Christine Aramburu Alegría PhD APRN FNP-BC Orvis School of Nursing / University of Nevada Reno

1. Identity and Relationships Following Disclosure of Transsexualism in Long-Term Close Couple Relationships Christine Aramburu Alegría PhD APRN FNP-BC Orvis School of Nursing / University of Nevada Reno aramburu@unr.edu 24 April 2014

2. MTF-NF Relationships • Increased awareness and focus on transgender persons and issues affecting this population • Relatively little research on transgender persons and their close relationships • Call from Institute of Medicine (2011) for an increase in research on the transgender population

3. Purpose of the Study To explore individual and relational identity reformation in MTF-NF couples in which the disclosure of male-to-female transgenderism occurred after the relationship was established as man-woman. To explore relational activities that facilitated successful relationship adjustment and reformation

4. Methodology • Individual questionnaires Relationship maintenance activities • Individual interviews – Open questions on: Relational dynamics MTF transition status (e.g., hormones, surgery) Views on self, partner, and the relationship Evolution of views

5. Participant Recruitment Internet forums TG groups / organizations Network sampling

6. Participants 17 couples (n=34; 17 MTFs, 17 NFs) Relationship: 3 - 44 years (m=21.8 years) Age range: 30 - 69 (m = 55) 70% of participants were 50 to 69 years of age

7. Participants Length of Relationship at time of Disclosure: >65% had been together more than 10 years Length of Time since Disclosure: 40% - 4 to 8 years 35% - 9 to 11 years

8. Participants MTFs identified as Female and / or Transwomen 14 of the 17 MTFs: Full-time (as women) 3 of the 17 MTFs: “Majority of the time” 6 of the MTFs: SRS 3 of the MTFs: Pre-op SRS

9. Reformation of Identity Through communication, interactions, and re-framing, the process of reforming views of the other, the relationship, and the self occurred in a fluid, non-linear manner. Importance of: • Language • Interpretation • Re-forming / Re-integrating

10. Disclosure: How it Occurred Intended and gradual e.g., evolution from CD to TS Intended and single event Unintended and single event e.g., finding clothing, emergency hospital visit

11. Initial Reactions to Disclosure Confusion Meaning for the self, partner, and relationship Language Sexual orientation e.g. “situational lesbian” Pronoun usage in public Definitionof “transsexual” Lack of awareness of similar others Inhibiting the exploration of identity Preventing disclosure to partner Feelings of isolation

12. Initial Reactions “It was uncomfortable and it made me question what it would mean for me and what it was. Is this normal or not, and then if I’m in this relationship, am I normal or not. Whatever thatmeans. In this situation that’s what you think. This is not what I signed up for. This never occurred to me. Idon’t know anybody like this. It was just so out of my normal range of what my world included on a day-to-day basis.” (NF 9)

13. Identity Reformation Fourmain themes related to individual and relational identity reformation emerged: • Gender expression • Societal presence • Sexuality • Relational Growth

14. Gender Expression Partners’ views of gender expression evolved in phases: Exploration / Experimentation Re-gender (as woman): Adolescent phase Maturation Gender roles Identity / body congruence

15. Gender Expression: Experimentation “[We went to] a dominant-submissive group – female dominant-male submissive – because we were thinking that maybe he needed to be more submissive at home. Maybe that was where we needed to go with our relationship and then this would all go away. It was like, ‘Well maybe if we do this, this will be what’s right and it won’t necessarily have to be about being a woman; maybe it’s just a role’” (NF8)

16. Gender Expression: Exploration “She would get together with other cross-dressers, and for a while I thought – and she did too – that that was enough. I was fine with it. It was confined and limited, and that’s what I needed – to believe it was about the clothes and that it was confined.” (NF17)

17. Gender Expression: Adolescence to Maturation “I was like a teenager. I had to mature. We went from being husband and wife, to being like a mother and daughter, to being two mature women. She (NF 13) had to guide me on an appropriate presentation as a woman my age. ” (MTF 13)

18. Gender Expression: Gender Roles “For a period of time I felt kind of butch because, really, [MTF 12] is more feminine than I am. I don’t wear makeup and jewelry and all that stuff, and now she’s taken to primping and getting earrings. She’s very interested in feminizing herself. I completely understand, and I think it’s fine, but I’m the opposite now. I don’t need to shave my legs, but she does. She is the feminine one.” (NF 12)

19. Gender Expression: Identity / Body Congruence Duality (i.e. man and woman) Initial expectation as partners work to make sense of the situation Eventual elimination of duality Sex reassignment surgery Typically, the long-term objective

20. Gender Expression: Identity / Body Congruence “I actually got to the point where I couldn’t deal with this [duality] anymore. I told her,‘You are one person at home and another person that goes off to work and I’ve just had it. Do one or the other. I’m done. I cannot deal with this two-person.’ It was upsetting and confusing.” (NF2)

21. Societal Presence The couples reported changes in how they perceive their place in the social world: Marginalization / finding community Being viewed as “lesbian” Viewing selves same as non-MTF-NF couples Successful outings increased confidence for future outings

22. Societal Presence “We have our straight friends in the neighborhood and in church, and I don’t feel I really belong there. The people at the LGBT diversity center – I’m not really one of them. I’m an ally there, but I’m not of them. So I kind of walk between two worlds and I just kind of walk that thin line now. I feel like I’m neither one. It’s kind of an original place. And for that I feel grateful.” (NF 13)

23. Societal Presence “One way we explained it to ourselves over time was that many couples who married for better or worse deal with some really horrible things that happen with their spouses. My uncle was bedridden most of the time my aunt was married to him. These are horrible things, but good loving spouses will do whatever’s necessary.” (MTF 1)

24. Societal Presence “When we first started going out in public, I could walk next to her, but couldn’t hold her hand or put my arm around her. I couldn’t do anything that would obviously lead someone to believe that we are a couple. But that is no longer true. People don’t bother us, so it gets easier.”(MTF 9)

25. Sexuality The couples reported changes in their sexuality related to: Sexual Fluidity Authenticity Cessation of sexual activity

26. Sexuality “My sexual identity has really been a difficult thing with all this. Am I a lesbian, am I still hetero? Labels mean so much. I think of myself as a ‘situational lesbian.’ (NF 12)

27. Sexuality “I had to get those pictures out of my mind of what a married couple should be, what my ‘husband’ should be. I’m much more comfortable now, being with a woman, and I’m much more comfortable with sex and imagining sex with a woman and enjoying sex with her being a woman.” (NF 4)

28. Relational Growth Couples reported overall growth in their relationships: Closer, more authentic relationship through communication More positive and pleasant interactions Agents of change / trans-advocacy Charting new territory

29. Personal Growth Time of reflection for NFs Examination of life / of what’s important Examination of relationship / investment within Examination of gender roles / sexuality

30. Personal Growth “I needed to find myself separate from another. In coffee shops I could sit and there would be people all around me, and I could feel where I was, as opposed to where they were, and that seemed to be what I needed to feel. In couples there is so much connectedness. So on a certain level, I needed to feel my wholeness, and I would work things out that way. It took me on a thought process for myself and about what I want and need in my life. I needed to reclaim and feel myself and my relation to the world. It’s been amazing. I tell you, [MTF’s] disclosure and transition process has been most wonderful for growth.” (NF 16)

31. Pro-Relational Activities Support groups Education (for self and providing for others) Selective disclosure to others Adjustments in public behavior and language Adopting confident demeanor Communication Compromise / Negotiation

32. Pro-Relational Activities View relationship as joint transition Acknowledge loss involved, e.g.: Loss of partners as men Loss of future as envisioned Loss of “hetero” privilege

33. Conclusion Over time, increases in confidenceand validation as a couple Day-by-day negotiations (especially initially) Transition as joint evolution, requiring ongoing communication and positive interactions View selves as agents of change: MTF-NF couples are just another way of “being in the world.”