Transition Through 5 Stages of Grief and Loss.


Gender transition is an individualized process and each person goes through it differently. The process carries along with it many feelings. Grief and loss, being one of them.

Some people would say feelings of grief or loss are not associated with transition. After all, why would you grief your old self, the self that doesn’t resonate with who you are.

But what if the feelings of grief and loss go deeper than your sense of Self? Transition offers an opportunity to be your true Self at a costly price of claiming that which you value. Family. Friends. Your career. Financial income and stability. Health. The life created up to that point. Home. Memories. Relationships. Opportunities.

The list is endless and varies drastically for each individual. But the losses are there. And where there is loss, the grief follows. They are inseparable. And like to mingle together.

Working with transgender and gender diverse people, I have observed a pattern of grief and loss during gender transition. A pattern very similar if not identical to the five stages of grief and loss model.

Studying terminally ill patients who were dying, a Swiss psychiatrist, Elisabeth Kubler-Ross, introduced her five stage grief model in her 1969 book On Death and Dying. The five stages of grief and loss are: Denial and isolation; Anger; Bargaining; Depression; and Acceptance.

It is important to note that these stages are not linear. And not everyone goes through all five stages. I have observed some undergo two stages rather than all five, one stage, or just three.

But the stages are there. At least, in my professional experience of working with transgender and gender diverse people. One doesn’t have to go through terminal illness to experience feelings of grief and loss. Transition alone elicits these feelings.

Here are the stages of grief and loss seen through gender transition. Please keep in mind that we all grief differently. The key to understanding the stages is not to feel like you must go through every one of them.

Instead, I encourage you to look at them as guides in the grieving process. To help you understand where you might be in the process.


Often the first reaction to learning about your gender identity is to deny the reality of your authentic Self. “I am not trans,” “This is only a phase I am going through,” “It’s just a sexual fetish,” are common thoughts.

Denial is a common defense mechanism. Buffering the immediate shock of the truth. Numbing our emotions. For some, denial can last for a few months. For others decades.

Denial often leads to isolation. Withdrawal from our loved ones. Part of us wants to retreat and hide. For many, this stage is temporary and carries them through the first wave of pain.


As one confronts denial, reality and its pain re-emerge. “I am not ready to transition,” “Why me?,” “I hate my life,” are common feelings. The anger is often aimed at ourselves. It can also be aimed at family, friends, strangers, society, the world you live in.

Anger brings up feelings of shame. Feelings of inadequacy. As if there is something wrong with you.


As anger settles in, one often begins feeling helplessness. This leads to a need to regain control through a series of “if only” statements.

“If only I transitioned sooner,” “If only my parents took me to see a therapist when I was younger,” “If only I had words to describe who I am when I was a child,” “If only I can continue to secretly cross dress.”

All in an attempt to bargain. Guilt often accompanies bargaining. One starts to believe they are responsible for feeling this way. That they are responsible for how their partners or children feel about their transition.


Sadness follows. One begins to feel hopeless and helpless. Worry about potential losses that come with gender transition take over. Duration and intensity of depression will vary from person to person. Usually one begins to feel much better once they start gender transition.


The most difficult stage to achieve for many. To be able to accept who you truly are and make peace with yourself. Acceptance often comes in a form of claiming your true Self. The claiming may not be the happiest period for many. It an essential aspect of acceptance offering a feeling of an inner resolution of peace.