If you haven't already done so, you might consider reading Resources for families with a transgender member, especially for the discussion of a few clinical concepts.  These include:

 

• Family Stress Theory - What a family experiences when a family member transitions may depend on the historical time, place, and environment (Whitley 2013*).  There is a long history of transgender-related behavior and surgeries to alter primary sexual characteristics that spans from biblical times until today.  If you aren't already familiar with this history, consider starting by reading the brief history of transgender-related behavior section in Why is this topic important?  Familiarity with this history is important because it helps to place this behavior in historical context, and in turn understand how families' ability to cope may be affected by factors such as this context.

  • In addition to this history of transgender-related behavior, the history of its clinical treatment from the 19th century to the present day is available on the Clinical History page.

• Relational identity conflict - Unclear and shifting self-definition in relation to the transgender family member’s new identity (Whitley, 2013)

• Stigma, shame, embarrassment  (Veldorale-Griffin & Darling, 2016; White & Ettner, 2007; Whitley, 2013)

• Ambiguous loss - death that lacks closure (Boss, 2007; Coolhart et al 2017; McGuire et al 2016; Norwood 2012, 2013a; Zamboni 2006; McGuire, Catalpa, Lacey, & Kuvalanka, 2016; Wahlig 2015).  More details about family members' experience of ambiguous loss are available in the sub-section, "Ambiguous Loss," in Resources for Families​. 

• Grief (Brill & Pepper, 2008; Canfield-Lenfest, 2008; Ehrensaft, 2011; McCullough, 2020; Norwood, 2012, 2013b)  

• Disenfranchised grief (that can't be expressed in public and is not recognized by society) (Doka, 2002; McCullough, 2020; Testoni & Pinducciu, 2019). This concept is related to relational identity conflict (described above) in that disenfranchised grief can stem from a loss of the type highlighted here that affects family members' identities.  More details about family members' experience of disenfranchised grief are available in the sub-section, "Disenfranchised Grief," in Resources for Families.

• Some family members of transgender adults may experience feelings of depression, anger, and/or betrayal (Freedman, Tasker, & di Ceglie, 2002; Leland, 2017; Zamboni, 2006)

 

The intensity of feelings of stigma and shame can vary depending on the family member’s relationship to the transgender family member, gender, and age of each party. This table illustrates this concept.  For example, a wife whose husband transitions to become a woman may also feel that she did not get what she agreed when she married. A male child whose father becomes female may feel shame if the transition occurred when he was an adolescent than if the transition occurred when he was a child.  This reaction could be different if the child was female.  A father who was proud of having a son may feel some loss when he becomes a she.  These experiences are illustrated in this story written by the mother of a transgender daughter about the family's struggle and adjustment during transition.

 

Kübler-Ross' Stages of Grief is a useful framework for explaining how different family members may react to the gender transition of one of its members (Kübler-Ross, 1969; Emerson & Rosenfeld, 1996).  The table in this document shows examples of behavior as it relates to the stages.  However, family members may go through the stages at different rates, and some may not complete all the stages.  

 

Going through this process may bring up the need to forgive since families may be angry with the member who transitions.  See the sub-section, "Reflections on forgiveness," in the Resources for families with a transgender member section for more details.

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*The citations on this page come from the research literature and other publications and are available upon request.