09/03/2013 02:57 pm ET Updated Feb 02, 2016

Chelsea Manning -- Courageous as a Trans Woman

Chelsea Manning has already had quite a life. Being sentenced to 35 years in prison is a serious matter, but awakening to and acknowledging the existence of gender dysphoria within oneself is huge, probably even bigger. Among trans people, our transitions to correct gender are often referred to as the hardest thing we'll ever do in life. It's certainly true in my case.

I've spent some time comparing the hardships I've surmounted during my transition with the challenges I faced getting my medical education. Clearly, transition is much harder. Medical school was very difficult, to be sure, but it was really never overwhelming. On the other hand, many facets of transition have left me totally overwhelmed as to how to handle them or proceed through them. Furthermore, all throughout my medical education, I always knew there were backup plans, viable alternatives in case I couldn't achieve my goals. With transition, there really is no choice; I cannot continue to live as a man. This has to work, and I often have no idea how I'm going to accomplish some aspect of it. I've just had to figure it out as I went along, and keep trying until something works.

I sympathize with Chelsea. I can't fathom the idea of 35 years in prison, but I remember being in her place regarding my transition. All I knew was that I had to do it. I didn't really know what "it" would entail, just that it had to be accomplished, however or whatever it took to do it.

I suspect that her revelation of her true gender at this time is something of a coincidence with her trial and sentencing. I suspect she would have brought forth this news even without those events. For most of us in the trans community, our transitions quickly become the all-consuming passions of our lives. To be honest, I think even being sentenced to 35 years in prison is minor compared to Chelsea's realization that her true, real, honest gender doesn't match her birth sex. This is a truly earth-shaking revelation. To have to go through it in prison will be extra difficult.

Clearly the government (and prison officials) owe her the same respect and treatment that anyone outside prison would get. I've checked, and the dose and brand of estrogen I'm on costs about $8 a month. This can hardly be a burden; certainly a prisoner deserves basic medical care.

That raises an interesting issue, however. Is hormone therapy basic medical care for a trans woman? I've thought about my own case, of course. Doubtless there are many who feel I'm "not a real woman." I am absolutely, totally, completely convinced that I'm just as female as any other woman. I am female, I was born female, I was just born with a somewhat unusual birth defect. This is simply a medical condition, like club feet. If Chelsea Manning had been born obviously completely female in genitals and genetics, but with club feet, would there be any debate about whether the foot deformity should be treated? Would there be any doubt about who's responsible?

Why is this a different issue? Just like someone with club feet, I didn't ask to be born with this "deformity." I would never have chosen such a difficult path for my life had I actually had the choice.

In addition to estrogen treatment, which I believe the government owes her (if she needed blood pressure pills we'd pay for that), she needs housing and other accommodations consistent with her true gender. If she had been a "g and g" (genital and genetic) female, there would be no doubt that she should be housed with women. I seriously doubt that housing her with male inmates could work at all. Based on my experiences with g and g women, I would imagine that she would be accepted by her fellow female inmates. By and large, I have been completely accepted as a member of the community of women by g and g women. As one female coworker put it succinctly, "You already were the dominate gender; now you're forsaking that to be us, the nondominant gender, female. How can we not be impressed by that?"

A few women have been standoffish--generally hyper-feminists who think I've somehow "cheated" by living first as a man (this completely denies the reality of how hard it is to switch genders).

Ultimately, Chelsea's a she because she said so and we have to accept that. Since this means she always was female, she should always be referred to as she, even in past tense. Chelsea Manning is a woman, plain and simple. She deserves the same care and treatment any other woman would get. She deserves at least basic medical care. Receiving hormones for a trans woman constitutes basic medical care.

Chelsea certainly has my deepest sympathy, thoughts, and best wishes. I'm pleased that her case can add visibility to our cause.