When Chelsea Manning, formerly known as Pfc. Bradley Manning, declared that she wanted to live as a woman, the Army’s response was callous and out of step with medical protocol, stated policies for transgender people in civilian federal prisons and existing court rulings.

Private Manning, who has been sentenced by a military court to a 35-year prison term for leaking government files, issued a statement last week that she had felt female from childhood and wanted “to begin hormone therapy as soon as possible.” She did not say whether she planned to pursue gender reassignment surgery.

An Army spokesman said the Army did not provide hormone therapy or sex-reassignment therapy. A spokesman at the military prison at Fort Leavenworth, Kan., where Private Manning will be incarcerated, was uncertain whether she would be permitted to undergo hormone therapy, even if she paid for the treatment herself.

Prisoners have a constitutional right to care for their serious medical needs. In the case of individuals with gender dysphoria, treatment often includes hormone therapy, and failure to provide it can raise the risk of serious depression, self-mutilation attempts or even suicide.