Trans-identified people may experience themselves as male gendered, female gendered, bigendered, intergendered or agendered; they may be born male bodied, female bodied or intersex. However, for diverse reasons, society’s attention has focused on female-gendered trans’ people – those born male bodied. This group has been publicly demonised more than the others; indeed, some parts of society still struggle to accept them. Perhaps it is for these reasons that it tends to be their partners presenting for counselling, and therefore this is where this article will focus. This is not to say that partners of female-bodied and intersex-bodied people have no issues – it simply affords me space to explore issues at some depth rather than surface skim within the word limits of an article.
Similarly, trans’ emergence and/or transition previously seemed associated with middle years. This was due in part to the fact that the population was heavily stigmatised and subject to severe regulatory discourse, and in part because the minority were well scattered through the rest of the population. However, improved communication systems, equalities legislation, and an ever-growing body of knowledge, have enabled those who are born differently gendered to speak up at a younger age. Consequently, the UK now has a specifically designated unit for the support and treatment of transgender youth – the Gender Identity Development Service (GIDS) at the Tavistock and Portman NHS Foundation Trust. Again, it is not to be assumed that partner issues are irrelevant for trans’ youth. However, though there will be some similarities, these relationships are more often set in the sphere of knowing and therefore somewhat different.
Thirdly, it feels important to note that not all partners go into relationship with trans-identified and trans-historied people unwittingly. As society settles its struggles with diversity and becomes more open, it has become more common for people to knowingly enter into a relationship with trans’ people – both populations have become less socially anxious around each other. As with trans’ youth, there will be some similarities and some differences in the issues arising, but in writing an article rather than a book, I must focus in order to achieve some detail.
Female partners in existing relationships
When trans-identity is disclosed, natural human fascination with the unusual tends to direct curiosity toward the person concerned; the attention given to those in relationship with trans-identified and trans- historied people is miniscule in comparison. Indeed, it has been frequently considered understandable, and often presumed unavoidable, that any existing intimate partnership with a trans-identified person will fracture and fall away once trans’ nature has been disclosed or exposed. The regulatory discourse that silenced gender diversity for so long has had an equally silencing effect on those in relationship with them. The partner population thus suffers from not only being queered by association, but also from prejudice by proxy – in so far as a society that regards the trans’ population as disordered assumes their partners must be too!
Historically, divorce was a prerequisite for gender reassignment – treatment protocols categorised marriage as ‘a contraindication to cross-sex surgery’.1 This derived partly from the heteronormative assumption that men are naturally attracted to, and partnered by, women, and vice versa; so somebody who was genuinely female would want a male partner, and similarly no married female would wish to stay with a woman. It also concerned professional liability, one treatment protocol clearly stating the requirement for ‘proof of divorce to protect the surgeon and referring physicians from possible lawsuits from alienated spouses’.2 For some time, it was not possible to study the effect of gender transition in existing marriages simply because those marriages ended. Trans-identified male-bodied people not seeking clinical treatment were relegated to the category of transvestite and regarded as sexually deviant; consequently, their wives and partners were similarly described. Therapists at this time were encouraged to ‘help such women... develop sufficient insight and information to intelligently manage the dilemma’,3 with accepted outcomes being either the wife accepting her husband as perverted or severance of the relationship.
Clinicians pondered the flaws and weaknesses of those who partnered transvestites for many years. Their findings indicated the prevalence of obesity, childlessness, alcoholism, and psychiatric disorder; even the simple incidence of being first born in their family was correlated to neurotic tendency. This somewhat depressing perspective seems to have been developed from the work of Stoller in the 1960s, who created a binary model of ‘transvestites’ women’ as comprising ‘malicious male-haters’, all having in common ‘a fear of and a need to ruin masculinity’.4 In a later study of transvestites’ wives and partners, Wise3 similarly observed that ‘depression, hostility, sadism, and alcohol abuse were methods utilised to cope with their perverse mate’, and that ‘subjects were often demoralised and agitated’. He further indicated high rates of major affective disorders, borderline personality disorders, and a prevalence of acute sadomasochistic themes within this client group.
Until very recently, negative attitudes towards the trans’ population were also very prevalent in the press and media, parallel to which was a dearth of reporting any positive outcomes. Without some body of knowledge, there can be no reference points for any journey; thus it becomes something approached with anxiety, misgiving, and doubt. Without some understanding of potential and possibility, there’s little incentive to make any effort, thus it becomes easier to avoid or give up.
Moreover, if we are designated unnameable, our very existence becomes taboo. It is small wonder that the partners of trans-identified and trans-historied people have been conspicuous by their absence in the counselling room for so long... but they are coming. They are coming because cyberspace is teaching them that they are not alone, that it is possible to find support in their struggle, and, perhaps most importantly, that positive outcomes are possible.
Virginia Erhardt champions those who stay in relationship with trans-identified people as ‘willing to investigate and cultivate open-minded attitudes about gender variance’. She reports that they ‘often have high levels of ego-strength... capacity to self-soothe and self-validate, regardless of the opinions of others’, and that they have ‘good emotional boundaries’.5 I would say that they are as equally human as any other sector of the population, that they have diverse strengths and weaknesses, as do all individuals, and that their journeys are as unique and varied as anyone else’s. As with most client groups, they approach counselling full of fear, uncertain of both self and outcomes, and doubtful that they have the strength to survive. My hope for them, and you, is that whatever path they end up taking, whether a relationship ends or continues, they move forward knowing that they have been truly heard, did their best, and are as valid and valued as anyone else.
Exposure and disclosure
Whatever the trans’ nature of an individual – transvestite/transgender/transsexual – the first encounter for the majority of partners of male-bodied trans’ people generally concerns cross-dressing. Whether this is disclosed in conversation or discovered by accident or design, the partner concerned usually experiences some degree of shock, rapidly followed by a bombardment of doubts and fears. Common areas of concern include security, inadequacy, homosexuality, and identity. Anxieties about security often emanate from awareness of social stigma and a consequent cascade of questions such as: ‘What will other people think and how will they behave towards me/towards you/towards us?’ Fears of inadequacy rumble along the lines of: ‘Why am I not enough?’ Concerns about homosexuality rise up in the enquiry: ‘Do you really want to be with a man?’ Consideration of identity comprises diverse strands including the enquiry: ‘If you take the female role, what do I do?’ And statements of assertion may include: ‘I am not a lesbian’, and ‘I married a man’.
The nature of disclosure obviously affects the person receiving it, and unfortunately disclosure frequently feels extremely ill timed for the partner. Midlife changes are frequently precipitated by increased awareness of our mortality, and disclosure of trans-identity is no exception. Zamboni reports that, ‘death of a parent or another family member can prompt a transgendered person to “come out”’. 6 I have found that the emergence of cancer, or other life-threatening conditions, in a family member or a friend, similarly heralds change. Conversely, happy events that also mark the passage of time, such as the birth of a child, an older child’s graduation, or a major anniversary, can also precipitate disclosure. While, for some, the timing for disclosure seems to coincide with a notion that ‘things are so bad, it can’t make it worse’, others seem to think that the best time is when all is well, such as during a family holiday or romantic weekend away. My experience is that there is never a good time, but some times are worse than others.
Whether accidental discovery or exposure is deliberate, conscious or unconscious, is debatable. It certainly seems strange that someone who has been dressing secretly for years suddenly forgets to put away their stockings, or leaves their wife’s worn clothes in a heap. It is also strange that people well experienced in private use of computers suddenly forget to hibernate them while on a trans’ website or gallery. While genuine forgetfulness may be the reason, it could also be that engineering a discovery feels like a good way of at least sharing responsibility for it, if not totally transferring the weight.
Whatever the nature of the disclosure, one of the hardest things for the couple to manage at this time is their mutually heightened sense of vulnerability. As the partner’s world is well and truly turned upside down, the trans-identified person will be desperate for acceptance, emotionally fragile, and extremely fearful of loss. Both sides are likely to feel a burden of guilt for the distress of the other as circumstances unfold, and both may be unable to engage anywhere near the topic without distress. Commonly, what promotes one partner’s happiness causes the other upset, both become prone to launch grenades of emotional blackmail at the other, and neither is able to hear much beyond their own turmoil.
Almost every other eventuality in life will have been rehearsed; the ‘what ifs’ of life that arise when someone is inexplicably late, or we hear of someone else’s misfortune, will have played out over and over again. All except for this one. The profound sense of helplessness and isolation for a partner in such a situation is thus overwhelming, and frequently compounded by the need to sustain secrecy, since at this stage it is usual for other family members and the closest of friends to be outside the circle of disclosure.
At this time, partners are also subject to intense feelings of betrayal, as with the disclosure of any large secret.7 The fact that other people within the trans’ communities are likely to know about the situation before they do, and that things will have been going on behind their back, often exacerbates both the sense of being alone and hopelessness.
Perhaps hardest of all, neither partner has all the answers that the other wishes to hear – on the one side because while trans’ nature is submerged, it can only be partially known, and on the other because, in facing the unknown, we have no measure of how we will cope, let alone a picture of outcomes. The nature of adjustments the partner will need to make in order to sustain the relationship will depend very much on the trans’ status of her partner. Parameters will vary, from the hope that she will participate in erotic cross-dressing and allow her husband freedom to participate in the trans’ scene, through wishing for her acceptance of her husband living part time as a female, to her acceptance of full gender transition. At the point of disclosure, the fact that this is likely to be an unknown exacerbates the sense of precariousness.
Partners in existing relationships are likely to feel a sense of deep loss, akin to bereavement, because this feels like the point when their future dies. What is known cannot be unknown and therefore their picture of a future relationship, however nebulous, is duly shattered. Ellis and Eriksen8 recognised the emotional process for partners as being similar to the five stages of bereavement: denial, anger, bargaining, depression, and acceptance.9 As with all models, not every person will be subject to every aspect, nor will stages necessarily occur sequentially, or without repetition. Characteristically, the partner will first deny what is happening. This may be as simple and direct as refusing to look or listen – avoiding contact being one of the most common ways to sustain denial. At other times, people desperately try to tag the events with an alternative cause – such as work-related stress or midlife crisis – thus suggesting the situation is temporary and can be stopped. Anger is frequently fuelled by a sense of betrayal, and may initially be directed at full force at the trans’ person. It is quite likely to ricochet onto others, including helping professionals, and, of course, the self too. Notions of failure and seeking out fault and blame can become all consuming. At such times, Emerson and Rosenfeld10 advocate the importance of validating feelings and normalising thoughts. At the bargaining stage, attempts to restrict, if not reverse, the situation often escalate to the level of threat, rather than negotiation, and here experience in conflict resolution and mediation can hold the counsellor in good stead. Depression accumulates as the permanence of trans’ nature dawns and emotional exhaustion takes its toll.
If it’s not gone already, it is here that sexual dysfunction often occurs. People who are hurting seldom feel like being touched when what was once warmly familiar feels like a cold lie. Where sexual intimacy has already ceased, the situation merely confirms a partner’s fears of undesirability and sense of impending doom. Where a sexual relationship exists, it becomes a minefield of doubts. Whether sexual intimacy continues or not, the therapist working with a relationship at this level of risk should be able to hold real fear and deep distress. Here it can be really useful to enable the client to recognise any signs of affection and care remaining, as these can be crucial stepping-stones in affording the necessary space not to act in haste.
Once loved ones are able to start their grieving, it is reported that peer support or social contact with other SOFFAs (significant others (spouses and partners), family, friends, and allies) can be helpful.11 Much, of course, depends on the nature of the individuals and their situations – for example, hearing about the joys of non-monogamy is cold comfort to the wife who has just found her husband’s frilly knickers collection. Similarly, when one’s own desirability is in question, it is not always helpful to know that other people are happily living as sisters or soul mates. What can be useful is to know that one is truly not alone with such experience, that people not only survive but eventually thrive, both together and separately, and that all one’s doubts, fears, and feelings are truly understandable. Resonance may not contain all the answers, but for some it can ease the grip of desolation.
Loss has many dimensions, and so far as partners are concerned, it is not simply the potential loss of their partner that is at stake (as if that weren’t more than enough to handle), but also the potential loss of self, that feels under threat. Identity exists in relationship rather than in a vacuum, and when someone transitions in an existing relationship, the change is not solely about them. Whether the couple are heterosexual or not, a change of sex automatically impacts on partner identity. Most people’s sense of identity includes sexual identity, and most sexual identity is not simply about what happens in the bedroom, it is also about who we are in the world, and how society relates to that. One of the most devastating conundrums partners face is that any acceptance of their partner’s identity feels like a betrayal of their own; in being asked to change perception of the other, they feel they are asked to change themselves at a fundamental level. Most heterosexual women have no inclination to partner another female, and similarly neither gay men nor lesbian women readily welcome the notion of being converted to heterosexual. Here, labels can strangle away the very will to continue, and counsellors can ease the knot by sharing information. For example, in a gay relationship, it can be helpful to ascribe relationship as differently queer, while in a heterosexual relationship, a focus on the love of the person rather than usual labels can be helpful.
A major part of who we are comprises our roles in life. While couples in a same sex relationship tend not to ascribe gender role to their everyday living, gender stereotypical roles are often absorbed into heterosexual partnership. Cultural constructs around one’s place in home and society may comprise cornerstones of identity, even evoke a true sense of pride and purpose – thus feeling one’s identity as a husband or wife is at risk can be deeply threatening. Worries about who now fixes the car may seem trivial, but when a husband can no longer do his chores lest she break a nail, or refuses to take the lads to football practice, lest she be thought a man, domestic routines can soon become a nightmare.
Whether or not transition is intended, wives and partners are often expected to catch up with trans’ issues at a frightening pace. Those who show any signs of possible acceptance are bombarded with books, articles, and websites – often experiencing information overload. The fact is that when we are shocked, it can take time to work out our feelings, and when in distress and panic, it can be very difficult to think. Lev notes that in transgender emergence, subjects resemble a coiled spring, ready to pop, and that in their exuberance, ‘some do not think clearly about jobs, careers, spouses and children, and sometimes take risks that may entail grave consequences’.12 Examples given include fathers ‘cross-dressing at home and in front of their children, who are confused and frightened’ and ‘discussing hormone therapy with wives who are still bitter and angry over the disclosure’. Often, if the relationship is to stand a chance, boundaries must be negotiated;
a truly difficult thing to achieve against such an emotive backdrop.
When partners do assert boundaries, or try to negotiate pace, they often face accusations of being cruel and lacking understanding. Many report cases of ‘infantile tantrums’ and the sense of ‘dealing with a child’, experiencing their other halves as suddenly selfish and self-absorbed. Unfortunately, ‘narcissistic self- obsession can be recognised as part of the normative emergence process for a transgender person who has repressed or hidden these issues for many years’.12 This doesn’t make such behaviours any easier to live with, but understanding that it is both common, and a phase, can help people find the strength to stick it out, especially when their relationship is founded on genuine love. Indeed, when founded on sincere and deep affection, the childlike qualities of the repressed self emerging can trigger protectiveness in partners; as they remember that children have an endearing side, and that sometimes life can actually be fun.
This brings me to the point that, despite being one devil of a roller coaster, a partner’s journey is not necessarily all bad. The majority of trans-identified and trans-historied people hold acceptance, and those who are prepared to try to reach it, in the highest esteem. Often a deliberate disclosure denotes great hopefulness and immense trust. Sometimes, counselling partners is not simply about giving them space to air their struggles and process problems, it is about being able to share the good times and celebrate. One of my clients once explained that, unlike other wives, she felt obliged to have a huge smile slapped on her face all the time, and that it ached. It was not that she wasn’t happy – but she felt the loss of having a simple moan and grumble about her spouse, as people do from time to time. She confided that if she so much as looked glum, let alone expressed any discomfort, friends and family seemed to think her marriage was inevitably falling apart, and any denial simply resulted in them labelling her brave!
Being beside visible difference
Acceptance does not eradicate every issue. Indeed, where trans-identity is concerned, it can actually add other layers of difficulty. Whether full transition occurs or not, partners are often expected to adjust to visible and tangible changes at an alarming rate as their other half explores femininity. Even those who partner part-time girls, or where the boundary is set at not seeing the female side, may find the disappearance of familiar facial and body hair distressingly different. Manicured nails (even unpainted) and plucked eyebrows can be equally alarming. Aside from personal discomfort, these signals also trigger fear of exposure within the wider family, within social circles, and at work. Potential for ridicule, and even rejection, is often keenly felt, making it diffi ult for partners to be supportive even when they want to be. Moreover, when a spouse dresses in female clothes anywhere in public, many wives find themselves unable to hold hands or show the simplest signs of affection, lest they be thought lesbian; this is not necessarily about prejudice, it is simply about identity. Having acclimatised to who we are in the world, it can be devastating to feel that identity reframed from outside ourselves; good counsel not only holds that devastation, but also enables co-construction of a more acceptable and truly grounded self.
Where acceptance is sufficient to go out together socially, with the trans’ partner cross-dressed, non- trans’ partners are often surprised at the high levels of protectiveness that emerge. One recounted: ‘We were in the chippie and I noticed a group of lads looking. I found myself putting myself between them and her, and giving them such a look! I swear if they had said anything, I would have punched one.’ First outings can be exhausting for both sides because of the fear of being outed or ridiculed, and even when all goes well, adrenaline at the ready is very tiring.
Where dressing occurs in the home, despite the most carefully negotiated strategies to sustain privacy, the doorbell can suddenly become a direct signal for panic, and even doing laundry can become problematic. One client reported her anxiety rocketing when, as she unloaded the washing machine, her daughter noticed a rather short colourful skirt and asked who owned it. Trying to claim it as her own backfired when the daughter responded that it was too small, to which the mother countered that she was on a diet. The daughter then pushed her to say when she had worn it, and she snapped: ‘When you are in bed and I get some peace!’ While the humour in this and other situations did not escape this client, she struggled with being untruthful – to her children, to her parents, and to her close friends.
While asexual couples exist, and can be deeply happy, most people do not go into marriage or partnership with a platonic relationship in mind. Where trans’ emergence occurs, sex can be a major stumbling block in diverse ways, regardless of orientation. It often takes time for people to become comfortable and confident sexually, and once settled in sexual routine, however fabulous, notions of having sexual intimacy in alternative ways can be scary and repulsive, even unthinkable.
Mechanics aside, the simple realisation that one’s partner has been fantasising about being in your role during sex, rather than being truly with you, can evoke shock, humiliation, and despair. To see the light of hopefulness extinguished by such revelations in the counselling room can be truly hard to be with; understanding that it is not necessarily ‘game over’ enables one to hold that hopefulness for the client, in case it can be picked up again.
While acknowledging that the positioning of sex in any partnership varies, and accepting that for some, ‘practices of emotional care and the values of honesty and trust are emphasised above sexual desire’,13 it feels crucial that counsellors hold in awareness the possibility that such narratives can be simply avoidant.
Because they have previously been stigmatised as perverted, there is huge pressure on trans-identified and trans-historied people to present themselves as asexual; indeed, those transitioning to female frequently stereotype sex as a masculine pursuit to assert their femininity. Digging for such hidden truths, especially where a relationship seems comfortable for those in it, would be questionable. However, assumptions around sex being less important in trans’ relationships can be equally wrong. While genuinely respecting the clients, wherever they are, I would advocate we always hold in awareness potential and possibility. It was once my deep privilege to receive a breathlessly excited call from a wife whose marriage to a transsexual woman had previously transitioned happily into the platonic plane over a decade previously. The call was to let me know that, on holiday, after a good day and good wine, she and her lady had enjoyed great sex as never before. She told me that she had no one else who would understand, and the laughter in her closing words was wonderful: ‘I do hope we can remember how it went.’
The possibility of engaging in alternative sexual practices, whether in terms of activity or relationship configurations, is not something I would recommend bringing to the counselling room too early. Lacking knowledge is sometimes a blessing until it’s relevant to your own circumstance. However, it is without doubt useful to hold a non-judgmental attitude and have information to hand should this become relevant to the client. Sometimes, a wider vocabulary of sexual practice or honestly negotiated non-monogamy opens up positive possibilities, where elsewhere contemplating such things would simply have caused a meltdown. Sometimes expanding horizons heals; my experience is that open marriage, polyamory, and stable triads are all possible positive outcomes.
Self-discovery and change are inevitable consequences of a partner’s journey. The changes in their life partner, whether or not that involves transition, will make them more conscious of themselves in the world. Depending on outcomes, the final level of acceptance may be when the partner truly and wholeheartedly joins the journey of the trans-identified partner, when the relationship transitions to something more in line with siblings than lovers, or when they part without malice. I know couples who have revisited their wedding vows in church, both wearing dresses, people who still enjoy a fully sexual marriage, and others who live happily in sisterly union, as well as ex-partners, comfortable in their own lives, who happily take their children on holiday together every year. All things are possible – with time, respect, and love. It is simply that when we are devastatingly hurt, we cannot even contemplate the possibilities. Somewhere, there is a legally female lady who dresses male again once a year to take her wife out on their anniversary – no emotional blackmail, no regret, and no embarrassment, on either part, just love. There are also at least three female fathers who have proudly given away their respective daughters at the marriage altar. To have accompanied people on such journeys is a great privilege. My hope is that this article enables you to contemplate enjoying such a privilege too. Many of us understand the space where the possibility of laughter is forgotten – we should never lose sight of the possibility of its return.
Tina Livingstone is a client-centred counsellor and Pink Therapy Advanced Accredited Sex and Gender Diversities Therapist working in private practice. An experienced supervisor, consultant, and trainer, she has 15 years’ experience of working with gender diverse clients and their families. She gained an MSc in Counselling at Strathclyde University in 2013, based on quantitative research into trans-identified and trans-historied clients’ experience of everyday counselling. Further details of her work can be found at www.positivebeams.com
Pre-trial therapy: avoiding the pitfalls
Open article: Peter Jenkins, Joanne Muccio, and Nicky Paris consider the issues involved in providing counselling and psychotherapy for vulnerable witnesses. Healthcare Counselling and Psychotherapy Journal, April 2015
The human face of an RCT
Free article: Sara Perren, Stewart Richmond and Hugh Macpherson reflect on providing counselling for clients with moderate to severe depression in a randomised controlled trial. Healthcare Counselling and Psychotherapy Journal, January 2015
1 Randall JR. Indications for sex reassignment surgery. Archives of Sexual Behavior 1971;1(2):153–161.
2 Clemmensen LH. The‘real life’ test for surgical candidates. In: R. Blanchard R, Steiner BW(eds). Clinical management of gender identity disorders in children and adults. Washington, DC: APA; 1990 (pp212–135).
3 Wise TN. Coping with a transvestitic mate: clinical implications. Journal of Sex & Marital Therapy 1985; 11(4): 293–300.
4 Stoller RJ. Sex and gender. New York: Science House; 1968.
5 Erhardt V. Head over heels. Wives who stay with cross-dressers and transsexuals. Binghamton, NY: The Haworth Press Inc; 2007.
6 Zamboni BD. Therapeutic considerations in working with the family, friends, and partners of transgendered individuals. The Family Journal. Counseling and Therapy for Couples and Families 2006; 14(2): 174–179.
7 Reynolds A, Caron S. How intimate relationships are impacted when heterosexual men cross-dress. Journal of Psychology and Human Sexuality 2000; 12(3): 63–77.
8 Ellis KM, Eriksen K. Transsexual and transgenderist experiences and treatment options. The Family Journal 2002; 10(3): 289–299.
9 Kübler-Ross E. On death and dying. New York: Macmillan; 1969.
10 Emerson S, Rosenfeld C. Stages of adjustment in family members of transgender individuals. Journal of Family Psychotherapy 1996; 7(3): 1–2.
11 Weinberg TS, Bullough VL. Alienation, self image, and the importance of support groups for the wives of transvestites. Journal of Sex Research 1988; 24(1): 262–268.
12 Lev AI. Transgender emergence: therapeutic guidelines for working with gender-variant people and their families. Binghampton, NY: Hayworth Clinical Practice Press; 2004.
13 Hines S. Intimate transitions: transgender practices of partnering and parenting. Sociology: The Journal Of The British Sociological Association 2006; 40(2): 353–371.