The transgender literature dealing with couple and family dynamics is limited. Married couples with a transgender partner who wish to remain together have minimal information available and few models about how this type of transition might be negotiated. This qualitative study analyzed fourteen cases of the wives of male-to-female (MTF) transsexuals from Virginia Erhardt’s 2007 book, Head over Heels: Wives Who Stay with Cross-Dressers and Transsexuals. The authors used thematic analysis (Braun & Clarke, 2006) to identify and organize key themes in the experiences of wives who stayed with MTF transsexual partners. Themes clustered in three main areas: 1) Intrapersonal, 2) Couple Relationship, and 3) Family and Social Relationships. Conclusions from this study and implications for human service professionals are offered.