“I Can Now Share My Heartbeat with People”: Wholeness, Belonging, and Intergenerational Responsibility Among Post-Surgical Trans Masculine Adults

Background and Purpose

Post-surgical trans masculine adults remain among the most under-researched populations in social work and health sciences. Dominant frameworks have mapped the toll of minority stress¹ yet left largely unexamined what trans people actively do to construct wholeness, sustain belonging, and transmit resilience across generations.² As legislative attacks dismantle trans community infrastructure, understanding what sustains trans flourishing carries democratic urgency. Two frameworks anchor the analysis: Weston’s families of choice,³ establishing the kinship logic of chosen community, and Fricker’s epistemic justice framework,⁴ naming what is lost when survival knowledge is suppressed. This study examines how post-surgical trans masculine adults define and experience wholeness, belonging, masculinity, and spirituality, and how intergenerational connection shapes those experiences. The research team is entirely queer. Shared identity between researchers and participants produced disclosure participants described as rare, transforming interviews into cross-generational dialogue outsider research cannot replicate.

Methods

Semi-structured interviews (n=25, data collection complete) were conducted with trans masculine adults aged 18 and older, who had undergone at least one gender-affirming surgery. The sample spans Black, Latinx, Asian, White, Filipino, mixed-race, and white participants, and people who navigated transition across multiple national healthcare systems. Recruitment used purposive and snowball sampling. Five domains were explored: post-surgical wholeness; belonging; masculinity; spirituality; and intergenerational connection. Analysis followed Charmaz’s constructivist grounded theory⁵ through initial and focused coding, constant comparative analysis, and reflexive memoing.

Results

Five findings emerged. First, wholeness is described as eradication of a prior split between self and body: gender-affirming surgery “reduced the latency between myself and my body. I can now share my heartbeat with people.” Others named it peace, presence, or relief from constant self-editing. Second, belonging is defined not as visibility but as its inverse: “an absence of performativeness that is expected of you.” Third, chosen families and trans networks are primary sites of belonging, spiritual grounding, and masculine identity formation; shared storytelling, ritualized welcome, and reciprocal community care are constitutive of belonging, not consolatory responses to family rejection. Fourth, spirituality emerges as a meaning-making thread organized around authentic selfhood, from cosmic energy and religious conversion to music and creative practice. Fifth, participants describe a felt obligation to pass survival knowledge to younger trans people, naming this communal duty rather than choice; this holds among participants in their late 20s, establishing experiential tenure, not age, as constitutive of trans elderhood.

Conclusions and Implications

Social work cannot claim democratic commitments while standing silent as entire communities of queer and trans people are destroyed. Intergenerational trans networks are the architecture through which trans resilience is transmitted; settings that ignore them replicate the conditions of erasure this research documents. Intersectional diversity across the sample reveals layered marginalization within LGBTQ+ spaces, including the isolation of trans masculine people and those navigating multi-country systems. Findings require structured intergenerational mentorship as a clinical standard in trans-affirming practice. Implications extend to aging services, community programming, and policy advocacy protecting LGBTQ+ intergenerational spaces as conditions of democratic health and societal flourishing.