Negotiating Intimacy Before and After Gender Affirmation: Relational Agency in Transgender Adults’ Couple and Family Lives

This study examines how transgender adults in Italy negotiate intimate relationships before and after gender affirmation, with particular attention to couple and family processes. Existing research has often framed transgender intimacy in terms of minority stress and vulnerability or as an outcome of individual authenticity. While these perspectives offer important insights, they may underemphasize the relational processes through which intimacy is negotiated across interconnected systems. Drawing on written narratives from 98 transgender adults, we conducted a constructionist thematic analysis of participants’ accounts of couple experiences prior to coming out and following gender affirmation. Findings suggest that, before affirmation, intimacy was frequently experienced as unavailable, uncomfortable, or unsustainable within cisnormative relational and family scripts. After affirmation, participants described expanded possibilities for intimacy, alongside ongoing challenges involving disclosure, fear of rejection, embodiment, and the renegotiation of gendered expectations. These processes extended beyond the couple, involving families of origin and broader social networks that shaped recognition, belonging, and relational continuity. The concept of relational agency is proposed as an interpretative lens to understand how transgender individuals actively negotiate intimacy within—and sometimes in the absence of—viable relational positions. The findings highlight gender affirmation as a relational and family transition that involves shifts in roles, boundaries, and forms of recognition across systems. Implications for family and couple counseling include supporting disclosure processes, navigating relational loss and reconfiguration, and addressing structural conditions that may limit access to sustainable intimate relationships.