Marie was referred to me by her minister. She had confided to him that she believed her husband, Martin, "was turning into a woman." Marie was a 30 year old homemaker, mother of 4, who had been married for 8 years. Martin was a successful young executive with a bright future in a medium-sized corporation. She'd had no suspicions of her husband's gender issues until he approached her and confided that he could not continue with his present lifestyle. He felt he was smothering as he played his roles of father, husband and wage earner in a male-dominated company. She came to understand that since early childhood he has believed himself to be a woman in a male body and this persona was seeking expression with increasing vigor. He could not contain "her" any longer and wanted Marie's support and love as he began to experiment with "transitioning." This scenario embodies many of the following common concerns shared by spouses of transsexuals:
One typical issue is the absence of awareness by the spouse until her husband reveals his gender identity issues. The fact that the transsexual has inhibited his expression of his female persona since early childhood makes him particularly skilled in concealment. Additionally, because his dressing is not tied to erotic arousal, he is often more successful than the transvestite in hiding this from his spouse. My work with the woman often consists of a psycho-educational approach designed to raise both her understanding and her empathy for her spouse and what he is going through. At the same time full recognition is given to her experience of betrayal, disorientation and loss of a male partner in her life.
Another common assumption is that the transsexual is "turning into" someone else. The spouse needs to be helped to understand that while from her perspective it may seem that her husband is being transformed, in fact a hidden part of him is emerging. He is becoming more complex but not really different. I encourage her to think of her husband as a book she has only begun to read and she has many chapters to go before she can understand him and his gender issues. I discourage her from leaping to conclusions about where his transition will lead them and counsel her not to make any assumptions about husband's desire for hormonal or surgical interventions.
In almost all cases the issue of betrayal must be dealt with in therapy. Having concealed this important aspect of himself from his wife, and in fact denying her the chance to make a choice about marrying and bearing children with a transsexual, he has set her up to be hurt, bitter and angry. This is hardly the frame of mind that will predispose her to be loving and supportive as her spouse transitions. Feelings of betrayal can be moderated, with time and treatment, to the more manageable emotions of disappointment and regret.
If Martin plans to transition completely, a process which will most likely include cosmetic, hormonal and surgical changes, Marie must be prepared for some major changes in her life. If SRS is desired by Martin, divorce is inevitable. If he is unable or unwilling to remain on his job during this time, financial pressures will set in. She may have to find employment and give up her role as homemaker and full-time mother. In working with Marie I encourage her to educate herself about her options as well as those of her husband. It is essential that he enter treatment also, but not necessarily with me, both to prepare for his transition as well as to deal with the emotional fallout of his decision to proceed.
Of course, all couples with a transsexual partner are not alike. Although I have focused on the commonalities in such relationships, counseling also addresses their unique qualities, such as religious, health or financial issues that need special consideration. Families with orthodox religious beliefs present special challenges, especially around issues of divorce and interpreting the meaning of TS behavior to children.
If either partner's health is compromised, this must be considered. When the transsexual partner has a chronic illness, SRS may not be an option. If his partner has a life-threatening illness, the transsexual may fear that revealing his situation or acting on it will hasten a decline of her health, causing him to delay his transition indefinitely, and creating frustration and depression in addition to gender dysphoria. A family's financial situation must also be considered as they balance the needs of all individuals with those of the transsexual who may be considering the costly process of sex reassignment
The therapist must offer competent counseling, accurate information, sensitivity, and impartiality if a satisfactory outcome to therapy is to occur.
Dr. Anderson is a therapist in the San Francisco Bay Area. She can be reached at 415-776-0139.
© 1997 by Barbara Anderson & 3-D Communications, Inc.