Just one small change and the system was affected. Perhaps the system most impacted by transsexualism is the family system. I have worked with couples who want to stay together through the transition. It is incredibly difficult on the nontranssexual spouse to deal with the massive changes happening in the relationship as the transition proceeds. The practical and legal implications alone are staggering.
Divorce is inevitable as a legal requirement.
Same-sex marriages are not legal in any state thus health insurance coverage, social security benefits, tax exemptions etc. are all endangered by this change. If intimacy is desired after transition, it means the nontranssexual spouse has to change his or her sexual orientation. With children involved the systemic impact is even greater. As a counselor, you will need to be aware of the impact of the transsexual on the various social systems in her life as well as how those systems affect the individual. For instance, what happens if, as often happens, the individual is completely disowned by her family.