"She never really wanted this to be public to begin with," Coombs said. "When the information came out, you need to understand that she gave it to Adrian Lamo in a very private setting, in a one-on-one chat, never expecting this to be public. Now that it is, unfortunately, you have to deal with it in a public manner."
Lamo is a former hacker from California who pleaded guilty in 2004 to breaking into The New York Times secure computer network. In 2010, Lamo, in California, and Manning, in Iraq, chatted over a few days, Lamo has said.
The issue of taxpayers being required to pay for gender reassignment surgery has come up repeatedly in recent court cases.
Earlier this year, a federal appeals court reinstated a lawsuit brought by a transgender prisoner in Virginia, where a prison had refused to allow her to undergo sex reassignment surgery.
Last year, a federal judge ordered Massachusetts to pay for a sex change operation for a convicted murderer. The state is appealing that decision.
There are few good statistics on the number of transgender inmates in U.S. prisons, according to Vincent Villano of the National Center for Transgender Equality. A study of California prisons identified 330 transgender inmates in an overall prison population of 160,000, he said.
The center believes those numbers are higher, he said.
At Fort Leavenworth, Manning can't alter his clothing to reflect a desire to be seen as a woman.
Lewis noted that Army regulations require all prisoners wear a "distinctive ... uniform (with) a white name tag with black letters spelling the last name of the prisoner over the right picket of the shirt."
The letters won't change for Manning.
But, as Lewis said, Manning could otherwise go through the courts to legally change his first name -- to Chelsea.