INDIANAPOLIS — As a teenager, Lilith Le’fay Belladonna, recalls being confused about the relationship between her gender and masculine body and tried to repress any uncomfortable feelings. She hated how she looked and felt strange in her body, as if she were born with the “wrong parts.”
“I didn’t even know, more or less, that trans people existed like that,” Belladonna, now 35, said. “I didn’t know that there were people out there… that felt like me.”
Ever since socially transitioning 18 months ago, or living as her authentic self in public, she’s had transphobic altercations and banned people from the gas station where she worked in customer service after they made violent threats.
“I got tired of trying to live this fake life. It felt like an act… Ever since that day, things have gotten better and better mentally for me. For the longest time… (I wasn’t) caring. I was depressed all the time,” Belladonna, of Marion County, said. “But there’s no point trying to live my life for other people.”
According to the Pew Research Center, 56% of American adults believe that gender is determined by the sex assigned at birth, while 41% believe the opposite. Still the center notes that a growing number of people say they know someone who is transgender, or 42% of adults in 2021 compared to 37% of adults in 2017.
Some have called the rising acceptance and openness on gender diversity an epidemic, pushing laws discriminating against transgender youth and adults with little scientific evidence.
Richard Brandon-Friedman — an assistant professor of social work and pediatrics at the Indiana University School of Social Work at IUPUI, who provides counseling to youth considering transitioning with the Gender Health Clinic at Riley Hospital for Children — doesn’t accept that narrative.
“I think there’s been a large increase in understanding of gender diversity which has led to youth having a better sense of their experiences and a way to name their experiences versus the youth who had those experiences and just weren’t able to talk about it,” Brandon-Friedman said.
“When you have politicians come in, it just leads to this political association of transgender youth, and their experiences become somewhat demonized when they’re really just trying to live authentically.”
As part of the team that developed the initial protocols for the Gender Health Clinic in 2016, Brandon-Friedman continues to be involved as a social worker and works to help youth and parents understand the transition process.
He said the two biggest needs he saw were for support, whether from family or society, and addressing body dysphoria, or the sense that one’s body doesn’t match one’s gender.
The clinic at Riley can help with socially transitioning — such as changing names, appearances and pronouns — to prescribing puberty blockers and gender-affirming hormones. Puberty blockers are often used to delay puberty for children who menstruate early, help some children with growth disorders and even to treat endometriosis.
Brandon-Friedman said that the clinic doesn’t perform gender-affirming surgeries but may refer patients to Eskenazi Health’s Gender Health Program, though most surgeons won’t operate on minors.
“I think most of the youth are just looking for a way to feel comfortable with themselves,” Brandon-Friedman said. “I think part of it comes to this question of whether youth can really know and understand their bodies and I think those who propose some (of those anti-trans bans) don’t really understand what’s going on.”
In Indiana, Gov. Eric Holcomb vetoed a bill that would have barred transgender female athletes from participating in school sports. The General Assembly, which meets later this month, has vowed to override his veto with a majority vote.
Brandon-Friedman said that the Indiana High School Athletic Association, which governs school sports, has its own participation rules developed by professionals, not politicians.
With an increasing number of bans on transgender athletes and their gender-affirming care, advocates worry about the impact on mental health. Already ostracized by much of society and internally conflicted, transgender youth report attempting suicide at higher rates than their cisgender peers.
The Trevor Project, a nonprofit supporting LGBTQ youth, reports that respecting pronouns, allowing transgender youth to change their names/gender markers and giving youth access to gender-affirming spaces lowered rates of attempted suicide.
“If you’re bombarded constantly with questions of whether gender diversity exists and whether transgender affirming care should be banned or whether transgender athletes should be banned — that’s a constant negative messaging,” Brandon-Friedman said. “It’s a constant suggestion that you — that your experience — is wrong. That something is wrong with you.”
For Belladonna, a divorce and struggle with addiction derailed her transition, and only after she joined a methadone clinic and got clean could she focus on her relationship with her body. Now, with a close group of friends online and a partner planning to move to Indiana in a couple of months, she said she doesn’t want any special treatment — just respect.
“There’s a lot of trans hate in the country right now,” Belladonna said. “I don’t understand why people have this hate in their heart. It’s sickening; it’s depressing. All we want to do is live our lives just like everyone else.”