wrote in a Medium post published shortly after her suicide attempt. “When I cut my finger turning the page of a book, I bleed like everybody else.”

There is no doubt that Manning bleeds. But in the eyes of the law, it seems, the question of her humanity remains an open one.