Co-transitions: Understanding the ways couples navigate gender transition together

Abstract

Background: Gender transition is thought of as an individual experience, but it often occurs while the person transitioning is in a romantic relationship.

Aims: This study aimed to explore the romantic relationships of couples who maintained their relationships following a partner’s gender transition.

Method: Twelve couples were interviewed individually and as a dyad.

Results: Three key themes emerged in the interviews. First, couples struggled with initial grief and relationship ambiguity. Cisgender partners wondered about what their partner’s transition goal looked like and the transgender partner wondered if there was a transition breaking point in the relationship. Second, cisgender partners realized they had their own process of identity exploration. This process often included reexamining their sexual orientation, as well as considering what public and private intimacy would look like now. Finally, the couples discussed relationship stabilization. This is the point at which they knew the relationship would survive the transition. These experiences are not only common to the couples in the interview but also reflect the author’s clinical experiences as a therapist and her experience as a trans woman who maintained her romantic relationship with her cisgender wife through transition.

Conclusions: The results of this study are useful for transgender families, researchers, and clinicians.

Introduction

Transgender issues have gained increasing visibility and recognition over recent decades, driven in part by the rise of transgender activism and the introduction of protective legislation (Lenihan et al., 2015). Currently, however, within the United States, efforts at the federal and state levels are working to erase legislative and judicial protections for transgender people and their families. These efforts lead to further marginalization of individuals with gender and sexual identities that go against the dominant heteronormative and binary frameworks (Namaste, 2000). As a result, many transgender individuals and their families continue to experience significant stigma and discrimination (Turner et al., 2009). Within this social and political context, this project explores trans-inclusive couples that include one partner who has transitioned while in a romantic relationship with a cisgender partner to understand how they navigate this change in the relationship, and how they might be supported in this process.

Before this work delves deeper into the background literature, I would like to offer a note about definitions. Gender transition denotes the point when a person starts changing from the gender role normatively associated with assigned birth sex to a different gender role (Budge et al, 2010). Transition may include a combination of social (e.g. pronouns, clothing), legal (e.g. name change, driver’s license gender marker), and/or medical (e.g. hormone therapy, surgeries) aspects. With this definition, it is important to note that the transgender umbrella includes non-binary, two-spirit, and other gender diverse individuals. This understanding is important so no one gate keeps who is transgender enough to be considered transgender (Serano, 2007).

Couples in transition/co-transition

Gender transition is thought of as an individual experience, but it often occurs while the person transitioning is in a romantic relationship. The presence of a transgender identity can have various implications for couples and their relationships. Emerging research has begun to explore how stigma affects couples, with evidence suggesting that such experiences may negatively impact relationship quality (Gamarel et al., 2014). Additionally, couples in which one partner undergoes a gender transition—whether social or medical—may encounter unique challenges. Case studies have illustrated that gender transition can serve as a transformative process for both partners, with significant shifts in identity for each individual within the relationship (Malpas, 2006). In addition to navigating gender differences, many transgender individuals also identify with a minority sexual identity, with pansexual and queer identities being among the most commonly reported (Kuper et al., 2012).

To understand this impact, some studies have focused specifically on cisgender partners, who may also go through a renegotiation of their own sexual identity apart from the transgender partner’s transition (Brown, 2009). For example, if there is a transition in what was presumed to be a heterosexual relationship between a man and woman, but is now two women, the cisgender partner may face a struggle with society assuming they are queer when previously they never experienced an attraction to someone of the same gender or someone who is transgender. This challenge aligns with Buxton’s (2007) findings that a subset of co-transitioning relationships ended in the first few years as both partners wrestled with questions of physical attraction and sexual identity.

This current work, however, focuses on couples that remain intact. To that end, Theron and Collier (2013) coined the term “co-transition” to suggest that a partner’s transition has a broader impact on the relationship and impacts their partner’s identity as well. Theron and Collier interviewed eight female partners of transgender masculine individuals in South Africa (2013). These women talked about being in a relationship in transition that was both happening publicly in their community, as well as internally while they navigated their own positionality with their sexual orientation. While none of the women ultimately reported a change in their sexual orientation, they did arrive at a fluid notion of sexual orientation as they reflected on what attracted them to their partner was not initially their gender. The work to get to this realization underscores the co-transition process for the cisgender partners. Because of this unique relationship experience, Theron and Collier also remarked on how isolated the cisgender partners were and how they need more resources.

This echoes other research, such as Joslin-Roher and Wheeler (2009), who suggested that partners of individuals who transition often remain a hidden population. In their qualitative work with lesbian, gay, and bisexual cisgender partners of transgender men, they found interconnected themes that included revisiting their identity, caretaking for their transgender partner, and finding peer support among other impacts on mental health and community (Joslin-Roher & Wheeler, 2009). Identity for the cisgender partners brought up several emotions in relation to their transgender male partners’ transitions. One lesbian participant in their study noted that it took her a long time to come out as a lesbian and be comfortable in her identity, only to have her identity “shaken up again” with her partner’s transition (p. 39). These participants often wondered and were asked in the community what their partner’s transition made them, were they now straight? While there is not much research that includes the cisgender part in transitioning couples, this questioning seems to be a common process (Brown, 2009; Motter & Softas-Nall, 2021; Platt & Bolland, 2018). It seems clear from these studies, that understanding the cisgender partner’s experience is vital to supporting these individuals and couples.

More recently, Siboni, Prunas, and Anzani (2023) looked at open-ended survey responses from 107 cisgender partners of transgender individuals. This Italian study found that being in a relationship with a transgender individual frequently leads to reflections on gender and sexual identity for cisgender partners. The effects of these reflections are highly variable, however. The variability clustered in four main areas. First, some cis-partners had no reason to change. For example, they had already explored their identity, were attracted to multiple genders, or had no doubts. Second, some cis-partners engaged in exploration and changes for their own gender and sexual identity. Often this involved thinking about the labels they might use to describe their relationship now and how they would define their sexual orientation. Third, cis-partners may have gained a new perspective around how society might perceive gender and sexuality. Finally, the authors found that cis-partners might experience negative effects and confusion from their partner’s transition. One participant summarized this perspective as needing to come to terms with being a heterosexual, cisgender woman who is having a sexual relationship with a man who has a vagina.

Currently, only one study has exampled the phenomenon of couples that transition from both partners’ perspectives. Motter and Softas-Nall (2021) offered a qualitative examination that included interviews with the couple as a unit and with each partner. They found four main themes in their interviews. The first theme, love is gender blind, described cisgender partners’ reflection that they did not set out to just date their partner’s genitals, but rather wanted to date the whole person. This perspective was important for the relationship to stay together across the transition. The second theme involved relationship changes connected to the transition. These changes were changes to language and communication within the relationship. For example, the couples needed to think about language around parental gender presentations with their children (mama and papa language needed to shift), as well as language for genitalia when the couple wanted to have sex. The third theme revolved around the benefits of the transition. For example, cisgender partners talked about how there seemed like more openness and honesty in their communication with their transgender partners now. Some couples also discussed “passing privilege” which for one couple meant they could pass as a cisgender heterosexual couple, rather than a lesbian couple, thus feeling safer in mainstream community. Finally, the couples discussed that the personal is political. This theme largely focused on what it means to be transgender in the United States in current political context. Couples discussed feeling more on guard and vigilant for their safety, especially if they did not have passing privilege. These three studies, Motter and Softas-Nall (2021), Joslin-Roher and Wheeler (2009), and Theron and Collier (2013), were the primary articles that provided qualitative insight into the cisgender partner’s experience. Motter and Softas-Nall was the first to consider this co-transition process through interviews with both partners.

Positionality

This research is partially guided my nearly 20-year career as a psychotherapist and sex therapist working with transgender and queer couples, as well as my own experience as someone who transitioned while in a relationship with my cisgender partner. There were not many resources at the time, and relationship counselors did not have much, if any, experience with families like ours. We were fortunate to have support from loved ones and a commitment to staying together. Still, there were many hard conversations and tears throughout that process. These experiences and the literature detailed above, inspired this current project.

Methods

This present study focuses on how couples navigate a transition process and remain connected. To frame this work, this project will explore the following research questions:

1. How did the couple navigate their relationship during the early months of co-transitioning?

2. How did cisgender partners work through their own identity formation during the transition.

3. What factors do intact couples identify as contributing to their successful co-transition?

Study design

To explore these questions, this phenomenological study utilized interviews with couples who fulfilled the following inclusion criteria: (1) one person in the relationship needed to be cisgender, (2) one person in the relation must be transgender, and (3) the transgender individual must have begun transition during the current relationship with their cisgender partner. A purposeful sampling strategy was used to ensure intersectional representation of BIPOC people. Once institutional review board approval was attained, couples were recruited through major transgender-serving community agencies and healthcare providers in the midwestern United States, as well as through fliers posted on social media (e.g. Instagram, Facebook, Discord). Each interview cluster occurred via video conferencing and involved three interviews: the couple together, partner A solo, and partner B solo. The semi-structured interviews lasted about 75 − 90 min for the couples, and around 60–75 min for the partners. All of the interviews utilized a semi-structured interview protocol that allowed the researcher to both stay focused on the research questions and explore unique participant experiences through follow up questions. At the end of the interviews, participants were given the opportunity to provide insights on the interview and any experiences the interview may have failed to capture. Finally, the researcher also collected sociodemographic information from participants at the conclusion of the individual interviews.

Data analysis

All interviews were first transcribed using the video conferencing system (Zoom), then cleaned by the researcher. The interview data was then analyzed using NVivo and a grounded theory approach as outlined by Strauss and Corbin (1990). This methodology emphasizes the concurrent collection and analysis of data. During the interview process, emerging themes were documented using field notes (Braun & Clarke, 2006). Once the interviews were complete, the transcripts underwent an assessment to identify overarching concepts and themes (a process known as open coding). Subsequently, these themes were further analyzed to uncover potential sub-themes, a process referred to as axial coding.

To ensure validity, the researcher provided summaries to a random subset of the research participants. These summaries were the researcher’s notes on the interview including what questions were asked and how the participants responded. This member-checking process was also part of the data analysis framework for the project. This step aimed to achieve a consensus on the conclusions drawn from the data analysis, to further refine the findings, and to monitor the researcher’s bias. Data saturation for this project was achieved after nine couples with three additional couples included (N = 12), which echoes the time to saturation that Motter and Softas-Nall (2021) found in a similar study.

Results

Among the 12 couples who participated in the study, the average age was 39 years old (range of 30–65). The average length of the relationships was 7 years at the time of starting their transition (range: 3 weeks to 13 years). Participant sociodemographics are displayed in Appendix Table 1.

Three primary themes emerged for the interviews: grief and relational ambiguity, identity exploration, and relationship stabilization. These themes may suggest different phases for the couple in transition with grief and relational ambiguity occurring primarily after the gender transition disclosure. Two subthemes nested here are questions from both partners. From the cisgender partner, they often wondered “when do the changes stop” and from the transgender partner, they often wondered “how far can I go without losing my partner?” These questions led to the second theme: identity exploration. Here both partners may be exploring their gender identity and sexual orientation. Included in this theme are additional questions about what the transition means for their intimate connections and sex life. The final theme covered here is the point at which the partners realized they “would be okay.” Participants largely discussed the feeling of when they knew the relationship had stabilized and that the transition would not be the end of the relationship.

Grief and relational ambiguity

The couples expressed grief in different ways throughout the transition process, but most acutely in the beginning. For cisgender partners there is the feared loss of the person they fell in love with at the start of the relationship. What happens to that person and what will the relationship look like moving forward? For the transgender partner there is often an anticipatory grief as they wonder if and when their cis-partner might leave them. This parallel grief for the partners flow into relational ambiguity as they reimagine their relationship.

When does it stop? (Cisgender partner)

After a transgender partner discloses that their gender does not match the sex they were assigned at birth, nearly every cisgender partner comes to this question of where are we going and how will I know when we get there. For Liz (38) she wondered, “What’s the end goal here, like, where are we? When is it gonna stop”? Similarly, Mark (31) said, “my main concern is like … you’re changing a little bit now, when is this going to stop changing, and you know, where does it land?” These quotes represent common feelings from cisgender partners to understand their trans partner’s transition goals, to get a sense of how long they will be in a period of change, and many other questions that may or may not be voiced. Emily (37) summed up much of this discomfort, “I am educated enough on the subject to know it wasn’t my timeline to control, but that didn’t make it less uncomfortable.” As Emily noted the ability to comprehend gender transition intellectually, does not mean it is an emotionally comfortable space when it is your partner experiencing the transition. It was not uncommon in this study for the cisgender partners to note that their response to their partner’s transition would be far less anxious if it was a friend transitioning rather than their partner transitioning.

How far can I go without losing my partner (transgender partner)

From the transgender partner’s perspective there is a blend of being in control of their transition and feeling anxious about what their transition will do to their relationship. Luna (41) talked about her concerns, “well, with Sophia my fear was just that like there would be, and I still fear this on some level, that there would be this like invisible line. [That she’d say] you know I love you, but I’m just not into you anymore. That just like scared me to death.” This anxiety potentially exists for any change transgender partners make. Jay (31) wondered after cutting their hair, which was previously long to being much shorter, “Is this going to be the thing that pushes my partner over? That’s what surprised me. The haircut was the thing that caused the biggest reaction.” This anxiety can be so heightened that transgender partners might curtail or slow down some changes. Brooke (38) spoke about this directly in her individual interview, “I’m only gonna give myself inches because I’m afraid that if I change too much too quickly it’s gonna fracture, like, we’re not gonna be able to [make it].” Max, who is 36 and has been with their partner for six years, echoed these concerns, “And my biggest fear was that I would lose her, you know … Like, if I cross that line, if I cross that, then [she] will be like I’m out”. Transgender participants also noted that while they don’t have this anxiety as loudly as they once did, there is still that questioning voice in the back of their mind.

Identity exploration

Throughout the interviews questions around identity formation were present for both partners. The transgender partners talked less about their own identity formation within the relationship yielding the space to their cisgender partner’s identity formation. For that reason, this theme will focus primarily on the cisgender partners. As in the research discussed above, cisgender partner’s identity formation process most often revolved around how their partner’s transition impacted what their sexual identity was now and how to re-define their relationship. Because these conversations are tough to separate, they have been included together in this theme.

For cisgender people in presumed same-gender relationships that co-transition, this identity process can be doubly complex given that they may have spent years coming out as gay, lesbian, queer, or bi/pan. As the transgender partner transitions, and potentially passes as cisgender, the perception of being a straight couple can be uncomfortable. Annie, a 34-year-old lesbian talked about when her partner asked what would happen if they fully transitioned and would Annie want a boyfriend. Annie responded,

I do think that’s a harder conversation…Like the idea of saying, “Oh, like this is, my boyfriend” feels real weird. They didn’t directly say we’d be a straight couple. But it was something along those lines. My response is, like, we would not be a straight couple. We would still be gay.

Clover, a 65-year-old cisgender partner who was in a presumed lesbian relationship, had a similar experience as Annie. Clover noted,

My bi-phobia showed up. My identity had always been lesbian feminist and there was this strain in there of discrimination, of pushing away the bi identity. Which in hindsight has been my identity all along. I’ve had boyfriends. I’ve had girlfriends. Oh, but there was a process that I had to go through to embrace that identity and shift from an identity as a lesbian and as a lesbian feminist in particular.

Straight-identified cisgender partners may face some pressure from their partners to identify as lesbian or gay to affirm their transgender partners’ gender identity. Sophia, a 39-year-old cisgender woman who has been with her partner for 10 years, talked about how she discussed her sexual orientation and how that upset her transgender partner. “That really bothered her for a long time that I still identified as straight … It bothered her that she felt I didn’t see her as a woman or that I couldn’t find her attractive as a woman”. This perspective mirrors a general conclusion around many of the cisgender, straight-identified partners that while they may not have initially chosen to date someone of the same gender, they remain attracted and connected to their transgender partner. For Sophia and her partner, Luna, they opened their relationship to other partners so Luna could have the experience of dating women who have sex with women to see if that provided more gender euphoria. After a few dates and experiences, they essentially closed their relationship again.

Moving beyond labels, Erin, a 38-year-old cisgender woman who has two children with her partner of ten years, reflected,

I just feel like we’re something else that doesn’t really even have a name. And I find that kind of exciting and cool. We’re not necessarily a big fan of binaries in general. And so like the idea of expanding the language we have around human nature and human relationships, and like what it means to be human…Yes, I am straight. I identify as straight. I’m attracted to men I don’t identify as queer, but I am also in a queer relationship. I am married to someone who does not identify as a man.

This perspective simultaneously reaffirms Erin’s self-identity, the strength of the relationship, and her love for her partner.

Subtheme: intimacy and sexuality

Intimacy and sexuality are important identity components as couples transition. For the transgender partner, sex may trigger gender dysphoria and for the cisgender partner, they may have only known the kind of sex that they have experienced with other cisgender people. This exploration of intimacy involves a range of things from how you display affection in public to what sex looks like. Kaylee, who is trans femme and 45-years-old, talked about the struggles with public affection her wife had earlier on in the transition.

Her biggest obstacle with all this was or is still dealing with the outside world. She doesn’t want to be noticed and so like going out holding hands in public is a big no, no. She couldn’t do it. She didn’t feel safe. She doesn’t want to be seen. She doesn’t want the outside world to see two women kissing or holding hands. She talked to me and she said that being comfortable with me in public was not something that she took off the table. It’s just that she needed to get used to how she was being viewed.

This quote also speaks to how visible transgender families and couples can be while in public and the anxiety these families and couples may experience while in public. Indeed, it is difficult to be hyper-vigilant and affectionate at the same time.

At home, however, couples may be more free to explore. Kendra, a 45-year-old cisgender partner, talked about how she and her wife are figuring things out and engaging their curiosity.

She started going through more of the body changes and identity changes, and dysmorphia and stuff, and wasn’t as sure what she was comfortable doing with her body. And so then I had to back up because it was like, well, I don’t want to do anything that accidentally like steps on what you’re working on, or like what you know triggers you, or makes you feel weird. So you need to kind of figure out what you’re comfortable with, and how you want to interact. And so now, we’re kind of like more just redefining things and sort of like exploring in a parallel way. It’s not that our intimacy is absent, but it’s a little bit more like I take care of myself over here, and you take care of yourself over there, and then we compare notes and see how it went. And we’re sort of like together, but not necessarily like doing everything together. If that makes sense.

In this quote, Kendra addressed the process of figuring out how to center pleasure in ways that respect each other’s bodies. For Kendra and her partner, this involved parallel play. For others, like Carli, who is 30-years-old and gender non-conforming, they talked about how transitioning allowed them to come back into their bodies and understand what they enjoy.

I was much more maybe disconnected from my own body, almost maybe a little dissociated from my own body. And I think now I’ve had to learn … how to be very present in my body, and how to pay attention to what feels good, how to communicate to Larissa (her partner) in the moment, or even beforehand. What I like, or what I don’t like, or what’s off limits. So I think it’s actually allowed Larissa and I to be much more open about our bodies and much more open about what we like and what we don’t like, and allowed us to be a lot more honest about it. I’ve learned a lot more about Larissa, and I think she’s also learned a lot more about myself, because I’ve been more open with how I feel and what’s true for me.

This insight from Carli encapsulates the ways in which transitioning can slow down intimacy and allow both partners to understand what feels good to them rather than continuing to do what they have always done.

When we knew we’d be okay

All the couples who participated in the study spoke about the point when they knew the relationship would survive the transition. This is the point when the stress of the transition starts to subside and the relationships find a new equilibrium. For Max, a trans man, he talked about a very specific moment. He started the story by noting,

[early in my transition] I’d gotten like my first professional office job, and I had to buy office, professional or like, you know, ‘business casual’. So we went into one of those like girly stores, and the salesperson is like handing camisoles and stuff to me like, ‘oh, try this on, try!’ And I’m sobbing because, like I am like, I can’t. I cannot wear these clothes.

Max’s partner, Hazel finished the story saying, “And I’m like, let’s go then, like, let’s go. Just leave this shit. So we just bust out. He grabs my hand, and we just walk out of the Mall.” This fierce protection from the cisgender partner is a hallmark of many couples in transition, and was also present in earlier research on cisgender partners.

Max and Hazel’s story is very specific and very public. For others, the process was more internal. Kendra, a cisgender partner who spoke earlier in this work talked about her process:

For those first, like 3 or 4 months, I was like, okay, I need to be really honest with myself, too, like I can’t just like kind of morph myself around somebody else, and just try to make it work. I have to actually see if I want it to work, and if this still feels like something I can do, because it’s so different than what we kind of entered into initially. Just in terms of how we’re…being in the world like we still feel the same way about each other at our core. But like. yeah, it’s just a very different way to be in the world. I just kept coming to the conclusion that it’s more important for me to be with the person that I want to be with. It’s worth it to do that work, and I may even grow from it, and I have for sure.

This process of partners actively choosing the relationship is important. Kendra and others talked about how they needed to have a conversation with themselves to make sure they understood what they wanted for themselves and for the relationship.

One common experience cisgender partners mention is the feeling that their transgender partner is now a whole person, which helps the relationship find balance. Riley, a 39-year-old transgender woman told this story about their partner,

I remember Emily was talking to one of her family members. I think it was her dad, or maybe her mom, I can’t remember. It’s not important. The question to her was like, ‘Well, what’s it like being with Riley now?’ And her response was, ‘It’s like having a whole person. It’s like being with the whole person that I met that first date night, you know, like, when you have all those butterflies and stuff.’ So when she told me about that, first, it made me feel good; second, just like her response to who she was talking to. Emily doesn’t sugar coat, so I knew she meant it. I knew she was all in.

This notion of the transgender partner being a whole person now came up in several themes, and also featured prominently in other studies.

Discussion

This research is among the few projects examining the experience of couples navigating a gender transition. These results align with Motter and Softas-Nall’s (2021) findings that for couples who stay together, the core aspects of the transgender partner’s personality are most important to their cisgender partner. Motter and Softnas-Nall labeled this part, “love is gender blind.” Participants in both studies spotlight benefits from the transition process. These benefits include greater communication and openness among the partners, as well as a feeling that the transgender partner is “a more complete person” (Emily, 37) after their transition. Indeed, as individuals try to compartmentalize parts of themselves, they also tuck away joy and other aspects of themselves. Coming out and transitioning may allow one to live a more integrated life.

This study affirmed other themes within the co-transition experience. Principally, this research focused strongly on the way that a change to one person in the family affected changes throughout the family system. Simply put, the transgender partner is not the only one in transition. Once the relationship moves beyond some of the initial grief, fear, and anxiety, both partners start to consider how the transition affects their sense of self. For the cisgender partner, this can settle around how they define their sexual orientation and how they define the relationship. Are they now in a queer relationship, a straight relationship, a same-gender relationship? After I transitioned, for example, my driver’s license was the first official gender marker document that changed, which led my partner to declare herself a “DMV¹ lesbian.” These points of definition may be different for every couple.

One area where this study pushed into relatively new territory is how transition affects a couple’s intimacy, both in public and in private. Some couples expressed initial hesitancy particularly about public displays of affection (e.g. hand-holding, a kiss on the cheek, arms enlaced while walking) with their transgender partners. This reaction may be a shift from when their partner presented as a different gender. Likely, this increased vigilance is due in part to the sharp growth in transmisia within the United States. With more than 600 pieces of anti-transgender legislation being introduced each of the past 2 years (20× the number of bills compared to 2019) and a federal push toward trans erasure in the United States, there is a palpable anxiety within transgender communities (Transgender Legislation Tracker, 2024).

Couples also discussed a transition period in the bedroom. The transgender partner expressed needing to learn what feels good to them now, what language they want to use for body parts, and how they want to give and receive pleasure. The cisgender partners were also taking things slowly because they wanted to be sensitive to avoid touches that led to more gender dysphoria. This finding seems congruent with Platt and Bolland’s research (2018). In that study, cisgender partners discussed mourning access to a partner’s body parts and changes in their partner’s smell, along with the complications that body dysmorphia can bring to sexual intimacy. At the time of the interviews for the current study, about half of the couples were still exploring how they wanted to connect sexually and working on expressing not only what does not feel good, but also what does feel good. The other half of the couples seemed more confident in their sex life post-transition and discussed how sex became better as they understood their bodies and their partner’s bodies better.

Limitations and implications for future research

This study increased representation among racial and ethnic minority communities but still fell short of a fully representative participant sample. For example, the lack of Black partners or couples is a gap not only in this project but also in other projects that explore couples who transition and transgender families. Similarly, while this study included Latinx mixed-race, and Indigenous couples, there needs to be greater inclusion of these families and relationships in transgender-focused research. In terms of representation, there also needs to be more research about transgender couples and families by transgender researchers (Motter & Softas-Nall, 2021). While I am transgender and these narratives greatly reflect some of my own experiences, there remains a paucity of research by members of transgender communities on transgender experiences.

This study and others on this topic offer insights into where the future of the research should go. First, research on transgender families is vital. Within the United States, about half the states have either passed or are trying to pass laws that are hostile to transgender families and individuals. While empirical research may not change the minds of bigoted politicians, understanding family experiences can help clinicians provide better support to the entire family system. Second, longitudinal studies that include transgender partners and their families would help build understanding of how the family system experiences transition and how best to support all parts of the family throughout a transition. Reliable data on how many transgender people exist and how many families are in transition do not exist, but anecdotally from clinicians, a rise in people identifying as transgender is likely. Third, with data now accumulating on the transition experience for couples, clinical guidance for therapists would be helpful. The World Professional Association of Transgender Health (WPATH) sets guidelines for transgender health care. Most of these guidelines focus on medical care, rather than mental health. Additionally, the guidelines rightly focus almost exclusively on the transgender individual, rather than the family system. Greater focus for clinicians on transgender families and their needs would go a long way to reducing the symptoms of minority stress.

Appendix A.

Table 1.

Participant sociodemographic characteristics.

Gender Identity (n = 24)
Cisgender woman	11
Cisgender man	1
Transgender Woman	5
Transgender man	3
Non-Binary	2
Gender Non-Conforming	1
Gender Fluid	1
Race/Ethnicity (n = 24)
White, Non-Hispanic	13
Hispanic, Latino	5
American Indian	2
Biracial	4
Age (n = 24)
30–34	7
35–39	5
40–44	3
45–49	4
> 49	1
Length of time in Relationship at transition (n = 12)
< 1 year	1
1–4 years	3
5–9 years	4
10–14 years	4

Funding Statement

This research was funded through an internal grant from the University of Minnesota.

Disclosure statement

No potential conflict of interest was reported by the author(s).