But these icons of popular culture have also shone a light on a segment of the transgender community that has remained pretty much in the shadows — those who transition later in life, often at middle age or into their senior years.
"I think in part what we're seeing is a generational phenomenon, insofar as transitioning feels much more possible now than it ever did before in terms of an increase in trans visibility and role models, and more widespread access to trans-competent therapy and medical interventions," says Dr. Nicola Brown, a psychologist at the Adult Gender Identity Clinic at Toronto's Centre for Addiction and Mental Health.
Still, there is no one story. Nor is there a "right time" to transition, experts agree.
"We've seen a few people for whom it feels like this identity comes as some amount of surprise," Brown says of clients she sees at CAMH and in private practice. "But for most people, it's something they've struggled with for most of their lives."
Some have been held back by shame while others have been in denial about their at-odds gender identity, convinced that they can "beat this." Many are gripped by a crippling fear that transitioning will mean rejection by loved ones, friends and co-workers, and the loss of their job.
"We live in a very transphobic world and historically people have misconceptions of trans people as somehow perverted, or in the media they've been portrayed as the butt end of jokes," says Brown.
"It's terrifying to come out in that context ... people have built an entire life for themselves imbedded in communities and jobs and often family where they might have kept these feelings quite secret."
"So coming out would come as big shock to people around them and there's much more at stake."
For 60-year-old Christina Comeau, finally choosing to fully embrace her female identity two years ago was a choice between life — or death by her own hand.
"Suicide was my constant thought for a very long period of time," admits Comeau, whose depression arose from not being "the person I was."
"I just finally got to the point where No. 1, I didn't want to die. And No. 2, the life I was living wasn't worth living and therefore whatever it cost was going to be worth it."
It was a decision Comeau had wrestled with since the age of two or three, when as a boy named Christopher, he had learned to hide his feminine leanings or pay a terrible price.
As a four-year-old pre-schooler in 1950s small-town Ontario, Christopher was cared for in a woman's home while his divorced single mother went to work.
"One day, that women caught me playing with dolls," Comeau recalls, barely above a whisper, "and she beat me into unconsciousness with her husband's belt."
"I felt like all of a sudden my life was very much in danger ... I realized by the time I went to school, I had to find a way to fool everybody."
That decision to hide in plain sight eventually led Comeau to pursue an ultra-macho career — life in the Canadian military and a rise to the high-powered rank of lieutenant-colonel — as well as marriage and five children before age 30.
But over time, the disconnect between biological sex and gender identity was taking a huge psychological toll.
Approaching 40 and retired from the military, Comeau told his wife he could no longer bear the torment of living a lie (she'd known early on about her spouse's dual nature, but preferred not to talk about it), and screwed up the courage to come out one at a time to his teenagers, who were "amazing" in their acceptance.
Comeau started with his oldest daughter, then 18, stumbling to get out the words: "And she said: 'Are you trying to tell me you're really a woman? Because I've known that since I was five years old.'"
"My biggest worry was my oldest son," who was 17. "He listens and he listens and he goes: 'Yeah, OK.' And I said: 'I'm afraid that I'll never see you again,'" Comeau says through tears. "And he said: 'I've always been proud of you and I always will be.'"
So began 10 years of living a dual life within the family: each morning, Christopher the man left the house to work as a senior consultant. In the evening, it was more often a female-garbed Christina who went out socializing.
"My two worlds did not overlap other than in my home," says Comeau, whose wife had left after about five years. "She didn't want to be married to a woman."
So why not transition fully?
"I was afraid that I would lose my life," says Comeau, who knew that transgender people can be targets of violence, especially if they don't "pass" well as the opposite sex. "And I had worked hard. I had a really good job. I was well-paid. I did interesting things. I was respected in my profession. I was taking good care of my family."
"I thought the worst might happen. The worst would have been I would have lost my job, my friends, been cast out by my family — lost everything that I had spent 50 years working to achieve."
Discrimination is one of the major reasons that some people wait to transition, says Hershel Russell, a Toronto therapist who provides counselling to transgender clients, both young and old.
Coming out as the gender opposite the one assigned at birth can be fraught with risks. A 2010 Trans Pulse survey in Ontario showed half of transgender people live below the poverty line, making less than $15,000 a year, often because they are unable to secure employment. Many can't obtain housing and violence is rife: a national survey by Egale Canada found three-quarters of trans youth had experienced verbal harassment, while 37 per cent reported being subjected to some form of physical assault.
"The big risk is suicide," says Russell, noting that 77 per cent of transgender Ontarians have considered suicide, while 43 per cent have attempted to end their lives. But with family support, that rate drops by 93 per cent.
"With family support we're safe. Without family support we are at risk."
While transitioning later in life has its challenges, there are also many joys, says Russell, who began his own female-to-male metamorphosis in his 50s.
"In yourself, it's so wonderful, it's so thrilling — these are the common stories I hear: 'I feel so alive in my body. I look in the mirror and I see myself.'"
Still, it takes what Comeau calls "unbelievable raw courage" to publicly leave one persona and live as its polar opposite.
"I have jumped out of airplanes, been shot at, stood on the edge of mountains and survived five teenagers," says Comeau. "Yet, I have never been so afraid in my entire life as the moment before I took the first irreversible steps of my transition."
One of the last was to inform about 500 people on LinkedIn that as Christina, she hoped their professional relationships could continue.
"It was less than five minutes before the first responses came back overwhelmingly positive," says Comeau, her voice breaking with emotion.
"It's amazing. It's everything I've ever wanted in my whole life," she says of living as the woman she was meant to be.
"The price I paid was not in transitioning; the price I paid was in not transitioning. I was less of a human being for 58 years."
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