*Please address all correspondence to Gary H. Bischof, PhD, Professor and Dean, Lee Honors College, Western Michigan University, 1903 West Michigan Avenue, Kalamazoo, MI 49008-5244. Email: gary.bischof@wmich.edu.

Abstract

This article provides an update to “Thematic Analysis of the Experiences of Wives Who Stay with Husbands Who Transition Male-to-Female,” which was published in Michigan Family Review in 2011. A lot has happened in the lesbian, gay, bisexual, transgender, queer, asexual+ (LGBTQA+) arena since the initial article. This current article begins with a brief overview of the recent sociopolitical context and evolving vocabulary regarding transgender individuals and couples, and then addresses recent literature and thinking on transgender couple and sexual issues, gender non-conforming partnerships, self-esteem issues for cisgender partners, faith and spirituality as resources, and recommendations for future research.

Keywords: Transgender, couples, transmen, transwoman, couple therapy.

We appreciate the opportunity to update the original Michigan Family Review article, Thematic Analysis of the Experiences of Wives Who Stay with Husbands Who Transition Male-to-Female (Bischof, Warnaar, Barajas, & Dhaliwal, 2011). Of all the first author’s more than two dozen publications, the 2011 article has garnered more interest and emails than any other, with people typically expressing appreciation for attention to this issue, and asking about further research opportunities. Three new co-authors join this update; two are transmen. A lot has happened in the lesbian, gay, bisexual, transgender, queer, asexual+ (LGBTQA+) arena since the initial article, and we begin with a brief overview of the recent sociopolitical context and evolving vocabulary regarding transgender individuals and couples. This article then addresses recent literature and thinking on transgender couple and sexual issues, gender non-conforming partnerships, self-esteem issues for cisgender partners, faith and spirituality as resources, and recommendations for future research.

Recent Sociopolitical Contexts

The 2011 article analyzed information collected in the early 2000s, a time when transgender people had overall little visibility in our culture. Many of the women depicted in Erhardt's (2007) book were living in a social context that did not prepare them for the possibility that their husbands may transition to living as a woman. Though transgender women in particular gained visibility throughout the 1990s and early 2000s, much of what was available to the public featured negative or one-dimensional representations of transgender women. This kind of representation depicted transgender women as deceiving others of their “real gender,” and created a biased representation of transgender women's lives and experiences. However, as the internet became more widely accessible throughout the mid-2000s into the present, transgender people have been able to more directly control the narratives of their stories and experiences (Cavalcante, 2016).

The Internet provides opportunities for transgender individuals to share their stories directly with others like them, and create their own narratives describing more nuanced understandings of the variety of transgender experiences (Shapiro, 2004). Thousands of individuals' stories about their experiences as transgender people, as well as their partners’ experiences, are available online. Stein (2016) referred to growth of these kinds of digital spaces as akin to feminist consciousness-raising groups of the 1970s. Today there is growing visibility of multiple transgender experiences, in both mainstream media and online, including the very public transition of Bruce Jenner to Caitlyn Jenner. The inclusion of transgender women TV characters like Sophia on Orange is the New Black (Galehouse, 2014) and popular movies such as Dallas Buyer’s Club (Brenner, Winter, & Valee, 2013) and The Danish Girl (Bevan et al., 2015) have included transgender characters, and the latter keenly focused on a real-life couple relationship through the transition process. News reports of parents fighting for the rights of their transgender children to be treated consistent with their gender identity have become relatively more common as well. Media portrayal of transgender individuals and couples has led to vocal and visible discussion over whether a cisgender actor should play transgender characters (Stahler, 2014). The fact that this conversation is happening at all points to a change in our society.

Legal precedents set in the last few years include the Obama administration's interpretation of Title IX requirements for public schools covering gender identity and expression (which has since been rescinded by the Trump administration as of February, 2017), and some states and local municipalities passing gender identity and expression-inclusive non-discrimination laws. Unfortunately, as all too often happens, as transgender people began to make gains in some areas of society, political backlash was brewing in the background. According to the National Conference of State Legislatures (NCSL), from 2013 to 2016, 24 states considered so-called “bathroom bills,” which proposed legislation that would “restrict access to multiuser restrooms, locker rooms, and other sex-segregated facilities on the basis of a definition of sex or gender consistent with the sex assigned at birth or 'biological sex'” (Kralik, 2017, p. 1). These types of bills seek to roll back gains made by transgender people to be accepted in society, and to have equal access to public facilities. Over 160 municipalities throughout the United States have enacted laws, ordinances, and policies prohibiting gender identity-based discrimination (ACLU, 2017). Despite the legislative gains transgender advocates around the nation have been able to make, transgender people still face legal discrimination and barriers to protection in many areas of the U.S.

The most recent national study of discrimination against transgender people, the 2015 U.S. Trans Survey (James et al., 2016), is only the second national study of its kind. This study is a follow-up to the National Transgender Discrimination Survey (Grant et al., 2011), a groundbreaking study that highlighted the breadth of discriminatory experiences faced by transgender people in the U.S. The U.S. Trans Survey found what they refer to as “disturbing patterns of mistreatment and discrimination” against transgender people in “the most basic elements of life, such as finding a job, having a place to live, accessing medical care...” (James et al., 2016, p. 4). The findings highlight the evidence of challenges and barriers uniquely faced by transgender people on a daily basis.

Evolving Vocabulary

Language used by and to describe the transgender community has shifted dramatically since 2007 (Trans Student Educational Resources, 2017). Words that were used in previous research (e.g., transsexual, pre-op) have since been ushered out of most discourse surrounding transgender narratives and categorized as problematic. Some previous word usage reinforced the medicalization of trans identity, or reduced trans identity to binary/fixed categories determined on a strict set of gender performance that reinforce heteronormativity. This language intended to provide one overarching narrative of transgender experiences, effectively erasing the visibility and credibility of varied experiences, narratives, and identities. Below are some key terms as understood by the authors, though the language for this community is incredibly fluid and evolving to provide people with terminology that is more accessible to and representative of their specific situations. Definitions have been adapted from the National Center for Transgender Equality, PFLAG (Parents and Friends of Lesbians and Gays), and the University of Michigan School of Medicine.

  • Gender identity: A person’s innate knowledge of who they are as a person in regards to gender. This does not always match sex, which is biologically determined.
  • Transgender: A transgender person is somebody whose gender identity differs from the identity expected at birth, which is typically determined by sex. Transgender is also considered an umbrella term under which a variety of non-binary gender expressions and identities fall.
  • Cisgender: A person whose gender identity is consistent with their biologically determined sex. Preferred over using the term, “non-transgender partner.”
  • Transwoman: A woman who was thought to be male when she was born, but lives as a woman today. Sometimes in place of transwoman, the term transfeminine is used as well.
  • Transman: A man who was thought to be female when he was born, but who lives as a man today. Sometimes in place of transman, the term transmasculine is used as well.
  • Non-binary: Gender identity that is neither entirely male nor entirely female.
  • Gender non-conforming/GNC: A person whose gender expression often runs counter to societal gender stereotypes. For example, a man who wears skirts and dresses but still identifies as a man is considered gender non-conforming.
  • Queer: An umbrella term, often used to describe anyone who is a part of the entire LGBTQA+ community or who has a gender identity or sexual orientation that is somewhat fluid. The word “queer” was reclaimed by certain members of the LGBTQA+ community from its widespread earlier use as a pejorative term for gay people. Other members of the community still find the term hurtful or offensive. As a result of this, the term should only be used as a self-identifier and never forcibly applied to another person.
  • Pronouns: The set of pronouns that an individual would like others to use in reference to that individual. The two sets of pronouns that are most popular in the English language are he/him and she/her, but others include they/them and ze/hir.

Couple and Sexual Relationships between Transgender People and Partners

Published literature on the couple or sexual relationships of transgender individuals and their partners has modestly increased since the initial 2011 article. Scholars talk about the initial wave of research about transgender people as focusing on individual development and the process of transition. A second wave, of which the 2011 article was a part, broadened the focus to include the intimate relationships of trans individuals and partners, more often on transwomen and their cisgender partners. Recent literature has continued the couple and sexual relational foci and expanded to include more nuanced experiences, such as those of transmen, trans people of color, and intimate partner violence and power dynamics for these couples.

Several recent articles and book chapters are briefly highlighted here. Bethea & McCollum (2013) interviewed seven transwomen on their disclosure experiences with their partners and found three primary themes: 1) An obligation to disclose, 2) Unpredictability of the disclosure process and of others’ responses, and 3) Feeling liberated after disclosing. A study of 17 couples from five different states who began as a “heterosexual” couple, now comprised of a transwoman and her cisgender female partner, interviewed the partners separately and found themes related to gender expression and identity re-formation to involve various phases, re-gendering as women, and the impact of visual congruence as individuals and as a couple (Alegria & Ballard-Reisch, 2013). Other couple-oriented studies have focused on role negotiations (Casani, 2013), substance abuse (Reisner, Gamarel, Nemoto, & Operario, 2014), intimate partner violence (Cook-Daniels, 2015), and the interaction among transgender discrimination stigma, relationship quality, and mental health (Gamarel, Reisner, Laurenceau, Nemoto, & Operario, 2014).

Scholarship on transmen and their partners and transgender people of color has appeared more often in the professional literature. For example, Hager (2015) explored the relationships after transition of transmen and their sexual minority partners in San Francisco. Six couples participated in this qualitative study and areas impacted by the gender transition included gender and sexual identities, medical and social transitions, relational issues, and the positive role of support and community connections. Jackson (2013) utilized mental health experts who specialized in transgender issues to develop guidelines for clinicians for working with dual minority clients who are transgender and a member of a racial/ethnic minority.

In an excellent overview chapter on the sexual relationships of transgender couples, Lev and Sennott (2012) thoughtfully address what they note has been largely absent until recently. They focus on sexual desire as it relates to bodily changes, stress of the transition process, and the importance of nurturing resilience. Moran (2012) studied the sexual relationships of transmen and their partners and found the traditional labels for sex are inadequate, that sex needs to affirm transmen’s masculinity and be different from lesbian sex. Relational body image of women involved in relationships with transmen was investigated by Goldenberg (2011) and findings fell into four domains: 1) Carrying forward history, 2) Identity development, 3) Finding femme, and 4) Impact of couple-hood.

Other guidelines for working with transgender people and their partners have also been developed in recent years in addition to the counseling field’s guidelines that were noted in the 2011 article. The American Psychological Association came out with guidelines for psychological practice with transgender and gender non-conforming people (APA, 2015) that fell under areas such as foundational knowledge, stigma, discrimination, and barriers to care, and life span development considerations from childhood through older adulthood. Therapeutic guidelines for couple therapy are presented by Malpas (2012), who traces the role that couple therapists have historically taken with transgender couples and offers a contemporary approach, illustrated by case vignettes, specifically designed for the unique experiences of transgender couples that formed prior to the transition of the transgender-identified partner. Those guidelines include the use of couple and individual sessions, dealing with grief/loss, the negotiation of conflict and commitment, and changes in relationship and sexual boundaries.

A final theme appearing in recent literature on transgender couple dynamics has involved the development of more sophisticated conceptual and theoretical frameworks that may lead to greater understanding and more comprehensive clinical care. Two particularly transgender-related articles appeared in the journal Family Process in a 2015 special section on “LGBTQ Families in the 21st Century.” One, authored by Shawn Giammattei (2015), emphasizes the importance of thinking “beyond the binary” in our consideration of transgender negotiations in couple and family therapy. In the other article, Addison and Coolhart (2015) propose a feminist model of intersectionality to understand queer couples that goes beyond consideration of one’s individual status in a variety of dimensions of identity (e.g., gender, gender identity, race, sexual orientation, SES, etc.) and includes how those aspects of identity overlap and interact for partners. They also recommend therapists consider how their own identities interact with the couple, and offer two instructive case studies that involve transgender couples. The next sections consider non-binary people in relationships, and address updates to issues related to two key findings from the 2011 article (Bischof et al.), self-esteem for the cisgender partner and the role of faith and spirituality.

Non-Binary People in Relationships

Although no conclusive research has been conducted that indicates the effect of one partner’s transition to a non-binary identity, such a transition would likely prove even more difficult to process both for the transitioning individual and the partner due to the challenges that result from a gender binary-oriented society (Understanding Non-Binary People, 2016). Due to the influence of gendered performance and policing, gender expression for non-binary individuals is difficult to navigate: clothes, hairstyles, makeup, or other means of expression are primarily classified as either “for men” or “for women.” Even the aspects of appearance that are considered “gender neutral” (such as pants, T-shirts, etc.) do not culturally signify the presence of a gender outside of the socially ingrained binary. Furthermore, finding legal or medical confirmation is far more difficult and sometimes impossible for non-binary people; only two U.S. states legally recognize non-binary gender identities (Ferguson, 2016). This lack of recognition and understanding in society increases the hardship of merely existing publicly as a non-binary individual, let alone coming out as such to a spouse, partner, or family.

Self-Esteem and Adjustment for the Cisgender Partner

Self-esteem for cisgender women who stay with their transwomen partners remains relatively understudied. At the same time, research on the partners of transgender individuals has grown in the study of sexual minority women and their relationships with trans men (Brown, 2009; Forde, 2011; Iantaffy & Bockting, 2011; Meier, Sharp, Michonski, Babcock, & Fitzgerald, 2013; Pfeffer, 2010). Studies done on queer-identified, cisgender women who stay with transgender male partners indicate that these women have similar self-esteem concerns to the heterosexual cisgender women in Erhardt’s 2007 book (Brown, 2009). Self-esteem concerns stem from a shift in cisgender women's sexual identity as a result of their partner transitioning. This can be a stressful new understanding of sexual orientation for cis women who had previously gone through a coming out process as lesbian or bisexual, and find strength in that identity or feel pressured to give up that identity-based community. Joslin-Roher and Wheeler (2009) found that once the transgender partner began transitioning, the partner of that individual experienced higher levels of stress, as a result of worrying about new social and political barriers. This stress is coupled with the renegotiation of relationship dynamics, roles, and interactions between both transgender and cisgender partners (Schilt and Westbrook, 2009; Tate, Bettergarcia, & Brent, 2015).

For sexual minority women in particular, this relationship dynamic, if not attended to through open communication, equated to performing a majority of the emotional work within a relationship (Pfeffer 2010). Pfeffer’s ethnographic investigation revealed cis partners often take an especially active role in managing their trans partner’s emotional well-being once they began transition. This dynamic left cis partners unable to move through their own transitionary period, not unlike the cis women in Erhardt’s Head Over Heels. Cisgender partners often felt held back, responsible for all aspects of emotional well-being of their transgender partner, and that they were not allowed to grieve at being left out of big decisions such as medical transitioning.

Faith and Spirituality

In the Head Over Heels (Erhardt, 2007) cases, various transwomen and their partners expressed sustained commitment to their faith, and their interactions with religious communities were integral to their experiences, with the responses of churches varying from full acceptance to the individual being asked to leave the congregation. Religiosity and spirituality are critical factors in successful aging of transgender adults (Porter, Ronneberg, & Witten, 2013). Successful aging includes mental well-being, and transgender adults who participate in LGBT-affirming religions reported higher levels of satisfaction with their lives than those who did not. Overall, spirituality outweighs specific religious affiliation among transgender individuals, in part due to the historical context of oppression associated with many organized religions (Halkitis et al., 2009).

Future Research and Considerations

In the few years since the Bischof et al. (2011) article, research on this topic has advanced considerably and is expected to broaden and deepen in the next decade and beyond. Much of the early research has been qualitative in nature which has been important to understand the dynamics of these particular relationships. Many qualitative studies have interviewed partners only individually; we recommend future researchers conduct both individual and couple interviews to gain an even greater understanding of relational dynamics. In fact, the first author and a team are conducting a study that does just that, in which a couple interview is held after an individual interview with each partner separately. Future quantitative studies are recommended to test out some of the emerging themes on transgender couples. Further research on transmen who are partnered with people of various genders, including other transmen would be helpful. Comparing casual and committed relationships with a trans partner, and exploring various relationship structures, such as polyamorous and non-monogamous relationships is also recommended (Moran, 2012). Finally, it would be useful to study transgender couples as they proceed through life cycle transitions, including dating, committed partnering, becoming parents, divorce, adulthood, and later life, as well as interactions with their families across the life span.

Demographic data reveal transgender people are coming out and transitioning earlier in life, perhaps due to some of the sociocultural advances noted above (Moran, 2012). This is likely to impact future intimate relationships of transgender individuals, with some people transitioning before involving themselves in committed relationships. It is also likely, though, that transgender individuals will continue to come to terms with their identities and transition at various ages and stages of life. The growing literature on the maintenance and enhancement of committed romantic relationships through the transition process will likely provide hope and strategies for couples navigating this major life transition. Not too long ago, a transgender transition was believed to be a death knell for a relationship. That is no longer true, as more and more courageous couples navigate this life stressor effectively and work through the issues involved to further develop and strengthen their committed relationships.

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