Transgender Hoosiers transition to new lives

From the moment of birth, society identifies a person in large part by sex. It starts with a check of the body parts, then moves to what pronouns we use, what bathrooms we enter, even the toys we play with or the colors we're expected to prefer — pink for Eve, blue for Steve.

The concept of gender identity, though, is much more complicated. It may have nothing to do with body parts, chromosomes or sexual orientation. Instead, it has everything to do with what sex the person feels to be on the inside — an identity that for transgender people can contradict all those other measures.

"This is a medical condition. It's genetic and biological," said Caroline Gibbs, a Kansas City psychotherapist and founder and director of the Transgender Institute. "It is not a choice. ... This is not an easy thing to bear by any stretch of the imagination."

Between 0.3 and 1.2 percent of the population is transgender, studies have found. Even the lowest estimate suggests enough transgender individuals live in Indiana to fill Bankers Life Fieldhouse and then some.

Nearly half a century after the first gender reassignment surgery in the United States, transgender issues are receiving an unprecedented level of attention, spurred, at least in part, by the celebrity notoriety of Caitlyn Jenner. Transgender characters — fictional and real — appear on screen more frequently than ever before, from movies to television shows such as "Transparent" and "I Am Jazz."

Now there's discussion of allowing transgender individuals to serve in the United States military. A recent New England Journal of Medicine article stated that about 12,800 transgender people are serving in the country's armed forces.

Still, coming out as transgender can alienate a person from family and friends. Studies show that about 20 percent of transgender people have been discriminated against when searching for a place to live. About 11 percent have been evicted because of their gender identity. A 2011 study of almost 6,500 transgender people found that almost a third had experienced harassment at the hands of the police.

These statistics, along with the lack of acceptance in some quarters, has led lesbian, gay, bisexual and transgender advocates to view transgender rights as the next battleground after same-sex marriage.

The Indianapolis Star recently sat down with three members of the transgender community to share their stories — stories as varied as the community itself.

***

Five decades ago, when Jacqueline Patterson was growing up as a boy in Brownsburg and Indianapolis, she knew only that she did not feel like the boy everyone saw. Her mother had an intuition something was different about her son. She warned him not to let anyone see the feminine streak she sensed.

"She kind of knew it, but I was a son, and I had to be that way," Patterson said. "In those days, there was no other choice."

So Patterson lived life as the man her body said she was. She joined the Army, became an engineer, married, divorced, married again and had three daughters.

This pattern is not uncommon for trans women, experts say. In fact, the New England Journal article suggests that transgender women who are born male may try to deny their transgender tendencies by gravitating to the military with its "hypermasculine culture."

Such thinking goes, "I am going to bury this feminine thing," Gibbs said, "because I'm going to lose my family, lose my job, be an outcast."

Patterson had a secret self, one who wore women's clothes surreptitiously. A few times after being caught by her spouse, Patterson purged her closet of the offensive items and vowed not to do it again.

Seven years ago, everything changed. Patterson developed cancer, then heart trouble. As she recovered from four cardiac catheterizations, the recognition of mortality spurred her to act.

"How am I going to live the rest of my life in this falsehood? ... Am I going to live it true to myself?" she asked herself. "That's when I made the decision to finally live my life true to who I am."

Once Patterson made up her mind to undergo surgery, she told her wife. Before she married for the third time, she had told her wife that she liked to cross-dress but promised to try to suppress that desire.

About a year and a half later, however, that promise was no longer tenable. Patterson's wife supported the decision and agreed to remain with her. Patterson and her wife, who declined to talk with The Star, are still married.

"She has been on board since the beginning, and she has helped me a lot with dressing and the way to put on my makeup," Patterson said. "She likes to be called my partner. She does not consider herself a lesbian."

Patterson still can remember what she wore the first time she went out with her wife as her new self. She had on a pair of capris, blue top, blond wig and makeup.

"I was so glad to be out and just be in the world as me," she said.

Last year, Patterson founded the Indiana Transgender Wellness Alliance, which aims to improve life for gender variant adults and youths. The organization provides resources and advocates for the transgender community, and it teaches those on the outside — such as health care providers and police officers — how to provide services to this community.

The alliance had planned to hold its first conference this summer. Lack of funding has delayed those plans until next spring. But Patterson, 63, said she feels the tide turning.

"Socially in Indiana, people are just not educated enough on the transgender community and the importance of it," she said. "I just think that companies that I went to couldn't wrap their minds around something that they couldn't envision. The visibility is just not there in Indiana yet, but it has really picked up a lot of speed."

***

Korvin Bothwell could easily pass as cisgender, a term that refers to people who feel comfortable with the gender identity and sex they were assigned at birth. As a trans man, he struggles with how much to delve into the past in which he lived in a different body from the one he inhabits now.

"My transculinity has nothing to do with who I am," he said, then added, "That's not true. But it's not pertinent."

Bothwell spent almost 10 years mulling whether to go through gender reassignment. Married to a man for three years in his early 20s, Bothwell then lived as a lesbian for several years as he pushed away thoughts of transitioning.

"It's like not having the puzzle piece," he said. "I had no idea why I was different."

Aside from the loss of his breasts, Bothwell said, he didn't look much different than he does today, sporting a short hairdo and androgynous clothing. In 2008, he joined the Naptown Roller Girls, a group of tough, intelligent, feisty women. Four years ago, he opened his own skate shop in Fountain Square, Vital Skates.

At the back of his mind, he always wondered whether he was a man.

"It was like a question that kept wanting to be answered, and my answer was always, 'It isn't right for me. It's such a massive change, how do I possibly justify making this change?' " Bothwell said.

Then one day about three years ago, he was sitting alone in his room. He looked in the mirror and smiled. And he saw the face of a man looking back at him.

"I just smiled even bigger. I was so happy," he said. "I was like, I am a man. And that realization — I couldn't erase it and I wasn't going to, and I just knew."

***

When her 16-year-old child came out to her as transgender, Sheila York breathed a deep sigh of relief. The girl had been acting more and more depressed, and York did not know what to do.

So when Drake Eilert told his mother he had been thinking about gender reassignment, his mother responded with the words every child wants to hear: I will love you no matter what.

"I can't explain the amount of relief, because now I knew we could get help," York said.

The old photo albums show Eilert playing basketball, singing with the Indianapolis Children's Choir, attending the father-daughter dance. The photos don't reflect it, but Eilert always knew he was different from other girls. In warmer months, he preferred to go shirtless — a habit his parents eventually squashed. He donned shorts to swim. When he and his friends played house, he was the dad. When they played fantasy games, he wasn't the princess; he was the one who saved her.

"I just felt more comfortable in a masculine role than I did in a feminine one," he said.

Eilert's father and stepmother attended a conservative Christian church that did not allow women to talk in church or pray publicly. Eilert feared any variant of normalcy would test their love.

Channel surfing one night at his father's Whiteland house, he found a documentary on Chaz Bono. He watched, rapt. Then his stepmother walked in and ordered him to turn off the television.

"That was terrifying because I felt like, 'I feel like him. What will her reaction be if I tell her?' " he said. "At the same time, I felt OK, I'm not the only one. ... Before that, I thought I was stuck, there's nothing I can do."

Yet his anguish grew. His mother's second marriage was disintegrating, and he did not want to burden her with his secret. The internal pressure intensified. Eilert toyed with suicide.

Depression and suicide are not uncommon in the transgender population. About 41 percent of transgender people attempt suicide. About 20 percent are successful, statistics show.

But once Eilert shared his feelings, he had help. He started seeing a therapist and support groups at the Indiana Youth Group.

In the past few years, the number of youths coming out as trans or gender variant who come to the Indiana Youth Group has increased significantly, said Myranda Warden, program manager. As many as 35 to 40 percent of the youths who turn to the group are trans or gender variant, she said. Now the first link under "Resources" on its website provides information on trans resources.

Eventually, Eilert felt strong enough to share his decision with his father and stepmother. Slowly, they too accepted it.

"The idea that God doesn't make mistakes was one of the things that was very hard for me to hear from my parents," Eilert said. "When I frame it to them, I frame it as you're human, we don't know what God's purpose is for me."

***

Even under the best of circumstances, gender reassignment is not easy. Patterson was fortunate. Not only did her wife support her, so did her workplace, Cummins Inc.

Although Patterson was the first Cummins employee to come out as transgender, the company's insurance covered her counseling, therapy, breast augmentation, facial surgeries and gender reassignment surgeries.

Many other companies do not offer such comprehensive coverage. For those who pay out of pocket, health care costs can run upwards of $100,000, Gibbs said, depending on what a person opts to have done.

When Patterson began to transition about three years ago, starting on female hormones and undergoing hair transplants, she told Cummins officials of her plans. Paul Wright, then a global diversity special projects manager, helped ease the transition.

"In a workplace setting, it always comes down to the restroom. All the drama, all the resistance is around which bathroom do we use," said Wright, who formerly served as board president of the Indiana Transgender Wellness Alliance.

Best practices dictate that employers not delve too deeply into an employee's private parts, Wright said. Instead, they should just let the employee choose.

Patterson eventually took medical leave to have facial surgery to soften her features. Beforehand, she wrote a letter to her colleagues. Then, the company provided sessions to educate its workforce on transgender issues.

On the day Patterson returned to work, the company served coffee and cake and introduced Jacqueline to her colleagues. Then it was back to business.

Transition does not always go as smoothly at the workplace. About a quarter of those who transition say it costs them their jobs, said Julie Walsh, founder and executive director of GenderNexus, an Indianapolis-based support organization for people who are gender diverse, their friends and family. Three-quarters report experiencing some form of discrimination. Conversely almost 80 percent of those who go through gender reassignment surgeries report that their job performance improves, citing a decrease in stress.

"One of the things you always tell people is that you will never change. ... You're staying the same person; you're just going to look different. But that's not really true," Patterson said. "What I found was, you're not the same, you're actually better than you were. ... Once you transition and become who you really are, a lot of anxiety goes away."

She continued on her path, undergoing breast augmentation and gender reassignment surgery about two years ago. While her 93-year-old father completely accepted Patterson, other family members spurned her. Only one daughter sees her, and Patterson can see only two of her seven grandchildren. Her siblings also cut off contact.

"They say I took away the person that I used to be," she said. "The difficult thing is if people don't get on the conveyor belt or the superhighway exit with you, you're going to leave them behind pretty quick. You're going to change, and they're just not going to be able to keep up with it."

***

For Eilert, who is the youngest of the three at 21, the road to transition was a relatively smooth one.

In January 2013, as he began the second semester of his senior year, Eilert started on testosterone. He, his mother and therapist went to his Whiteland school beforehand to talk to the principal about his plans. Knowing it was a small, conservative community, York didn't predict the talk would go well.

She left shocked.

One of Eilert's most pressing concerns had been the thorny bathroom issue. The principal arranged to have him use the nurse's bathroom or faculty facilities for the rest of the year. Eilert also wanted his teachers to start using his new name. The principal met with his teachers, asking them to acknowledge the change. Some struggled with pronouns at first, but for the most part, his classmates and teachers welcomed him.

Before enrolling at Indiana University the following summer, Eilert officially changed his name to Drake, deliberately choosing a name that began with a "D" to keep his initials the same as his father's. His first year at school went well, and he would have returned had his health insurance fully covered his medical bills.

Even though his parents helped pay for his top surgery, done in May 2014, Eilert spent his savings on the costly procedure and decided it would be financially prudent to transfer to Indiana University-Purdue University Indianapolis.

Although Eilert had been wearing a binder to compress his breasts for about a year before his surgery, he was amazed at how different he felt afterward.

"I was happy because my chest was a lot of my dysphoria. I didn't like to touch people, I didn't like to be close to people, I didn't like any contact here in this area," he said, pointing to his upper chest. "And I thought, I will hug people now, I'm cool with that."

Now, some of Eilert's college professors do not realize he was born a different sex. He plans to study criminal justice and work to improve rights for transgender people.

His mother looks at her child and sees the individual she has loved from birth.

The past three years have been a learning curve for her.

"It doesn't alter who he is. He's the same person he's always been," York said. "We just didn't know he was that person."

***

Once Bothwell, now 37, decided to transition, he didn't delay.

"It was like the clock was ticking. If not now, then when," he said. "You have to start making things happen because your life is passing you by. I got a very strong sense of urgency."

In late 2012, he started seeing a therapist. By the summer of 2013, he was taking testosterone. That fall, he changed his name, choosing a name with the same first initial as his birth name so he would not have to change his Gmail account. He announced his decision on Facebook: "Woke up. Walked the dog. Read the paper. Changed my name." That November, he had top surgery.

The enormity of the decision never eluded him. But, he figured, he had already lived a full life as a woman. What was the worst that could happen to him as a man?

"It's the first change I've ever made in my life in which there's no going back," he said. "That level of commitment, I can't think of a parallel."

Before he started testosterone, he made the bittersweet decision to quit playing roller derby, though he continued coaching. In January, he went to a men's roller derby practice for the first time.

Some people may think that once a person has transitioned physically, the process is done. For some transgender individuals, that is the case. But not for all.

Just as someone who moves from one country to another can never completely leave his or her past behind, a transgender person carries his or her experience as one sex into his or her experience as the opposite sex.

"It's an ever-evolving transition. We're all always evolving," said Walsh, the GenderNexus executive director who is married to a trans man. "Being transgender is always a part of someone's history, so even if someone passes as a male and no one would ever know, they always have that transgender history."

Since he transitioned, life has changed in unpredictable ways for Bothwell. People often stop him on the street for directions, something that never happened when he was a woman. His friendships with men have improved.

As a woman, he was never interested in being a mother. But now he finds himself wishing he was a father.

And he doesn't see his life as being much different from anyone else's.

"In my opinion, the challenge in everybody's life is trying to figure out how to conform to society," he said, "and then step back and say, 'Wait a second. How am I who I am?' It's just something that's really public with trans people."

Call Star reporter Shari Rudavsky at (317) 444-6354. Follow her on Twitter: @srudavsky.

A whole lexicon has arisen to describe the transgender community.

Transgender: People whose gender identity, expression or behavior differs from the one typically associated with their assigned sex at birth. "Trans" can be used as shorthand for "transgender." Transgender is considered an adjective, not a noun. Using it as a noun — i.e., transgenders — is seen as disrespectful.

Transgender man: A transgender individual who currently identifies as a man, also known as female to male or FTM.

Transgender woman: A transgender individual who currently identifies as a woman, also known as male to female or MTF.

Gender identity: The internal sense a person has of being male, female or something else. Because gender identity is internal, one's gender identity is not necessarily visible to others. This has to do with who a person is, not whom they like or are attracted to.

Gender expression: How a person represents or expresses one's gender identity to others, often through behavior, clothing, hairstyles, voice or body characteristics.

Transsexual: An outdated term for people whose gender identity is different from their assigned sex at birth and who wish to transition from male to female or female to male. Many think this term sounds too clinical and prefer not to use it.

Cross-dresser: A term for people who dress in clothing stereotypically worn by the other sex but who do not want to live full time as the other gender. Many consider the older word "transvestite" derogatory.

Drag queen: Male performers who dress as women for the purpose of entertaining others. It is also sometimes used in a derogatory manner to refer to transgender women.

Drag king: Female performers who dress as men for the purposes of entertaining others.

Genderqueer: A term used by some individuals who identify as neither entirely male nor entirely female.

Gender nonconforming: A term for individuals whose gender expression is different from societal expectations related to gender.

Gender dysphoria: An extreme discomfort that persists over time about one's physical sex characteristics or sex assigned at birth.

Gender fluid/genderqueer: Someone who identifies as both male and female either at the same or different times, or someone who identifies as neither male nor female, but somewhere between the two.

Bi-gender: One who has a gender identity encompassing both male and female genders. Some may feel that one side or the other is stronger, but both sides are there.

Two-spirit: A contemporary term that refers to the historical and current First Nations people whose individuals' spirits were a blend of male and female spirits. This term has been reclaimed by some in Native American LGBT communities in order to honor their heritage and provide an alternative to the Western labels of lesbian, gay, bisexual or transgender.

Sex reassignment surgery or gender reconstructive surgery: Medical procedures to change one's body to align with a person's gender identity. This includes "top surgery" (breast augmentation or removal) and or "bottom surgery" (change the genitals). Many different surgeries. These surgeries are medically necessary for some people, although not all people want, need or can have surgery as part of their transition. "Sex change surgery" is considered a derogatory term by many.

Transition: The time when a person begins living as the gender with which they identify rather than the gender they were assigned at birth, which often includes changing one's first name and dressing and grooming differently. Transitioning may or may not also include medical and legal aspects, including taking hormones, having surgery or changing identity documents (such as a driver's license or Social Security record) to reflect one's gender identity. Medical and legal steps are often difficult for people to afford.