The process was laid out by the Department of Defense. A service member must first secure a medical diagnosis from a military medical provider. Next, the service member must tell his or her commander of the diagnosis. A diagnosis which is, “indicating that gender transition is medically necessary.”

The service member’s commanding officer plays a critical role throughout the process. First, having to approve government-funded medical treatment for the transition. Later overseeing when the individual is able to return to service.

There are currently between 1,300 and 1,600 transgender service members in the active force. Those numbers are according to a study by Rand Corp.

The directive, which seeks to address the “unique challenges” of transition in the military, prohibits personnel from living their “preferred gender” lifestyle. They define that as “Real Life Experience,” on a military base with other service members until the transition is complete.

Real Life Experience is defined as “The phase in the gender transition process during which the individual commences living socially in the gender role consistent with their preferred gender.”

The 18-page manual takes effect on Oct. 1. The directive makes clear that “Effective immediately, no otherwise qualified service member may be involuntarily separated, discharged or denied re-enlistment or continuation of service, solely on the basis of their gender identity.”

Defense Secretary Ash Carter made the announcement last month. He stated that transgender military personnel will now be able to openly serve in the U.S. armed forces.

“This is the right thing to do for our people and for the force,” Carter said in June. “We’re talking about talented Americans who are serving with distinction or who want the opportunity to serve.

“We can’t allow barriers unrelated to a person’s qualifications to prevent us from recruiting and retaining those who can best accomplish the mission,” he said.

Current Transgender Military Rules “Outdated”

Last summer, Carter called the Pentagon’s current regulations regarding transgender military service members “outdated”. He said they were “causing uncertainty that distracts commanders from our core missions.”

“At a time when our troops have learned from experience that the most important qualification for service members should be whether they’re able and willing to do their job. Our officers and enlisted personnel are faced with certain rules that tell them the opposite.” Carter said in 2015.

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Chelsea Manning was taken to a hospital near Fort Leavenworth early Tuesday and returned to the Kansas military base’s prison later in the day, Army spokesman Wayne Hall said. He said the 28-year-old transgender soldier, who is appealing her 2013 conviction and 35-year prison sentence, was being monitored.

Hall and other Pentagon officials declined to say why the Army private was hospitalized. Fort Leavenworth spokeswoman Denise Haeussler said federal privacy laws precluded her from commenting without Manning’s consent.

CNN said that it was believed that the 28-year-old had tried to kill herself.

Chelsea Manning suspected of attempting suicide. Was taken to a hospital Tuesday from Fort Leavenworth, CNN.

— Shimon Prokupecz (@ShimonPro) July 6, 2016

There was no immediate independent confirmation of this. A spokesman for the US Army told The Independent he was waiting for an approved statement before being able to comment. TheWashington Post reported that the military said Manning had since been returned to her cell but provided no other details.

Leaks to media outlets about the hospitalization angered Manning’s appellate attorneys, who said they weren’t apprised of the hospitalization. Manning’s sister, Casey Major, said she also was unaware of the matter until reached Wednesday by the AP.

Manning’s lawyer, Nancy Hollander, said in a statement that she was “shocked and outraged” that an official at Fort Leavenworth provided “confidential medical information” about Manning to the media but had not shared anything with her team. She said she had been due to speak with her client at 2pm on Monday but was told she could not be connected.

“Despite the fact that they have reached out to the media, and that any other prison will connect an emergency call, the army has told her lawyers that the earliest time that they will accommodate a call between her lawyers and Chelsea is Friday morning,” she said.

“We call on the army to immediately connect Chelsea Manning to her lawyers and friends who care deeply about her well-being and are profoundly distressed by the complete lack of official communication about Chelsea’s current situation.”

Big: Political prisoner's lawyer says Army is blocking even scheduled calls from attorney. https://t.co/AJiN6YomOX

— Edward Snowden (@Snowden) July 6, 2016

The base declined the AP’s request Wednesday for a telephone interview with Manning.

Manning, arrested as Bradley Manning, was convicted in military court of six Espionage Act violations and 14 other offenses for leaking more than 700,000 secret military and State Department documents, plus some battlefield video. Manning, who was an intelligence analyst in Iraq at the time, later filed a transgender prisoner rights lawsuit.

Manning has appealed the criminal case, arguing that her sentence was “grossly unfair” and that her actions were those of a naive, troubled soldier who aimed to reveal the toll of the wars in Iraq and Afghanistan. The appeal contends Manning’s disclosures harmed no one, but prosecutors have said the leaked material damaged U.S. security and identified informants who helped U.S. forces.