Israel (2004) suggests that in order to determine what is going on with a client and their family, one simply just needs to ask. Including both the spouse and the transgender partner in all aspects of care is important, and in the Thematic Analysis by Bischof et al., (2011) they offer the idea of using the Trans-formative Therapeutic Model as a nursing approach to working with a spouses with a transgender partner. This model “supports the partner in conjunction with the transgender loved one as a cohesive and dynamic systemic unit” (p.18). It allows the couple to make joint decisions regarding their marriage and future as a team. “An emphasis should be placed upon shared decision-making and respect for the views of all involved (Bischof et
