Abstract
It was once believed that if a husband had transgender issues it spelled the end of a marriage. Unquestionably, this can be a complicated scenario that is best handled by a therapist who has experience with such issues. Many marriages and comparable relationships can survive and even be enriched by such a revelation. Many couples can live happily together even when the husband has a transgender identity and even if “he” transitions to live fully in the female gender role. Several factors must be taken into account by a therapist when approaching this work. A thorough basic assessment of each individual and of the underlying strength of the relationship is essential. This should include: transgender-specific assessment of the husband, including self-awareness and intentions; learning when and how the wife found out about his transgender issues; and information about the relationship dynamics in the extended family. The therapist should be informed about things such as: the most common fears of the wife of a transgender husband; recommended approaches for coming out; and the broad range of normal human sexual behavior. This information will be useful when helping the couple explore the options available to them in their relationship with each other, in their sex life and in their family and social life.