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.

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“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

threat.

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.

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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

treatments.