Starting on Hormones – what is actually required?

Starting on Hormones – what is actually required?

It can be confusing trying to figure out how to access hormone replacement therapy (HRT) in Aotearoa New Zealand, as practices vary between both regions and individual healthcare providers.

Usually, the first step is to get in contact with your sexual health doctor or general practitioner (GP).

If your GP is clinically competent to treat transgender patients, they will usually carry out the screening as below, and prescribe hormones for you. If they don’t know what to do or don’t feel confident to do this, they might refer you to an endocrinologist, or to a psychologist for a readiness assessment before going to an endocrinologist. 

It is a common misconception that a psychological assessment and endocrinologist assessment are mandatory, but this is false. Some GPs will choose to require an endocrinologist assessment, and some GPs or endocrinologists will choose to require a psychological assessment, but these are not required by a regulatory body or by law.

Under the Health and Disability Commissioner Regulations (1996), Right 7., you have the “Right to make an informed choice and give informed consent”.

Psychological

You should not be required to undertake any ‘extra assessment’ unless your healthcare provider has reason to believe that you may not have capacity to give your informed consent.

If you are asked to undertake a psychological readiness assessment, this should never be a “mental health screening”, nor a test of your gender, nor ask you invasive questions relating to partners or sexual activity. It should be a simple assessment of your ability to give informed consent. It should aim to determine:

1. If you have mental capacity to make your own healthcare decisions, and
2. If you understand the effects of hormone therapy. 

You must have both 1 and 2 in order to give your ‘Informed Consent’.

Endocrinology

An endocrinologist’s job is to test your blood for the levels of certain hormones, and make sure your endocrine system (hormone related system) is safe to receive hormone therapy. A GP can run these tests in most cases, however if you have complex issues or coexisting conditions an endocrinologist may be necessary.

General Health

There are also a few general health conditions which may affect treatment – your GP can assess these general risks. Hormone sensitive cancers may be serious contraindications. Other risk factors can usually be managed and should not prevent hormone treatment.

Further Information

Our guide for patients, Gender affirming hormone treatment, is essential reading for both you and your GP. Other resources are available on our website, such as information on informed consent, recommended doses, and the Guidelines for Gender Affirming Healthcare in Aotearoa (Pages 30 to 37, and appendixes C through F).

You can also download our checklist for clinicians below.

Autistic Transgender People

Autistic Transgender People

While transgender people make up about 1% of the general population, they make up at least 10% of the autistic population. Some studies suggest 23% or higher.

Studies also suggest that while autistic people make up around 5% of the general population, they make up 13% of the transgender population.

Autism diagnosis by gender

Graph showing autism diagnosis by gender identity - a dataset of 514,100 people. It shows cisgender male and female as each below ten percent, and gender diverse as over twenty percent.
ArticleResearch

Autistic-Led Research

A 2018 study (linked below) shows autistic people’s responses across a range of issues, alongside responses from non-autistic people who have an autistic relative, and the responses of those who are neither autistic nor have autistic relatives (usually professionals who work with autistic people). It is not a representative study, but it is an enormous study by any research standards with over 11,000 respondents from across many different autism forums in several different countries.

Which terms do you use?

Chart showing a strong preference for the term 'autistic' amongst autistic people, while non-autistic people prefer the term 'person with autism' strongly.

20 key findings

1. Autistic respondents preferred the term “autistic person” (52%) rather than “person with autism” (12%). “Both” was selected by 28%, and “neither” was selected by 9%. In contrast, non-autistic respondents strongly preferred “person with autism”.

2. When asked if they identified as LGBT+, 7% of non-autistic respondents answered yes, while 38% of autistic respondents answered yes. 20% of respondents who said they might be autistic answered yes.

3. When asked if they were cisgender (not transgender), 17% of non autistic respondents replied no, while 23% of autistic respondents replied no.

4. There was a major correlation between being non-binary and being autistic.

5. Autistic respondents were more likely than non-autistic respondents to disagree with the statement “I have a religious faith”, and this was especially so for non-binary autistic respondents.

6. When asked if they agreed with the statement “I identify as liberal rather than conservative”, over 42% of autistic respondents strongly agreed, and over 20% agreed..

“Many autistic advocates prefer “identity-first” language (“autistic person” instead of [“person-first” language] “person with autism”). Our disability is part of us, and we don’t want to dance around it. And please — don’t call us “high functioning” or “low functioning.” If you don’t respect our language, you don’t respect us.” – AAPD

Studies have shown that autistic people are less likely to make decisions based on “what everyone else does” and are more likely to make decisions based on pragmatism. They often have a strong sense of fairness and social justice. This may partly explain the liberal (rather than conservative) tendency, and openness to exploring their gender and attractions in non-heteronormative ways.

Visual of the information presented above.

Autistic young people

7. 84% of autistic respondents disagreed (74% strongly disagreed) with the statement “I am concerned about a link between vaccines and autism” while 62% of non-autistic respondents disagreed (47% strongly).

8. Most autistic respondents said their school didn’t know how to provide for them.

9. Almost half of the autistic respondents who struggled in school did not have an academic learning difficulty.

10. Most autistic respondents were strongly against ABA (Applied Behavioral Analysis therapy) for children.

11. Autistic respondents strongly believed that autism awareness focused too much on children.

While we don’t have data on autistic trans students in Aotearoa, we know that 23% of trans students experience weekly (or more frequent) bullying in schools, while this is experienced by just 5% of their cisgender counterparts. We also know that this bullying is often not addressed appropriately, and not dealt with effectively. There are schools which make it difficult for trans students to attend; including not providing bathrooms, insisting on inappropriate clothing (eg. wrong gender uniforms), and not making school content relevant for them (eg. sex education teaching only about cisgender boys and girls). We also know anecdotally that bullying and accessibility issues are common for autistic young people. We believe there is crossover here.

Applied Behavioral Analysis therapy on children is considered by many to be analogous with conversion therapy. It focuses on teaching autistic people to “not act autistic” through rewards and punishment. It has been alarmingly popular with non-autistic people for a long time, but autistic adults are now speaking out against it.

“The stated end goal of ABA is an autistic child who is ‘indistinguishable from their peers’—an autistic child who can pass as neurotypical. We don’t think that’s an acceptable goal. The end goal of all services, supports, interventions, and therapies an autistic child receives should be to support them in growing up into an autistic adult who is happy, healthy, and living a self-determined life.” – Autistic Self Advocacy Network.

ABA for children

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“Curing autism”

12. 72% of autistic respondents would not take a “cure for autism” if one existed, and 14% said they would. Of non-verbal and selective mute autistic respondents, 75% said they would not take a “cure”, and 12% said they would. 69% of autistic respondents with learning difficulties said they would not take the “cure”, and 16% said they would.

13. 34% of non-autistic respondents said they would not give a “cure” to an autistic relative, and 41% said they would.

14. Respondents who had a positive association with autism – as represented by those who selected “awesomeness” as a characteristic of autism – were much more likely to be anti-cure, to say “autistic person”, and to be autistic (especially if they also had an autistic relative).

15. Almost three quarters of autistic respondents struggled with employment.

16. 75% of autistic respondents felt socially isolated.

Many non-autistic people believe that it would be better if autism didn’t exist. Autistic people disagree. Autistic lives are worth living, just like trans lives are worth living. Stereotypes, prejudices, and discrimination are common, but it is these things – not autism – that autistic people would rather live without.

Visual of the information presented above.

Conditions and effects

17. 60% of autistic respondents had an anxiety disorder, 42% had a Sensory Processing Disorder, 40% had depression, and 35% had ADHD, followed by digestive issues at 20%.

18. These conditions were consistently more common for non-binary autistic respondents (anxiety disorder 78%, depression 75%, ADHD 46%, digestive issues 40%). Non-binary autistic respondents had higher rates of Sensory Processing Disorders (56%) and Post Traumatic Stress Disorder (56%).

It is worth noting that male and female respondents were not separated by being transgender or cisgender, so it is possible that all transgender respondents had elevated rates of these conditions.

19. The most common effects of autism for non-binary autistic respondents were sensory issues (91%), anxiety (90%) and enthusiasm for special interests (90%).

Making environments accessible for autistic trans people means not only eliminating transphobia and providing appropriate bathrooms; but considering sensory needs, social stressors, and managing trauma triggers and responses.

Empathy

20. Respondents were asked about empathy, and options included intense empathy, lack of empathy, both, and neither. Excluding the ‘both’ responses, 58% of autistic respondents ticked ‘intense empathy’, while only 11% ticked ‘lack of empathy’.

Including those who selected ‘both’, 67% had selected intense empathy. Responses were similar across non-verbal autistic respondents and autistic respondents with learning difficulties. Of the non-autistic respondents with an autistic relative, only 22% ticked intense empathy, while 27% ticked lack of empathy, and 47% selected ‘neither’.

Autistic respondents who are both non-verbal and have learning difficulties selected 60% intense empathy, 15% lack of empathy, 14% both, and 11% neither (a total of 74% intense empathy), while respondents who were non-autistic relatives of a non-verbal autistic person with a learning difficulty selected 51% neither, 32% lack of empathy, 13% intense empathy, and 3% both.

Autistic people are vastly more likely to feel intense empathy than a lack of empathy. But non-autistic relatives are likely to believe that they don’t feel intense empathy, and almost a third believe they lack empathy.

What it means

Autistic transgender people face unique challenges, and high levels of stigma and discrimination. Families, communities, and healthcare providers must be culturally competent and work to unlearn bias against autistic people, and recognise where this bias may affect the ways they interact with the autistic trans people they come into contact with.

GMA has a number of autistic transgender staff, and hears from many dozens of autistic trans people every year, who are struggling to access gender affirming healthcare at a disproportionate rate, and who are struggling with a lack of accessibility and safety in their schools, workplaces, and home environments.

It is common for autistic people to be denied gender affirming healthcare as their gender expression may not be binary, or because they may struggle to express or parents/clinicians may struggle to understand the autistic person’s complex ideas and understandings of gender. They may believe the autistic person is unable to fully understand the consequences of transition – most often due to difficulty with communication, rather than understanding. It is essential that a transgender diagnosis should not be withheld on the basis of a patient being autistic.

Download our resource

Visual of the download available below.

Further research

Further research is needed on autistic transgender experiences. GMA advocates for more research into autistic adults’ experiences, and for this to be developed by or in collaboration with autistic researchers and autistic populations, including those who are rainbow and transgender.

Further Reading

Facebook Groups and Pages:

Autistic Spectrum New Zealand.
Autistic Not Weird.
Autistics Worldwide.
Autism Inclusivity.
Autistic Newsfeed.
The Autistic Cooperative.
Tone it Down Taupe.
Autistic Black/Indigenous/People of Color & Latinx Advocates to follow – Autistic, Typing.


Website and Articles:

Autistic Self Advocacy Network of Australia & New Zealand.
Autistic burnout, explained – Spectrum.
Reframing Autism.
Good Autistic Advocacy Organisations and Bad Autism Charities – In the Loop About Neurodiversity.
Safe Places Online for Parents of Autistic Children and Autistic People to Learn About Autism – The Autistic Advocate.
The Ableist History of the Puzzle Piece Symbol for Autism – In the Loop About Neurodiversity.
The man behind ex-gay “conversion therapy” started out trying to make autistic children “normal” – Sabastion Rubino, LGBTQ Nation.
I Self‑Diagnosed My Autism Because Nobody Else Would. Here’s Why That Needs to Change – Rakshita Shekhar.
In Silence and in Sound: Autistics Do Not Benefit From Presumptions of Deficit – Thinking Person’s Guide to Autism.
Here’s Why You Should STOP Using Functioning Labels – Planning Across The Spectrum.

Detransition or Retransition Support

Detransition or Retransition Support

What is detrainsition or retransition?

A small number of people affirm a transgender identity (sometimes referred to as “coming out of the closet”), and later realise they aren’t, or decide to affirm a cisgender identity again.

They may have a change of gender identity – affirming that a cisgender identity is the one that feels best for them, or they may simply decide to outwardly take on a cisgender identity while inwardly maintaining a transgender identity (“go back into the closet”).

Sometimes those who affirm a cisgender identity after having affirmed a transgender one are referred to as “detransitioners”, “retransitioners”, or someone who has “detransitioned” or “retransitioned”.

“People are said to retransition or detransition if they affirm a cisgender identity after affirming a transgender one. Although gender identity does tend to evolve, to some degree, throughout a person’s life, detransition is relatively rare—particularly for those who have engaged with medical or surgical gender affirmation.” Elizabeth Boskey, PhD.

What’s the difference between ‘detransition’ and ‘retransition’?

Usually “retransition” is the term that acknowledges that gender identity is a journey of exploration, and that it is possible to transition to a transgender identity or a cisgender identity multiple times.
The word “detransition” is most often used by anti-trans campaigners, who wish to stop people from accessing gender-affirming healthcare – either to affirm a transgender identity or a cisgender one.

Both words are used in this article, to help people find it when they search the internet.

No matter what kind of transition journey a person is on, it is important to have appropriate healthcare and supports.

Why do people retransition?

A 2015 survey of nearly 28,000 people, carried out by the National Center for Transgender Equality (USA), showed that 8% of respondents reported ‘detransitioning’. Of those who detransitioned, 62% said that they only detransitioned temporarily.

The most common reason for re/detransitioning was pressure from a parent.


0.4% said they detransitioned after realising that particular transgender identity didn’t feel right for them.

Conversion therapy

Conversion therapy (or transphobic bullying) by parents, schools, therapists, faith community leaders, or other adults is not OK. If you need to talk, you can get in touch with us. If you need immediate crisis support, contact a crisis line – there is one linked below. If you are experiencing pressure to retransition or detransition from a parent, GMA has resources to help your family be more supportive.

In the recent article Detransition as Conversion Therapy: A Survivor Speaks Out, a trans man and ex-detransitioner wrote:

“Ideologically motivated detransition is conversion therapy. It tries to convince trans people that our sense of self is false, that we can’t have happy or satisfying lives as trans people. I can see now that I wasted years of my life trying to fix a part of myself that was never broken and suffering needlessly in the process. I presented myself as a detransition success story but the truth is that detransitioning did not work for me and was an act of self-denial and rejection.”

Exploring genders

Exploring gender can be important, empowering, fun, and liberating. Regardless of age, the freedom to choose how one expresses their gender is an important human right. If a person explores being a different gender, and later decides it’s not for them, there is no reason why they should be made to feel shame, regret, or that there is something wrong with them.

This includes people who transition, for example, from “female” to male, then later realise they are non-binary. It’s perfectly OK to try out different genders before settling where one feels most at home.

It is healthy and OK to be whatever gender you are – whether you are transgender, or not.
You deserve to explore, express, and be yourself. There is no “wrong way” to be who you are.

Staying safe

Temporary re/detransition is relatively common, because it is so hard to be out in the world as a transgender person; due to stigma, discrimination, and violence. Many people retransition or detransition for a period of time after initially “coming out” as trans, in order to stay safe – whether this is at work, at home, or out in society generally. Most commonly, this is due to pressure from a parent. Most people who retransition or detransition eventually transition back to a trans identity when it is safe for them to do so.

Permanent retransition or detransition is much less common, but is usually also due to stigma, discrimination, and violence. International research has consistently shown that less than 1% retransition or detransition because they simply realise they were wrong about being trans.

“We can’t treat detransition as the end of person’s journey in exploring their gender identity, as many will choose to retransition [to a transgender identity] at a later point when they are safe and supported” – Stonewall UK.

Whatever the reason, respect a persons gender – it is OK to be trans, and it is OK to have tried out being trans at some point in one’s journey.

Retransition rights

Whether a person retransitions or detransitions temporarily or permanently, they deserve the same right to bodily integrity, autonomy, and accurate identity documents. GMA advocates for retransitioning people to have access to respectful and appropriate healthcare, including further hormone therapy and gender-affirming surgeries if necessary. For example, a retransitioned person who has had an oophorectomy may require estrogen therapy, and must be allowed to access this.

GMA also advocates for the ability to change the gender marker on birth certificates more than once – if a person has changed it and wants to change back, they should have the right to do so.

Bodily integrity, autonomy, and human rights are important for all people.

Social stigma

Most of the social stigma for having retransitioned is stigma for having transitioned in the first place. It is transphobia being misdirected at those who once identified as transgender, but no longer do.

All trans people and retransitioned people deserve to live free from transphobia, stigma, discrimination, and violence.

Medical regret

Research shows that the “rate of regret” for people who have undergone gender affirming medical treatments is below 1%, and is most commonly regret due a lack of support from families and communities, though some occasional (not complete) regret is due to poor surgical outcomes. (Smith, Van Goozen, Kuiper, Cohen-Kettenis 2005, M Landén, J Wålinder, G Hambert, B Lundström 1998).

One study over several decades showed 2.2% of participants experienced some form of regret for medically transitioning, however the rate of regret lessened over time, perhaps as medical procedures improved (Dhejne, Arver, Oberg, Landén 2014). However, recent longitudinal studies found that none of the participants expressed regret over medically transitioning (Krege et al. 2001, De Cuypere et al. 2006).

In a study of 22,725 patients who had undergone gender affirming surgeries, only 22 patients experienced regret on the basis of a change in gender identity. (Danker, Narayan, Bluebond-Langner, Schechter, Berli, 2018).

This study concluded that:

“Regret after gender-affirming surgery is an exceedingly rare event. Reasons for regret or detransition are diverse, ranging from change in gender identity to societal and relationship pressures to post-surgical pain. It is not uncommon for detransition to be associated with surgical complications.”

Whether a retransitioned or detransitioned person regrets past treatments or not, they deserve access to the healthcare they currently need – which may include further hormone therapy and gender affirming surgeries.

Pressure to retransition or detransition

Messaging throughout society puts pressure on young people to be the gender they were assigned at birth. This includes messaging that promotes cisgender (non-transgender) people as normal, and does not give the same positive message about transgender people.

There is also more overt transphobic messaging in many films and other media, with transgender people often portrayed in a negative light.

Many public places do not have gender-neutral bathrooms, dresses and skirts are usually designed to fit only cisgender women’s bodies, some schools refuse to let trans students wear the uniform that fits their gender, and there are sometimes pressures from healthcare providers as well, with a recent NZ study on 1,178 trans people showing that 17% of trans people had experienced conversion therapy in a healthcare setting. Trans people are routinely discriminated against in education, employment, housing, and other areas.

Fundamentalist faith based groups, anti-trans campaigners, and ultra-right (conservative extremist) groups promote misinformation aimed at frightening families into pressuring their young people to detransition.

Another article Detransition Awareness Day: Inconvenient Truths and Community Building talks about the ways that the narrative on detransition are constructed to attack transgender people and undermine retransition:

“We created a community that often encouraged people to use their trauma to attack the trans community and trans healthcare […] Transphobic radical feminists were the first to use detrans women. Later on transphobic parent groups, conversion therapists, right-wing Christians and other anti-trans groups would also seek to harness detrans women.

“Transphobic people latch onto to detrans people because to them detrans people are proof that transitioning and living as a trans person is harmful. Therefore they have an investment in detransitioned people’s suffering rather than their healing and happiness. They have an investment in detrans people viewing transition as “irreversible damage”. If a person harmed by medical transition can get all that they need to heal and have a good life, they are no longer so useful in proving the inherent harms of transition. Rather, they show that the problem is access to resources and competent medical treatment.

There is so much pressure – both political and personal – to retransition or detransition. But whatever the reason for retransitioning or detransitioning, the supports needed by the individual are very similar to the supports needed by those transitioning to a transgender identity: access to appropriate medical care, accurate identity documents, and the freedom to express their gender however they see fit.

Get support

If you are struggling with gender, being pressured to retransition or detransition, or are unable to access gender affirming retransition or detransition medical care and need information or support, get in touch with us.

We support your right – no matter what the reason – to retransition or detransition, and to have access to appropriate medical care, identification documents, and support.

References:
Signs of an unhealthy relationship dynamic

Signs of an unhealthy relationship dynamic

Sometimes our relationships have dynamics which are unhealthy, harmful, or even abusive. This article talks about signs that something may not be working, identifying unhealthy dynamics in a relationship, and dealing with common scenarios for trans people.

It touches on working through some issues, or leaving a relationship which may be difficult or dangerous to leave. There are also links to some of our other resources to help you talk through problems and change behaviors, and resources to help you safely leave a dangerous situation.

Keep reading online, or download the PDF version

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Признаки нездоровых отношений – Russian translation

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Signs of unhealthy dynamics

Physical safety

  • Pulling your hair, grabbing, pushing, restraining, kicking, pinching, choking, or hurting you in any way.
  • Shouting at you, calling you names, breaking things, making you feel afraid for your safety.
  • Preventing you from leaving – for example blocking the doorway, taking your keys.

Psychological, emotional, and spiritual safety

  • Treating you differently because they are upset, but refusing to tell you why.
  • Overwriting your emotions or perceptions: convincing you that you feel the way they want you to feel, or that you want what they want, or that you agree with their version of events.
  • Saying cryptic things to keep you guessing what they mean and feeling uncertain.
  • Insisting that you trust them completely regardless of whether they have earned that trust or repeatedly broken your trust.
  • Refusing to let you talk about your emotions when you need to.
  • Insisting that you must always talk about your emotions when they want you to.
  • Taking their moods out on you – it is OK to have big emotions but we can choose how we express them.
  • Blaming you for all the problems in the relationship.
  • Telling you not to speak to anyone about your relationship, or becoming angry when you do.
  • Telling you that you’re hard to love, bad at life, or not a valuable person.
  • Invalidating your lived experience, including denying gender based discrimination against you, systems which disadvantage you, and social dynamics which harm you.
  • Undermining or disrespecting your culture, refusing to acknowledge important cultural practices, laughing at your religion, culture, or language, saying their culture is more normal or better than yours. Making you feel ashamed or bad about your culture, or removing your access to your culture and your people.

Sexual safety

  • Attempting to be sexual with you when you are angry at them, trying to avoid talking about your feelings by distracting you with sex, or minimising your anger by saying they feel sexual towards you when you’re angry.
  • Attempting to be sexual with you when you’re sad, upset, or triggered (experiencing associations or flashbacks to traumatic events).
  • Forcing or pressuring you to be sexual in any way, hurting, humiliating, or otherwise harming you during sex (without your consent).

General control

  • Extreme jealousy or possessiveness.
  • Constant accusations of flirting or cheating.
  • Sulking, avoiding, and passive aggressive tactics.
  • Saying that you look “too sexy”, or getting angry at you when other people look at you.
  • Telling you the clothes/hair/makeup you choose look bad and pressuring you to look a certain way.
  • Using your insecurities about your body or gender presentation to make you feel less confident and more reliant on them.
  • Excessive demands to tell them where you are, what you’re doing, or how you’re feeling.
  • Telling you to stay away from your friends or getting upset when you spend time with your friends or family.
  • Making you stay up all night when you need sleep – whether it’s to talk, to have sex, to party, or for any reason.
  • Criticizing or controlling your food and eating habits.
  • Taking photographs or film footage of you against your wishes, or using your image in ways you didn’t agree to – for example posting your nude photographs on social media.

Making you responsible for them

  • Insisting that it’s you who takes care of them whenever they need support.
  • Accusing you of abandoning them whenever you leave them alone.
  • Saying they will hurt themself because of you or if you don’t do what they want.
  • Blaming you for their bad behavior – ”look at what you made me do” and ”I wouldn’t have had to do X if you hadn’t done Y’‘.

Controlling, disrespecting, or harming a partner are signs of unhealthy relationship dynamics. You can find resources to help make a relationship healthier here.

Common scenarios

My partner wants to keep our relationship a secret

Many cisgender people who have attractions to transgender people are in denial about their attractions. They may be upset with their partner or with themself for their attraction. They may not want people to know about their attraction or their relationship.

It is important to remember that there is nothing shameful about love, that we are normal people, and that we deserve the same care and attention as any other partner.

If your partner respects you as a person, they should be willing to stand up against transmisogyny, transphobia, and other prejudices, and to support you 100%.

Accepting you and loving you will mean that they also have to work on themself – if they have any shame about dating you they will need to work through it and understand that there is nothing wrong with loving you, and nothing to be ashamed about. That way they can stand up against others who put them or you down.

If I have genital surgery my partner will leave – they’re just not into vaginas/penises

While some people have strong feelings about the genitals of their partners, this type of thinking reduces our attractions to being exclusively about genitals.

If your partner loves you for more than just your genitals, they should support you to decide what is best for yourself, even if it will take some getting used to for them. No one will be more affected by the decision to have or not have surgeries than you will.

Your partner should listen to you when you need to talk about the possibilities and not try to influence your decision either way. They should respect that it is your body and your choice, and should not pressure you or threaten to leave you if you’re thinking about changing your genitals.

My partner doesn’t like me talking about problems in our relationship to other people

If someone is being controlling in a relationship, it’s common for them to tell their partner not to talk with anyone else about problems in the relationship.

Often they are afraid that others will disapprove of their behaviors, or advise you to leave the relationship. They might say your friends will be judgemental, or interfering, or they might say it’s their own personal business and it would be disrespectful for you to talk with anyone else about it.

Talking is so important; it can help you work out what you need, and what you want to do next.

If your partner cares about you, they should be happy for you to talk about relationship problems, and work out how to fix or change the things that make you unhappy.
Talking doesn’t mean that you have to leave the relationship.

There are some people who have a legal obligation to share certain kinds of information if they think a person is in danger – these people may include a counselor or teacher, so ask if this is the case and find out what kinds of things they would be required to share. It is always OK to say ‘I’m not ready to talk about that with you yet’.

My partner gets really upset and then we have to talk for hours until they’re happy with the outcome. I end up going along with them just to end the fight

Talking can be important and healthy, but if you are cornered in a room and you can’t leave that’s not OK. If you’re being kept up all night when you need to sleep that’s not OK. If your partner forces you to talk when you can’t that’s not OK.

In some situations it can help to say that you care but you can’t talk right now. Give a concrete time when you will sit down and talk with them and an amount of time you can agree on for the conversation.

“Jay, I love you and I totally care about this, but right now I need to sleep.  We can give this proper attention tomorrow. I will come over after work at 5pm and we’ll sit down and talk about it until 7pm.’’

Sometimes it may help to show that you intend to still be in their life at the end of the conversation too, even if the issue can’t be sorted immediately.

‘’After we talk maybe we can have dinner together if we feel like it? Then I’m going to have to leave about 8pm so I can get things ready for work the next day, and sleep at my place. We can make another time for more talks too if we don’t work it all out tomorrow’’



If your partner is preventing you from leaving, you may be able to say you need to use the bathroom, and then call a friend or the police from your mobile phone. You may have to pretend to agree to your partner’s demands so you can leave and get to somewhere safe before you seek support.

I’m afraid my partner will hurt me when they find out I’m leaving

It is very common that abusive behaviors will intensify and escalate as you prepare to leave a relationship and your partner has less control over you. Leaving is the most dangerous time for someone in an abusive relationship.

Physical and sexual violence, kidnapping children, destruction of important documents, property damage, and counter claims of abuse are common at this point. These fears are very real.

We recommend that you build your support systems, make safety plans, and potentially seek legal protections, as discussed below.

Counter claims: I’m a trans woman, and I’m afraid that my cis woman or transmasculine partner might cut off my support by saying I abused her/them

When you start to speak out against abuse by your partner, it is common for your partner to make a counter accusation that the abuse happened the other way around.

Counter accusations are often an attempt to influence mutual friends, to limit the support being offered to you, and to allow the accused partner to maintain control over your life in some way, even after the relationship has ended.

Sometimes, if your partner has experienced abuse in the past, this can also be a way of maintaining their identity as a victim or survivor of abuse, as some people believe that a person who has been a victim or survivor of abuse is not capable of abusing others.

Because of transmisogyny, trans women are often in a double bind – being treated with misogyny as women, but also being considered to embody the worst of male violence. If they are counter accused of abuse they can be in an extremely difficult situation with very little support, particularly if the person counter-accusing them is a cisgender woman or a transmasculine person (who was assigned “female” at birth).

Patriarchal societies support men who counter accuse any woman (“she’s crazy /a control freak”). Some women’s support groups and agencies discriminate against trans women, or hold transmisogynist views which may privilege support for those assigned “female” at birth (“she’s *really* a man/male brain/socialised male”, “penis = patriarchy/rape”, or other transmisogynist arguments that frame trans women as being men).

Many friendship, school, and social groups, as well as rainbow, queer, and feminist communities, are all too ready to believe that trans women are secretly violent predators, despite evidence to the contrary.

Keep a record – gather any evidence of your partner abusing you, and have a support crew who can help you through this. See the section below on preparing to leave.

I don’t think I can find someone better who will love me

Society is full of negative messages about trans people, and at times it can be very difficult not to believe these about ourselves in some way.

The truth is, each of us is unique, and beautiful, and lovable. We all deserve healthy relationships with people who respect us. Sometimes it takes a long time, and many relationships which don’t work out, before we figure out how to have healthy relationships – even with ourselves.

Consider the advice you would give to a friend – you don’t deserve abuse, you deserve respect, kindness, and love. You are awesome, and along life’s journeys you will meet people who recognise that too.

My partner is heterosexual, gay, or a lesbian, they won’t be attracted to me if I start to transition

For people who identify as exclusively attracted to one gender, sometimes it can be especially difficult to accept that their partner is a different gender than they first thought.

This can be especially challenging if your partner’s gender and sexual orientation are one identity (for example ‘lesbian’ implies their gender as a woman as well as their attraction toward women).

It can be important that they realise that your gender hasn’t suddenly changed – even if you have recently come out about your true gender, chances are you have felt that way for a long time. Transitioning doesn’t mean they suddenly love someone of a different gender – you may have been trans the whole time, even if you didn’t always know it or you weren’t always talking about it.

If they are worried, it may help for them to talk with other partners of trans people, or to read things written by the partners of trans people as well as by trans people themselves.

It is not OK for your partner to:
a) accuse you of tricking them into sleeping with someone of the ‘wrong’ gender for them.
b) take, hide, or dispose of your hormones, makeup, binder, or other transition aides.
c) undermine your decision to transition.

Sometimes, especially in the case of medical transition, we do change in ways that are incompatible with existing relationships. Changing hormones can change the way we smell, how sensitive our skin is, how interested we are in being sexual, we may feel different, the ways that we like to be intimate may change, we may start to want different things in our lives.

It is not abusive to admit that one is no longer sexually attracted to their partner, but it is important that you can both talk about your feelings respectfully and in caring and constructive ways.

Society stigmatises me and stereotypes me as ‘probably not a suitable parent’. If I leave my partner, I’m afraid I’ll lose my children.

Many transgender parents hold deep fears that their children will be taken from them by the courts. This is especially so for trans folks who are poor, those on social welfare, Māori, Pasefika, and other people of colour, migrants, refugees, people who use drugs, people living with HIV, disabled people, people who are living in substandard housing, sex workers, people who are neurodiverse or who have mental health or developmental conditions, and people who have a criminal record or a history with the justice system.

Generally speaking, the courts prefer to leave children with their parent rather than placing them in state care, so long as the children are in a violence-free, safe, and secure home, they are warm, fed, clothed, and attending school if they are school age. These will also be factors in shared-care situations, as most family courts will prefer that both parents are involved. It can be more complicated for parents who aren’t legal guardians – you can get more info on this in the links below.

Without a doubt there are huge amounts of stigma and discrimination against marginalised people, but when it comes to caring for children it is in the interest of the state to leave them at home if it is safe to do so.

If the other parent may try to stop you spending time with your children, you can seek legal advice. Community Law have a fantastic guide to child custody, The Community Law Manual, and can offer you free advice.

Difficult decisions

If you’re experiencing unhealthy or abusive relationship dynamics, and your partner is not prepared to change or if you need to get out, some things you might want to think about include support systems, safety plans, and potentially legal protections.

It is always important to remember that we have choices in how we behave, and that we have a responsibility to recognise and change our own abusive behaviors. No matter what past experiences a person has been through, they can still choose to not abuse you, and you do not have to stay in a relationship which is not working for you.

My relationship is unhealthy but I want to stay with my partner

You may feel pressured by your partner, friends, family, or others to stay in the relationship and ‘get on with it’, or to ‘hurry up and leave already’. Ultimately the decision to stay or leave must be your own.

An unhealthy relationship can sometimes improve with time and effort from everyone. It is important to recognise that you can only change your own behavior, and only your partner can change theirs, so it is essential that you both recognise what is unhealthy in your relationship and make a commitment to changing your own behaviors.

Discussing the above relationship pointers, or some of our other relationship resources with your partner might be a good place to start.

Some people find that using active listening can help to clarify situations and facilitate understanding each other’s perspective.

You could also seek support from friends, family, and whānau, relationship counseling, or elsewhere. This can be especially difficult for those whose relationships are less conventional or more stigmatised (such as open relationships), as there are often no examples or blueprints on how to have healthy relationships or deal with unhealthy things which may be happening. There are resources linked below.

With time and work, many relationships can improve and become healthy and happy. Other times, people reach a point where they know that they are not happy in the relationship, or are happier when their partner isn’t around. If you decide to leave, there is advice below for safely leaving a scary or abusive situation.

My relationship is unhealthy and I’m over it: preparing to leave

If you are leaving a healthy relationship, it’s likely you can have a good conversation and talk about how you are feeling and why you want to end the relationship. Breakups are still hard, but people who are in a healthy relationship can usually also have a healthy mutual breakup.

However, if the relationship is unhealthy or abusive, it may be very difficult to end it amicably. Your partner may not accept that you want to end the relationship: they may try to make you feel guilty, afraid to leave, or worried that they will not cope. They may even threaten to hurt you, your loved ones, or themself. Even if they do not accept that the relationship is ending, you do not have to stay in the relationship.

It can help to keep the conversation direct, factual, non blaming, and future focused – telling them you are unhappy, you no longer want to be in this relationship, and that you are leaving. They may want to argue specific reasons or examples of them behaving badly, convince you that you were the one who behaved badly, or promise they will change.  These are tactics to control you and stop you leaving. You do not need to be drawn into this. You can leave whenever you are ready.

Getting support

There are many organisations that can help with sexual violence, leaving abusive situations, and staying safe. You can find some of these on the TOAH-NNEST national database, and there are others listed below.

Online Resources

Gender Minorities Aotearoa
https://genderminorities.com/find-transgender-info-services/resources/sex-and-relationships/

Love is Respect
http://www.loveisrespect.org

The Northwest Network of Bisexual, Trans, Lesbian & Gay Survivors of Abuse
www.nwnetwork.org

Are you OK?
http://areyouok.org.nz/

Trauma Pages
http://www.trauma-pages.com/s/t-facts.php

Organisations which can provide crisis support, information on your legal rights, or support you in other ways.


Te Haika – Crisis Support Line
https://www.mhaids.health.nz/our-services/do-you-or-does-someone-you-know-need-help-now/

Otipoti Collective Against Sexual Abuse (OCASA)
https://www.ocasa.org.nz/

Te Kupenga Whakaoti Mahi Patunga – National Network of Stopping Violence
http://www.nnsvs.org.nz/contact/north-island

OutLine
http://www.outline.org.nz/

Shakti Migrant Women’s Refuge
http://shakti-international.org/shakti-nz/help-nz/

SHAMA – National Ethnic Response for Sexual Harm
https://shama.org.nz/how-we-help/national-response-for-sexual-harm/

Women’s Refuge
https://womensrefuge.org.nz/domestic-violence/

Rape Crisis
http://www.rapecrisisnz.org.nz/

Te Ohaakii a Hine – National Network Ending Sexual Violence Together (TOAH-NNEST)
http://toah-nnest.org.nz/

NZPC: Sex Workers’ Collective
http://www.nzpc.org.nz/

Community Law Centres
http://communitylaw.org.nz/

Victim Support
http://www.victimsupport.org.nz/get-help/support-after-sexual-violence-or-family-violence/

LifeLine
http://www.lifeline.org.nz/corp_Home_378_2001.aspx

Whats Up?
http://www.whatsup.co.nz/

Shine
http://www.2shine.org.nz/

Government Agencies

The New Zealand Police
http://www.police.govt.nz/advice/family-violence/help
http://www.police.govt.nz/contact-us/local-contacts/diversity-liaison-officers
https://www.police.govt.nz/advice-services/sexual-assault-and-consent/understanding-sexual-assault-and-consent

Oranga Tamariki | Ministry for Children (Child, Youth, and Family Services/CYFS)
http://www.cyf.govt.nz/keeping-kids-safe/

Family Services Directory
https://www.familyservices.govt.nz/directory/

Family Justice
http://www.justice.govt.nz/family-justice
http://www.justice.govt.nz/family-justice/domestic-violence

How to hide your visit to a website

http://www.justice.govt.nz/family-justice/domestic-violence/hide-your-visit

Find more information on sex and relationships for trans people

Thank you to our sponsors

This resource was developed with support from International Trans Fund, and Wellington City Council.

Dating a Trans Person 101: Respect

Dating a Trans Person 101: Respect

Respect looks different to each person, and the things that feel respectful to one person may feel disrespectful to another. Use these tips to start a conversation about respect.

PDF version – read online or download

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Respect your partners gender and sex characteristics

Always use the name and pronouns they choose, and never say they’re not a ”real” woman, man, or trans person for any reason – including the way they dress, the name they use, their hobbies, their attractions or sexual orientation, the ways that they like to have sex or not have sex, or what you imagine life was like for them growing up. Even if you’re really angry at them; criticise the behavior you’re upset about, never invalidate their gender.

Respect your partners body

Respect their body, including the words they use to talk about it, and their choice to take or not take hormones and have surgeries or other medical treatments. Respect their right to make contraceptive and reproductive choices, and to use protection against STIs and HIV. Respect their ‘no’ if they don’t want to use alcohol and other drugs, or be around drug use if they struggle with it. Respect their mobility, hearing, seeing, and sensory or other accessibility needs.

Respect your partners sexual boundaries

Respect their boundaries, including the ways they are comfortable with being touched or not being touched, and sexual activities they don’t want to do or times they don’t want to do them. Sometimes you might feel rejected if they say no to cuddles, sharing a bed, or hooking up, but pressuring them will only make them feel that you don’t care what they want. Show them how much you love them by never manipulating them into sex or other kinds of affection.

Respect your partners autonomy

Respect their ability to make decisions for themself about the daily things they need in their life. This includes decisions about when and where they sleep, what and how much they eat, needing time to be alone, and not always being the person to take care of your emotional or other needs. Respect them as a whole person; accept responsibility for your share of the child care or house work and do not treat them as an extension of yourself. Don’t expect them to fulfill your ideals or fantasies of what someone of their gender, or someone with their sex characteristics, should do.

Respect your partners other relationships

Respect their other relationships, including with whānau, friends, kids, other partners, and ex-partners who they are friends or family with. It’s healthy for your partner to spend time with other people they care about, and sometimes they need to spend time alone too. It can be scary learning to trust, but controlling them just means pushing them to make a choice between you, and everyone else they care about. Even if they choose you in the moment, no one can can choose that in the long run. Don’t push them away by isolating them from others.

Respect your partners safety

Don’t put them in dangerous situations such as drinking and driving, or going places they will be exposed to transphobia or other harm.

Respect your partners emotions, mental health, neurodiversity, and wairua or life force

Be honest with them, make time to talk with them about things that are important to them, have patience to work through difficult emotions without blaming them, putting them down, or becoming abusive, accept responsibility for your own emotions and actions, and only expect them to take responsibility for theirs.

Respect your partners economic situation

Respect their economic situation, including their choice to do sex work or to not do sex work, do not prevent them from working or take their money or expect them to pay for your expenses. If they have work or study the next day they can’t stay up all night, so letting them sleep is part of supporting their economic situation.

Respect their privacy

Don’t tell other people personal information about their sex characteristics and/or gender, their body, their HIV status, or the ways they have sex or don’t have sex. Don’t share their private photos, videos, or messages. Do not insist that they share with you the intimate details of their past sexual experiences. Don’t insist on knowing their passwords, reading their email, or having access to their social media.

Respect their culture

Respect their whakapapa, their people, their language, their values, their spiritual or religious practice, and the land they’re from. Respect the histories of their people, and the ways in which gender and sex characteristics might be thought about differently than in your own culture. A healthy relationship has room for difference and can celebrate each others diversity.

Thank you to our sponsors

This resource was developed with support from International Trans Fund, and Wellington City Council.

Learn more about healthy relationships with transgender partners