Pulling Our Hair Out:
Transition and Stress

By Elizabeth Maples-Bays, RN, BSN

Entering the world of the trans community can be a new and exciting experience for the female significant other of a transman. Meeting new people, going to local support groups, socializing with other FTMs (Female-To-Males) and SOs (Significant Others), going to conferences, reading the literature, interacting online…all of these things can be fun. They can also be utterly overwhelming and leave one with a real sense of culture shock. If being in a primary or other important relationship with a transman is new to the SO, s/he may be ill equipped to handle the changes that are coming. Many female SOs come from the lesbian community while others are bisexual or heterosexual before partnering with a transman. In any case, the entrance to the trans milieu may be simultaneously exciting and frightening for those of us who are new to this scene. Learning the terminology, watching our partners grow and change, helping them to feel more comfortable in their own skin…all of these things can be extremely rewarding.

But in many cases, the tides can turn fairly quickly once the “shine is off the penny”. The stressors that are often inherent in the transition process can take their toll on the SO, the FTM, and the relationship. I have personally been told more than once that the “transition belongs to the FTM”. In the bio-chemical and body image sense, that is certainly true. But for any committed couple, the psychosocial changes are shared…not to mention the financial implications. The stresses can be devastating to all involved and can precipitate the need for professional intervention.

A lot of emphasis is placed in the literature regarding the necessity for therapeutic intervention in the lives of transpersons…and rightly so at times. In some cases, the SO may have as great or a greater need for this as well, and, in fact, so may the couple. Couples therapy is often undergone by straight and lesbian couples in times of crisis in the relationship. There is no doubt in my mind that a crisis can well be precipitated when one partner transitions to another sex. Unfortunately support for couples that would encourage longevity of the relationship is nearly nonexistent in the trans community. It is unfortunate, but true that short-term relationships are all too common. If that is the desire of the two people involved, that is well and good. But many times relationships fail due to outside pressures that decry the needs of the SO to the point that it is really intolerable for her*…resulting in her leaving the relationship altogether.

The implications for the SO are myriad, and there is very little if any support for many of us on the local level. FTM community meetings are sometimes open to SOs, but are often solely focused on the needs and interests of the FTMs. If you live in a large, urban area, there may be a support group for the SOs. These can often be helpful, however they can be harmful as well. The prevailing view in many trans circles that all things are wonderful when you are partnered with a transman can do a great deal of harm to those SOs who struggle with identity or abuse issues. The content of these meetings often consists of nothing more than information on how to be supportive to the transitioning FTM. The SO’s needs are often completely ignored. The resulting feelings of alienation and isolation can lead to depression and other problems. Often these problems are addressed out of context, when they are addressed at all. The chance to give real support to a woman in need is often lost.

Other issues encountered by SOs include financial stress due to the exorbitant costs of transitioning. Physician visits, laboratory tests, medications, surgeries, new wardrobes, legal costs, and all the other costs related to transition can put a strain on any relationship. Whether brand new or of several years duration, the relationship strain experienced by SOs and their FTMs secondary to bills, bills, and more bills leads them to a common area of conflict, for many couples. The reality of putting the SO’s material needs aside for the entire transition period is a reality for many couples. Her health needs, in particular, may be neglected. Certainly mental health needs, unless of crisis proportions, are often set aside due to “lack of cash”, especially since many health insurance plans do not reimburse for these types of services…or if they do, the co-pay is much higher than for physical health needs.

If you are an SO who is experiencing depression, anxiety, or other mental health problems and feel that you would benefit from professional intervention, it is just as important for you to find competent practitioners who are familiar with Gender Identity Disorder (GID) as it is for your partner. While other caregivers may or may not be well intentioned, if they are not schooled in this area they may not be able to adequately assess your situation and come up with a treatment plan that is helpful for you. You have probably already learned a lot about the needs of FTMs, the Harry Benjamin Standards of Care, the various terms and treatments involved in treating GID for your guy. But, have you ever thought that your needs are just as specific as his are? They are. A counselor or therapist unfamiliar with GID cannot possibly understand your problems without a great deal of preliminary research. If you come from a lesbian background, the same can be said regarding that milieu. If a counselor is willing to do the homework required, they can certainly learn how to be helpful, but it takes a commitment on their part to do this. Many counselors are willing to do so. Some are not. The best way to approach this is to simply ask them in the intake interview what their experiences are in this area. If they indicate they have none, just ask them if they would be comfortable proceeding with therapy after they have done the required research or if they would be more comfortable providing you with a referral to someone else.

* This article is written from the perspective of a bio-female womon-identified FTMSO. The intent is to address the needs of such persons specifically without ignoring the fact that there are other types of FTMSOs. Those persons are, in my opinion, better qualified to speak to their own needs in this regard.