Note: this article is written to be directed exclusively at the partners of trans people.

There are many issues that come up surrounding genital surgery for trans people (more commonly known as SRS or Sex Reassignment Surgery). Though these are important issues, another important issue that often gets overlooked is how this impacts relationships. Reactions can be extremely varied between partners of the person having the surgery; some (such as my own partner) are very loving and caring, while others feel uncomfortable with the idea of their partner having the surgery for various reasons.

First, a little bit of background information for those who have partners who plan on having SRS. Techniques have improved immensely for trans women over the years. Surgeons can now produce a set of female genitals that are fully functional for sexual activity. These genitals are often indistinguishable from the genitals of cissexual women, and carry the added bonus of not needing to worry about pregnancy (with that said, you should still practice safer sex, as a transsexual vagina is more susceptible to STIs than a cissexual vagina). However, they require a fair bit of maintenance following surgery. Your partner will need some time to recover, as full healing can take up to a year or more. Orgasms are likely, but aren’t guaranteed, and can take anywhere from a few weeks, to a few years following surgery before they start to occur.

Techniques for trans men still have some way to go. There are two basic techniques, metoidioplasty (where the clitoris is released from the clitoral hood, so that it may function as a small penis, usually around three inches) or phalloplasty (where a full penis is formed, but may not be fully functional for sexual activity). Because of the size of the penis following metoidioplasty, it is usually difficult to use for penetration. Phalloplasty is most often accomplished by taking a skin graft from elsewhere on the body (such as a forearm) and using the tissue to form the penis. The urethra is extended through the penis so your partner may urinate properly, but your partner will be unable to ejaculate. Also with phalloplasty, erections can only be achieved so far by using a manual pump that is implanted in the penis. However, the penis is adequate for penetration. Phalloplasty is a complex procedure that may take multiple surgeries (up to 4) in order to achieve, and can have a long timespan in between surgeries. Each surgery has varied recovery times.

Anyone going through SRS should never go through their surgery alone. If you can be with your partner through the surgery and recovery, be there for your partner. If it is too much for you to handle, make sure your partner has another family member or close friend who can be there to support them. Prior to the surgery, your partner may experience heightened anxiety, fear and doubt surrounding the surgery. Be supportive and help your partner alleviate these fears. Do not pressure your partner to go through with the surgery, as they may realize that the surgery is not right for them. With that said however, do not pressure them to cancel the surgery either, as it needs to be their choice. Support them whatever their choice may be. Follow your partner’s lead during this period. Remember, your partner’s genitals are still healing!

SRS is major surgery and can be very taxing, both physically and emotionally. During recovery, especially for the first month or two following surgery, your partner is likely to be focused on their own recovery, and may not be able to process information as easily as normal. You need to be able to assist your partner with that. This is a time, especially during their hospital stay, for you to be their advocate. Nurses and doctors only know your partner’s medical needs by reading their file, and sometimes can overlook some specific needs. You need to be prepared to speak up for your partner when something isn’t right. Immediately following surgery, your partner will likely be falling in and out of consciousness, and will almost certainly be in a lot of pain. You need to be there to help the hospital staff understand your partners’ needs.

Following your partner’s hospital stay, your partner will likely have very low energy available for daily routines. Especially if your partner is a woman, they will need to focus much of their energy on recovery, healing, and personal maintenance, both for the surgical area, and general hygeine. Do not try to push your partner to maintain household chores during this time. Do make sure, however, that your partner gets up to do simple exercises daily, such as short walks.Your partner may feel restless at times and desire to be more active. However, be aware that your partner may become suddenly fatigued any time.

For trans women, not only will your partner be going through recovery, but they will also be going through some abrupt hormonal changes. The sudden lack of testosterone can temporarily suppress your partners’ sex drive, as well as potentially trigger a period of post-operative depression. Estrogen is also frequently lowered following surgery. Be aware of your partners’ mood changes and, if necessary, help ensure your partner is seeing a doctor if your partner experiences depression. Over time, your partner will need to explore themselves and their new genitals sexually. Do not worry if your partner decides to masturbate, as this will help them get used to their new genitals. When your partner feels ready, they will include you in the process of sexual exploration. For some that may be right away, and for others it may take them some time.

One of the most common issues that can come up for a partner of a trans person is that the partner can find themselves emotionally invested in their partners’ existing genitals. A partner can fear the loss of attraction to their partner because of this, or they can simply fear the loss of their partners’ birth genitals. Some partners worry that they will not enjoy sex with their partner as much when they have the new genitals. If you have any of these fears, it’s important to acknowledge and address them. Do not try to ignore them for your partner’s sake; they will only breed resentment later. However, do not attempt to delay or prevent your partners’ surgery; that will only create resentment on your partner’s part, and will negatively affect your partner’s mental well being as well. Remember, too, that just as you became attached over time to your partner’s birth genitals, you may over time build an attachment to your partner’s new genitals as well.

If you really feel you cannot handle your partners’ surgery, or that you find yourself no longer attracted to your partner (which can and does frequently happen, especially if you identified as straight or gay prior to your partners’ transition), do not try to stay with your partner. Break up, preferably amicably. You’ll be doing both of yourselves a favor by granting the other the freedom to explore healthy sexual relationships with others.

Question: How can you help your transgender partner prepare for and recover from SRS?