Experiences of Discrimination and Support Among Trans Men and Women Partnered with Cis Men

Abstract

Trans individuals routinely experience discrimination. In this study, thirty-nine couples consisting of a trans partner and a cis male partner from the San Francisco Bay Area were interviewed about their relationship. The interviews were digitally recorded, transcribed and reviewed for accuracy. Guided by grounded theory, coders began thematic analysis until inter-coder reliability was achieved. Further qualitative coding produced several codes, two of which are focused upon here: namely, discrimination and support. This study highlights discrimination at the institutional level, such as being denied housing and employment, and at the interpersonal level, such as experiencing harassment from strangers and exclusion from queer community spaces. Trans individuals reported becoming desensitised to discrimination, moving to safer geographic locations, and acknowledged cis or straight passing as a privilege and a prevention tactic against discrimination, although this sometime left participants feeling their gender had been invalidated. Although most trans individuals sought support from their cis partners, some cis partners reacted with violence to discrimination, provoking the situation’s severity and upsetting their trans partner. Transphobic discrimination is widespread, and it is crucial for frontline health and other service providers to understand the impact it has on both trans individuals and trans/cis couples, and for agencies to offer resources to support these relationships.

Introduction

Over the past decade, studies examining the well-being of trans individuals have found high rates of discrimination and stigma, as well as multiple resultant negative health outcomes (James et al. 2016; Bradford et al. 2013; Grant et al. 2011). Trans individuals face discrimination that influences health inequities on structural, institutional and interpersonal levels, each having detrimental individual-level health results (Lelutiu-Weinberger et al. 2020). The 2015 US Trans Survey (USTS), a robust survey of over 27,000 trans and non-binary individuals, illuminated many areas of discrimination (James et al. 2016). Areas of institutional mistreatment include discrimination in housing (James et al. 2016; Kattari et al. 2016), employment (James et al. 2016; Dietert and Dentice 2009), and health care (James et al. 2016; Kachen and Pharr 2020). The 2011 National Transgender Discrimination Study (NTDS) reported that 55% of its 6,450 participants had been harassed by homeless shelter residents or staff and 29% had been denied access to public housing resources altogether (Grant et al. 2011).

The NTDS reported that 90% of respondents described experiences of workplace harassment or discrimination, or identity concealment to avoid workplace discrimination (Grant et al. 2011). Discrimination in healthcare settings was similarly common, with 33% of trans individuals reporting a negative experience surrounding their trans identity and 23% of trans respondents not seeking the healthcare they needed for fear of being discriminated against (James et al. 2016). In the year preceding the survey, many trans individuals experienced interpersonal discrimination, reporting high rates of verbal harassment (46%), physical attack (9%), and intimate partner violence (54%) (James et al. 2016). These interlocking negative experiences contribute to severe mental health problems, including high rates of suicidality and suicide attempts (James et al. 2016; Mizock et al. 2014), psychological distress (James et al. 2016), anxiety (Budge et al. 2013; Mizock et al. 2014), depression (Budge et al. 2013; Mizock et al. 2014; Nemoto et al. 2011), and more negative health behaviours such as substance misuse and sexual risk (Skeen et al. 2021; Lelutiu-Weinberger et al. 2020; Gamarel et al. 2019; James et al. 2016; Reisner et al. 2014; Reback et al. 2014).

Studies guided by minority stress frameworks describe a stress process among sexual and gender minorities, including trans and non-binary people, that includes experiences of prejudice, expectations of rejection, concealing minority status, and internalised homophobia (Mizock et al. 2014; Meyer 2003). Minority stress in a relationship context has been found to lead to relationship strain and dissatisfaction (Frost and Meyer 2009; Otis et al. 2006). Specifically, relationship stigma experienced by trans women with cis male partners was associated with depression and poor relationship quality, particularly for the trans partner (Gamarel et al. 2014). The mechanisms contributing to these negative outcomes are hypothesised to be an internalisation of negative messages about one’s relationship, leading to self-consciousness, self-doubt and the perceived need to conceal the relationship (Gamarel et al. 2014; Frost and Meyer 2009; Meyer 2003; Reisner et al. 2016). Concealment of trans identity, though sometimes mitigating day-to-day interpersonal discrimination, is considered to be a maladaptive behavioural strategy that may contribute to low life satisfaction, internalised stigma and transphobia (Bränström and Pachankis 2021; Bockting et al. 2013). Moreover, the impact of transphobic discrimination is not limited to trans people, as cis male partners report experiences of discrimination based on their relationship status with a trans woman (Operario et al. 2008).

The present study seeks to describe the discrimination and support that trans individuals and their cis male partners experience, at an institutional and interpersonal level. Essential to this understanding is breaking down the complex homonegativity, transphobia and cisgendered expectations of US culture. Reisner et al. (2016) use the term “gendered situated vulnerabilities” to describe the ways in which trans peoples’ health and wellbeing are situated within and influenced by power and the policing of gender and sexual social/cultural norms. Trans and non-binary individuals are, of course, neither responsible for, nor in control of, the disproportionately negative health outcomes associated with the stigma described by gender minority stress as compared to cis individuals. Rather, they are rendered vulnerable to the systems of policing – structural, institutional, and interpersonal – that allow discrimination to continue as a means to enforce cis-hetero cultural norms.

Materials and Methods

Participants

A convenience sample of trans women with cis male partners and trans men with cis male partners was recruited from the San Francisco Bay Area over a 12-month period between May 2016 and May 2017. Active (i.e. outreach by field research staff) and passive (i.e. fliers left in community venues and posted online) recruitment strategies were used in community settings. Recruitment material instructed those interested in participating to call a toll-free number for more information. Callers were screened over the phone and partners were screened individually for eligibility. Eligibility criteria required that participants identify as a trans man or trans woman currently in a primary relationship of three months or more with a cis male partner.

Trans men, a population whose sexual risk behaviours are understudied, and trans women, a population with high HIV prevalence, in relationships with cis men were targeted specifically to examine relationship dynamics that impact sexual risk behaviours for HIV, which was a key aim of the study and are addressed in another paper (Scandurro et al. 2022). All participants were asked their current gender identity and the sex they were assigned at birth to confirm trans and cis identities. Relationship was defined as, “being committed to your partner over anyone else and that you have had sex together”. Additional eligibility criteria included that the participants be at least 18 years old, have knowledge of their own and their partner’s HIV status, and agree to be interviewed in English. Informed consent was obtained from participants regarding their participation and permission to have their interviews be audio recorded. The study protocol was approved by the Institutional Review Board of San Francisco State University. Couples were eligible to participate only after both partners were screened and found to have met the eligibility criteria. In total, thirty-nine couples were eligible and went on to participate in the semi-structured interviews.

For some couples, there was a delay between time of screening and the scheduled interview. In one case, a participant identified as cis at screening and as gender queer at the interview. The data collected at screening was used to determine eligibility. Data collected at the interview is presented in Table 1. Thus, the minor discrepancies between eligibility criteria at screening and the interview date (e.g. trans identity and knowledge of HIV status) could be due to the time delay between screening and the interview.

Table 1.

Couple Level Characteristics (N = 39)

	N	%
Couple Gender
Trans women with cis male partner	22	56
Trans men with cis male partner	16	41
Trans men with genderqueer partner	1	3
HIV Status
Seroconcordant HIV-negative	28	71
Seroconcordant HIV-positive	5	13
Serodiscordant	5	13
Unknown	1	3
Couple Race
African-American/Black – African-American/Black	6	15
African-American/Black – European-American/White	4	10
African-American/Black – Latina/Latino/Latinx	1	3
African-American/Black – Mixed	3	8
Asian-American/Asian – European-American/White	3	8
Asian-American/Asian – Latina/Latino/Latinx	2	5
Latina/Latino/Latinx – European-American/White	2	5
Native-American – Native-American	1	3
European-American/White – European-American/White	14	35
Mixed – Mixed	2	5
Mixed – European-American/White	1	3
Mean Relationship Length			4.3 years
Mean Age of Participants			36 years old

Procedure

After a research staff member had screened both partners and determined the couple was eligible, they were scheduled for a 90-minute semi-structured interview. Partners were interviewed separately to allow for candid discussion of their relationship, agreements they have about whether sex with outside partners is permitted and how it is navigated, and any reported agreement breaks that may or may not have been disclosed to their partner. Interviews examined the following topics: gender, relationship history, attraction, experiences of discrimination, decision-making, sexual behaviour, agreements, sexual health, and relationship satisfaction. Interviewers were trained to guide the participants through the interview by posing questions in an open-ended, conversational tone, to probe for clarity when and where necessary, and to allow emergent topics to arise. Each partner was paid a $50 incentive at the end of their respective interview. All interviews were audio recorded using digital recorders and transcribed verbatim by an outside transcriptionist. The research staff member who conducted the interview was responsible for reviewing the accompanying transcript for accuracy (e.g. mistakes, misspellings, and omissions).

Once the interviews had been completed, transcribed and reviewed, they were grouped by couple and reviewed thematically to generate codes. Initial coding was informed by grounded theory and thematic analysis (Chun Tie, Birks and Francis 2019). (A description of how codes were generated is available in Scandurro et al. 2022).

Once codes had been identified and defined, research staff members applied the codes to selected sections of the transcripts to verify code definition and application consistency among team members. When agreement was found among research staff, which in some cases required revising the definition(s) of certain codes, the transcripts were coded. The coding process began by having two research staff members code the same transcript independently of one another. Afterwards, they met to compare their coded transcripts for discrepancies. This inter-coder reliability process was repeated until both coders demonstrated consistent coding on ten transcripts. Approximately sixteen transcripts were coded by both coders with ten showing consistency between coders. All subsequent interviews were coded by one coder only, rather than both simultaneously (O’Connor and Joffe 2020). Coding was done manually by highlighting text in each transcript.

Coded data were then uploaded to Dedoose (2021) a qualitative data analysis software. Once the data were in Dedoose, the authors were able to analyse the data using a thematic analysis approach (Nowell et al. 2017; Kiger et al. 2020). The coded data utilised for this analysis were the discrimination code and the support code. Analysis of the coded data included the authors reviewing coded text, identifying salient themes, reaching team consensus on themes by verifying the themes in the text, and identifying quotes to best represent the theme. To protect confidentiality, we have assigned a pseudonym to each participant. The study team was diverse in terms of sexual and gender minority statuses. The team received support and advice from an Advisory Board composed of trans individuals several times to develop the recruitment strategies, the interview guide and study procedures. The five staff that conducted the study included trans and cis individuals. The three authors, one of whom participated in the implementation of the study, all cis women, analysed the data with the intention of data fidelity and limited bias by reaching consensus in the interpretations made.

Findings

Participants reported discrimination on the institutional and interpersonal levels. Institutional discrimination included housing eligibility and workplace discrimination. Interpersonal discrimination was experienced within queer and trans communities and from strangers. Responses to discrimination varied, leaving some trans individuals feeling desensitised to discrimination or relying on specific geographic locations deemed safer. At the couple level, partners sometimes acted as a protective factor from discrimination, while other times they added tension to experiences of discrimination.

Institutional Discrimination

Housing Eligibility

Shelters and other housing arrangements can be discriminatory towards trans couples. The following excerpt provides one account of a trans woman/cis male couple seeking shelter. In this circumstance, the trans woman partner was required to perform her sex assigned at birth to be sheltered with her partner.

We were discriminated as a couple because I came in as a transgender female. They told me [that] in order to be housed with my husband, I would have to dress as a man. At that particular time, my name wasn’t legally changed, so I had to agree to be called my legal name and I had to dress like a boy… every morning I would get up… go into the bathroom… put on my female attire and leave. And before I got back, I would have to take off my female attire, take off my makeup and everything to be allowed back into the facility. (Michelle, trans woman, age 51)

Workplace Discrimination

In the workplace, trans people may experience discrimination in a variety of ways, including during the hiring process. One trans woman explained the difficulties she’d encountered trying to get a job,

If [employers] figure out you’re trans, they…think ‘walking lawsuit’… they’re [say] ‘I don’t understand trans people. I don’t want them around me. They might be a nice person, but I just don’t want to deal with that.’ I got a job finally, after like two years, [at] a low wage fast food [restaurant]. Four interviews before they hired me. That’s why [for] the last year and a half I stopped trying. It’s just so disheartening…Or I’ve had people look me up and down and say, ‘We’re not hiring.’ I had an interview with a guy that did not look at me once for the whole interview. (Sarah, trans woman, age 44)

As a result of employment discrimination, this same participant was left disheartened and uninterested in continuing a job search.

Interpersonal Discrimination

Queer and Trans Communities

Many participants reported feeling unwelcome in queer spaces. For example, a cis male participant recalled when his trans male partner was turned away from a gay men’s sex toy shop for not looking “manly” enough,

They…[said], ‘hey, no women allowed.’ And I…[said], ‘That’s okay, he’s a man.’ And they were like, ‘Well no one who is presenting as a woman.’ And we didn’t get into this because [Paul] just wanted to leave, but I…[said],’He is dressed way more butch than you, Mr. Pink Shirt..’ And it was really upsetting. (Caleb, cis male, age 42)

Queer community events that are strictly for trans people can feel unwelcoming to trans individuals with cis partners. One participant mentioned,

There is a lot of stigma in the queer community around heterosexuality… There is this ‘no cis male’ thing that happens a lot. And my partner is a cis male and I think that people feel really uncomfortable with that…[they] say things like, ‘this space is for women and trans men,’ which…[means], ‘no penises,’ which is [wrong]… And I feel like that’s really complicated for both people with penises. (Taylor, trans woman, age 29)

Queer spaces with limitations on specific bodies or kinds of queerness can be exclusionary to trans individuals and their partners. Sometimes this dynamic can compromise a trans person’s feelings of safety, comfort and belonging, therefore also affecting the couple as a whole.

There are some queer spaces that do not allow like cis men to come into them…And it makes me feel a little bit weird. I understand the need for a safe space for queer people and trans people but it’s a little awkward because we’re partners…I don’t have my support system when I go to these events because I don’t have a trans partner. (Warren, trans man, age 22)

In another interview, a trans woman recalled not feeling like she belonged in the trans community because she did not fit a certain criteria/guideline for being trans,

Growing up, I tried to hang in the trans community. [But,] it’s either you’re non-passable or you’re passable… [They would say] ‘Oh, you [are] too tiny. You think you’re better than us. You’re pretty’… So honestly, I grew up hanging out with more biological females than I did the trans community. (Katie, trans woman, age 47)

Although discrimination from queer and trans communities was common, some participants recounted occasions when they felt supported by these communities. This cis man noted that although he does not identify as trans, he had formed connections with people from the trans community.

I have a small group of trans friends. I don’t identify necessarily personally with that community, but I do seem to know people there and I’m comfortable with people there. (Justin, cis male, age 25)

Within queer communities, a subset of groups speak to the interests and hobbies of some trans individuals. In the following excerpt, a trans man conveys how the BDSM community is supportive of his relationship with Alex, his 34-year-old cis male partner.

People in the kink community…the BDSM community, are really supportive because they’ve seen [Alex] and I work on our relationship and devote energy and effort to it, and they respect that. I think most people are pretty supportive. (Warren, trans man, age 22)

Harassment

Trans couples reported harassment from strangers, including being verbally accosted and receiving threats of violence and physical assault.

A guy chased us for like three blocks and was yelling anti-gay slurs… I was getting concerned. And [Dylan] was like, ‘Oh, this happens a lot’ and I was like, ‘Jesus! This didn’t happen to me before’…this is like, ‘I’m gonna kill you’ kind of violence which I never have experienced before. (Peter, trans man, age 38)

In another interview, a trans woman described how she was cat-called and harassed by men, as if it were a typical and trivial occurrence.

Sometimes guys are just creepy…I guess it’s pretty normal…following me around and saying stuff… I’ve been pretty lucky and I think not a lot of stuff has happened to me. (Nancy, trans woman, age 27)

Taken together, the two preceding accounts suggest that sexual harassment is an experience that is often normalised in trans and non-binary peoples’ lives.

Responses to Discrimination

Desensitised to Discrimination

Most participants described how they had become desensitised to the discrimination they faced. Often, they were unable to recall how frequently they experienced discrimination.

I think we occasionally talk about [being discriminated against as a couple]…I just don’t really care [anymore]. Because I’m used to it. I’ve normalised it in my life. Like I don’t want to know every time that someone is staring at me or every time that someone is giving me a dirty look. I don’t have time for it all…Discrimination-wise there’s been so many little incidents that I can’t tell you for sure [how often I experience it]. (Vanessa, trans woman, age 26)

In another interview, Michelle, a trans woman, talked about her experience regarding her masculine voice.

My voice has gotten deeper…I’ve gotten used to it. I’ll have phone conversations, and I’ll say something… and the person says, “Sir”…I’ve had to ask myself, “Are you going to correct this person? Is it important for you to correct this person?” [Initially], I was very radical about, “My name is Michelle and I’m a female”. But I don’t do that anymore because I understand that my voice does sound masculine or male-ish. And I had to accept that. (Michelle, trans woman, age 26)

Several participants described that the transphobia they experienced in their youth felt less severe as adults now. One trans man said that the large, metropolitan city where he grew up,

… was really homophobic and transphobic. And after several years [in high school,] I just kind of developed this ‘fuck it’ attitude of, I’m not going to worry about this unless I think that I’m in immediate physical danger. I don’t care if people are going to verbally harass me or be jerks. I feel like I’ve put up with enough of that in life [that it doesn’t bother me anymore]. (Ben, trans man, age 27)

Geographic Location

Many trans participants identified geographic location as an influence on expectations and experiences of discrimination. Most noted the queer-friendly environment of California, and the Bay Area specifically, as a protective factor against discrimination.

Yeah [I feel like I do have the resources to deal with discrimination] I definitely feel this connection to [Philip] and then also the queer community where, if my mom says something, I can talk to one of my friends, and my friends will be really validating. I mean living in the Bay Area, living in a bigger city, definitely has a huge positive impact. (Lewis, trans man, age 35)

California was seen as a safe haven by some couples who had previously lived in states where they experienced more discrimination. For example, a trans woman explained how she and her cis male partner moved because in the Southern state they previously resided there were no legal protections against discrimination in work settings.

It’s an at-will state, which means they can fire for any reason or for no reason. They can just say, ‘We don’t like you. You’re fired.’ So [Ashton] couldn’t talk about me at work, trans girlfriend, you know, in [Southern state,] people don’t get it. We moved because he didn’t feel comfortable with me leaving the apartment sometimes, nor did I. And so he wanted to be out here in California where he felt I would be a little safer and that’s why we moved out here. (Sarah, trans woman, age 44)

Passing

Some couples drew attention to the ways in which they “passed” as a straight couple or as cis in ways that shielded them from experiences of discrimination. One trans man, Lewis, noted that his mother had been supportive of his relationship with a cis male because it created the “illusion that [he’s not trans and is] in a straight relationship” as a cis woman (Lewis, trans man, age 35). Despite feeling acceptance from his mother, this trans man felt conflicted about support that seemed contingent upon an invalidation of his trans identity. Another trans man similarly mentioned that he is lucky to pass as straight with his partner and avoid “a lot of outward verbal discrimination… but then at the same time it’s weird to have my gender invalidated by our relationship.” (Greg, trans man, age 19). His partner said, “I would say the fact that we are read as a straight couple in public has mitigated experiences of discrimination,” (Jason, cis male, age 20), although he did not address how that felt for his trans partner.

Passing has a complex relationship to trans individuals, their partners, and their experiences of discrimination. When discussing ways to avoid discrimination, some trans participants and their partners spoke of their attempts to pass as a straight couple. One cis participant admitted encouraging his trans woman partner to perform hyper-femininity to prevent discrimination.

My attempts to deal with [discrimination] are sort of petty and superficial. It’s…trying to encourage [Danielle] to wear makeup or do her hair in a more girlish fashion. But my way to try to solve the problem is to try to think of ways to help her pass better, which is kind of a superficial, petty thing to [do]. (Sebastian, cis male, age 33)

While this cis man attempts to improve his partner’s experiences of discrimination and harassment by encouraging her to present more femininely, he simultaneously acknowledges that this may not help mitigate experiences of discrimination at all. Rather, encouraging a trans person to pass or perform their gender in a specific way may add to dysphoric feelings and strengthen internalised transphobia.

In another interview, one trans woman, Penelope, highlighted the intersections of class, race and gender when discussing gender performance and passing. As a Black trans woman who struggled with income and housing, she felt more discrimination and more pressure to eliminate any semblance of masculinity in wealthy neighbourhoods. Though she chuckled and laughed throughout this part of the interview, she acknowledged feeling discriminated against because of her multiple identities, and displayed an internalised understanding of the strict gender norms she held herself to, especially in “upper class” spaces.

Upper class communities tend to frown on me because I’m not that stable. I go through times where maybe I don’t have a place to shave my face and I’m walking around with a little hair on my face. And they see me and they’re like, ‘Ugh! What the fuck is wrong with this person?’ (Laughs) In the beginning, it hurt my feelings but I’m like, shit! What did I expect? I’m walking around identifying as female with hair on my face. So I can’t get mad about it. (Chuckles). (Penelope, trans woman, age 32)

Cis Partners as Agitators

While many trans participants felt supported by their cis male partners in instances of discrimination, participants admitted that some cis male partners occasionally responded to prejudice with violence or aggression, making the situation more complex. Trans partners typically disliked this response from their partner, feeling unsafe or frustrated by it.

His first reaction is to get into a fight, so [Justin] gets very defensive. He’ll like throw his arm out and put me behind him and get his fists up. It’s an ordeal that unfolds, like breaking it up and making sure it doesn’t escalate. And I’m just like, ‘Ugh!’ I turn my head and I try to walk away and not deal with it. (Thomas, trans man, age 26)

One trans woman, Taylor, remarked that these disparate ways of responding seem like a difference in both their experiences of discrimination and the ways that different genders are allowed to respond.

His reaction is to get really angry, and…do this dude thing where he’s yelling and getting mad. And my reaction is to cry and be very quiet and depressed about it. That’s the difference in our temperaments…[which] plays out in the way that we experience discrimination – his reaction is a pushback and definitely aggressive, and my reaction is to shut down and remove myself from the situation. And I imagine that that’s really connected to our genders and the way we do or don’t feel safe in the world. (Taylor, trans woman, age 29)

In contrast to the above responses, cis men felt their angry response was appropriate or even protective. Some felt proud of their ability to stick up for their partner, despite trans participants feeling that they were creating a scene.

[Hannah] never wants me to say anything or do anything. And I would be very angry and distraught about that. Like, how don’t you want me to say anything? How don’t you want me to defend you? Especially with her being someone fighting for social justice…you can fight for everybody else, but you can’t fight for yourself, for your own humanity? (Marcus, cis male, age 29)

[Thomas] [was] better at just letting it go. I tend to react more poorly than he does. (Chuckles) It just makes me mad when people are doing that to other people for no reason other than to belittle them. That makes me furious…I tend to react more aggressively than he does for that kind of a thing… it’s happened a few times. One time someone approached [Thomas] aggressively and I got into a bit of a physical altercation with them briefly because they were really focused on [Thomas]. And he was like right in [his] face and he was calling him a [queer slur] and stuff. So yeah, [Thomas] usually freezes in those situations and I tend to do stupid things. (Snickers) (Justin, cis male, age 25)

In contrast, Rachel, a trans woman participant discussed the lengths she had gone through to manage the ways her cis male partner dealt with and understood her experiences of discrimination. She remembered bringing the subject up before they started dating and said she worries they will break up because he can’t handle the discrimination she faces.

I’ve been…gay…for many years, and then a transwoman and a drag queen, a prostitute… [Personally]…I’ve always been called names… So, when discrimination hits me in the face…I’m used to it. Whereas [Charlie], it bothers him. He’ll go off, he’ll curse you out real quick…when we first met, I explained to him to make sure this is what he wanted. Because being with a transgender [person], people are not going to understand. People are gonna talk about you, they’re gonna point fingers at you, they’re gonna laugh at you…Can you deal with it? I think it bothers me because this is my husband, and I can’t walk down the street with him freely. I see that it bothers him how people look at us…[how] I’m big and I’m not petite… that people may laugh and point fingers. But I think – sadly to say, I have already set myself up for this great break-up because he can’t handle the pressure. (Rachel, trans woman, age 52)

Cis Partners as Support

Many participants described how they felt protected and supported by their partners. Some, trans participants felt comforted having their cis male partners’ support within queer spaces. In the following quote, we see that this trans man feels supported and encouraged by his cis male partner in being actively involved in the trans community.

I guess [Alex] [is] really supportive of me finding support. I probably am more involved in the trans community because he’s like, “Yeah, let’s go to events and like you know go to groups, so yeah.” (Warren, trans man, age 22)

When queer spaces are supportive of trans/cis couples and cis partners feel welcome too, trans partners can feel more supported by their cis male partners.

Discussion

This paper, unlike many, examines trans/cis partnerships with a focus on couple-level dynamics. Throughout their accounts, an overwhelming sense of isolation and rejection was reported by couples. Some who sought support in queer and trans spaces, where one might expect broad acceptance of diverse gender identities and sexualities, did not find it because they or their partner did not fit the expectations of the queer community. This lack of acceptance can put an added strain on couples’ relationships by conveying the message that their relationship is unacceptable or not queer enough. This exclusion may be especially harmful to trans participants who feel their cis partners’ exclusion limits their support systems. While some couples found other communities to socialise in and gain support from, many were left feeling alone and unsupported.

In addition to community spaces being discriminatory or unwelcoming, trans/cis couples reported discrimination and harassment in relation to housing support. Although there are numerous housing and employment protections in place in California for members of the lesbian, gay, bisexual, transgender and queer (LGBTQ+) community (Kattari et al. 2016), when a trans/cis couple needs housing assistance urgently, obtaining legal support to fight against housing discrimination is not a priority, and many unfair practices are never legally challenged (Esses 2009; Pizer et al. 2012). Despite these threats to relationships, many couples showed incredible resilience in managing the aggressions they encountered and tolerating the unfair and insensitive practices of some housing programmes.

In several instances, trans participants’ feelings and wishes were not recognised by their cis male partners. For example, when cis partners acted as aggressors during instances of interpersonal discrimination and harassment, they chose to act out traditionally masculine social scripts, “protecting” their partner by meeting aggression with aggression. When describing these situations, cis men used tones of pride, while their trans partners recalled the events with frustration and annoyance. These gender differences at play during events of discrimination have important health outcomes. For example, cis men feeling masculine gender role stress can have negative health effects on levels of stress, depression and anger (Baugher and Gazmararian 2015; Eisler and Bialock 1991). The evidence in this study suggests that cis men defending and preserving traditional masculinities, especially in contexts of interpersonal conflict, may have a negative effect on relationship health with trans women and trans men.

Specifically, if the trans partner feels unseen within their own relationship, this may have a negative impact on the relationship and the individual. This situation can occur when a cis male partner encourages his partner to dress or act in a manner different to that which they themselves desire. Encouraging a trans partner to perform gender in a way inconsistent with how she, he or they see themselves may risk damaging the relationship and creating negative emotions for the trans partner. Many studies to date have focused on how relationship stigma and subscribing to traditional heteronormative roles impact sexual health and sexual risk (Gamarel et al. 2020; Skeen et al. 2021), but more research is needed to determine how these dynamics may impact trans/cis relationship health.

Implications for healthcare practice

In the light of findings from this study, healthcare providers including therapists and medical professionals may find it helpful to initiate conversations between trans/cis couples or cis male individuals partnered with trans and non-binary people by encouraging them to plan for how to deal with interpersonal discrimination. Central to the success of these discussions is a focus on trans partners’ needs and wishes. By initiating these conversations, health providers can help prepare trans/cis couples for what are unfortunately common instances of discrimination. In time, this may lead to more fruitful conversations that can foster safety, comfort and gender affirmation within a relationship. Cis male partners may then feel empowered to have further conversation with their partners, providers and others in the community about transphobic discrimination, thereby disrupting harmful adherence to rigidly defined gender roles and heteronormativity.

Limitations

There are several limitations to this study that should be noted. Participants in the study were self-selected, which may have produced a sample of couples who felt that their relationships were healthy and had relatively few problems. Moreover, the study was cross-sectional in design and therefore reflects a particular snapshot in time. Without longitudinal study, causal inferences cannot be drawn from the data presented here.

Conclusion

Trans women and trans men with cis male partners encounter complex relationship dynamics that are often exacerbated by not having a safe and welcoming community to which they feel they belong. Despite this lack of support, couples in this study were deeply committed to their relationships and found ways to manage the challenges they faced. Having a deeper understanding of how trans/cis couples experience and cope with discrimination gives service providers the critical insight and knowledge needed to be able to offer relationship, mental health and sexual health support.