One year after requesting gender reassignment treatment, political prisoner Chelsea Manning says the U.S. military has continued to deny her access to adequate medical care, NBC News reports.

Manning, who was sentenced to 35 years in Fort Leavenworth, Kansas for giving classified documents to whistleblower organization Wikileaks, came out as a trans woman on August 22, 2013 and requested gender reassignment treatment, which Defense Secretary Chuck Hagel approved last month. But in a letter sent to NBC News on Friday, Manning says the military has given her “silence, and then lip service” regarding her request to receive hormone therapy and be allowed to dress and live as a woman.  Military prisons like Fort Leavenworth “reinforce and impose strong gender norms,” Manning writes. “The U.S. Disciplinary Barracks restricts my ability to express myself based on my gender identity.”

“For example, in my daily life I am reminded of this when I look at the name on my badge, the first initial sewed onto my clothing, the hair and grooming standards that I adhere to, and the titles and courtesies used by the staff,” Manning said.

Manning’s lawyer, David Coombs, wrote in a statement that denying medical treatment “for Chelsea’s diagnosed gender dysmorphia violates her well-established constitutional right to be free from cruel and unusual punishment.”

“The military may not deny access to certain types of treatments based on a blanket policy that it does not allow for medical treatment of Soldiers with gender dysphoria,” Coombs wrote. “Courts across the country have held that the Eighth Amendment does not permit prisons to deny prisoners adequate medical treatment for gender dysphoria. The Constitution also does not authorize prison officials to withhold medically necessary care from a prisoner because of the arbitrary decisions of governmental officials.”

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