• diversity;
  • psychosexual difficulties;
  • qualitative methodology;
  • sexuality;
  • women's issues

Accessible summary

  • • 
    Healthcare providers are in a privileged position to counsel and offer resources to patients who identify as sexually or gender-diverse, or who are in relationships with sexually or gender-diverse persons. To optimize health outcomes in these persons, a call has been made to increase providers' awareness of sexually diverse populations.
  • • 
    This research builds upon existing knowledge on female sexuality through its examination of female sexuality in relationships in which one partner discloses as male-to-female transsexual.
  • • 
    Sexual and relational orientation can be fluid, and can evolve within a relationship. Females partnered with male-to-female transsexual persons reported reforming their sexual relations with their partners. They reported maintaining a heterosexual identity, yet reconceptualizing their relationships and sexuality to be situation-dependent. For example, language such as ‘situational lesbian’ was reported. The study findings also demonstrate that female sexuality within these relationships can range from cessation of sexual relations to a continuation of relations without disruption.
  • • 
    Healthcare providers need to be aware of fluidity and diversity among sexuality and relationships, and allow for expression of an expansive range of relationships and/or sexual activity.


This paper reports on a study examining sexuality in females who remain partnered with male-to-female transsexual persons. Participants' self-view and sexual fluidity following their partners' transition from man to woman is examined. Sixteen females participated in in-depth, semi-structured interviews. An inductive process of data analysis was conducted, using the constant comparative method, an iterative process by which data are compared within and across subjects. Data were collected until thematic saturation was achieved. Four themes related to sexuality emerged: (1) questioning of sexual orientation; (2) sexual orientation categorization; (3) relational fluidity without sexual relations; and (4) relational fluidity with sexual relations. Participants maintained a heterosexual identity, yet modified their self-view to include an identity that reflected their reformed relationship. The majority of the respondents reported sexual lives that were active or evolving. Others remained in relationships that no longer included sexual activity. The study findings highlight the potential fluidity within the sexual and relational lives of females, and can enhance healthcare providers' preparedness and efficacy with diverse populations. Providers are in a unique position to offer resources to patients who identify as sexually or gender-diverse, or who are in relationships with sexually or gender-diverse persons.