TORONTO - As the first transgendered participant on "Dancing With The Stars," Chaz Bono had controversy swirling around him before he even set foot on the ballroom floor.
The LGBT rights advocate made his toe-tapping debut this week on the popular series, receiving a standing ovation following his cha-cha with dance partner Lacey Schwimmer to close out the show.
While Bono has received outspoken public support from his mother, Cher, among many others, the 42-year-old had also been subjected to hateful blog posts and even calls by some for a "Dancing" boycott in the leadup to his appearance.
"I think there are a couple of different points that come up in theme, and one is certainly around the question of social exclusion," said Nicola Brown, staff psychologist with the Gender Identity Clinic at the Centre for Addiction and Mental Health in Toronto.
"`Does (Bono) belong on the show?' And of course he belongs, as much as anybody else. But this question of `Do you belong? Can you be in this space?' is a profoundly painful one, and has large-scale implication for trans people in every sphere of their lives."
"Some of these spheres are very high stakes — employment, housing, health care; the kinds of things that we recognize as being really fundamental social determinants of health for people."
Hershel Russell has been counselling trans individuals and their families since 1995. The Toronto-based psychotherapist, educator and consultant said he has the "warmest respect and appreciation" for Bono and his decision to appear on "Dancing."
"I feel so appreciative of all those people who are willing to stand up and be visible in this moment where discrimination is still so strong because that's how things are going to change," he said in a phone interview.
In 2000, Russell began taking hormones, embarking on the transition from female to male. Being in the position of counselling and supporting trans people while deciding to transition himself made the process both "easier and harder."
"I've had the realities of what it's going to be like rubbed in my face because I've been helping other people through them, and easier because I knew where to find medical care, I knew what the supports were, I knew how the system worked," he said. "I had done a lot of thinking and reading about the issues."
But Russell admits there was a long period of holding off on making the transition while raising his then-teenaged son, now in his 30s.
"He's a wonderful guy. He's very supportive. But I remember at one point he said: "`Mom! Couldn't you just be normal for once?'" Russell recalled, laughing, "And I said very sadly: 'Honey, no, I'm sorry. I can't.'"
Brown said she's not entirely sure what specifically distinguishes the stigma and discrimination experienced by trans people. But for those who haven't gone through the process, the idea of transitioning can be one that's difficult for some to comprehend, she noted.
"We don't call being cisgender — which is when our bodies match up with our internal sense of gender — a personal choice. Both are about being who you are," she said.
"Many trans people will tell you this doesn't feel a choice any more than anyone else's sense of gender. But I think that's a really hard thing for people to understand."
For those who have decided to transition, social rejection is a significant fear, said Brown.
"`What will my family think?' If they have a partner: `What will my partner think? Will my friends still be my friends? Will I be able to get a job? Will my doctor still want to treat me? What if I get challenged trying to use the bathroom?'" said Brown. "That fear is interwoven into the very fabric of our daily lives that I think can be so stressful and take a toll."
As a trans man, Russell has had to confront his own challenges with respect to facing stigma and discrimination.
At work as a psychotherapist, transition was a complex, worrying and "interesting" dance of figuring out what it might mean to each client and how to — or not — discuss the matter. He admits he was very worried he wouldn't be able to maintain his practice which was his main source of income.
"In the end, there was a dip for a few months and then a somewhat different demographic found me and I have had plenty of clients ever since," he said later by email.
Among close friends and family, Russell said he did lose one important person for a while, but managed to reconnect a few years later.
Medical care varies from terrific at his GP's clinic to "really uncomfortable."
"I could tell you about the joys of sitting in the waiting room in hospitals and being called up as `Mrs. Russell' when I am visibly and clearly male," he wrote. All of Russell's ID identifies him as female. Russell said the gender can only be changed on documents like a passport if someone undergoes surgery.
While there is still "immense discrimination" experienced by trans people, Russell said there have been significant changes since he first began his work counselling them. Among them: a vigorous, relatively well-organized trans community voicing their needs and concerns, and those involved in social services beginning to take notice.
Russell said greater visibility of trans individuals, such as Bono's participation in "Dancing With The Stars," is also making a difference. He also points to Thomas Beatie, the transgendered man who made headlines with his decision to go public with his pregnancy.
"Gradually, we're becoming this ordinary part of the culture that we always were," said Russell. "We've always been here, but now, we're becoming visible in a much more straightforward way."