This article explores an Illinois domestic relations case in which a father (who had undergone sexual reassignment surgery to remove his internal female organs, and obtained an amended birth certificate changing his legal sex from female to male) was denied custody of the couple’s children based on the court’s ruling that the marriage was invalid. The court reasoned that because the father still had external female genitalia at the time of marriage, it was a same-sex marriage, and therefore invalid under Illinois law. The authors argue (consistent with a decision from the European Court of Human Rights) that “gender identity, public persona, hormone levels, and medical and psychiatric diagnoses” taken as a whole would be a better legal determinant of sex than “what physical genitalia a person has between his or her legs.” The authors further argue that “the law should not require complex surgery for a female-to-male transsexual.”

Expanding on the common trope that marriage is one-man-one-woman, the author notes that its full expression is "one male, who has all the biological and psychological characteristics of a male, and one female, who has all the biological and psychological characteristics of a female." The effects of the Massachusetts decision that included gay couples into full marriage protections, Goodridge v. Dept. of Pub. Health, 440 Mass. 309 (2003), were denied to nonresidents from states where such marriages would be invalid under a 1913 law upheld by Cote-Whitacre v. Dept. of Pub. Health, 446 Mass. 350 (2006). Kajstura suspects that because the "Cote-Whitacre opinion lists some barriers to marriage in other states--including the fact that a couple is of the same sex--but...does not appear to specifically contemplate the effects of sex determination by home states," the outcome for transgendered persons is that they "may have more obstacles to marriage now then before Massachusetts allowed same-sex marriage."

Transgender youth face a number of obstacles when considering their options for transitioning. The author reviews some of the legal variables associated with the three scenarios of parental agreement, parental disagreement between themselves about transitioning, and when both parents oppose the process. While this discussion may not be as in-depth as some would like, it can serve as an accessible means to frame one's deeper investigation of the issues.

Writing from her perspective as a practitioner specializing in the issues surrounding domestic violence in LGBT relationships, the author examines the topic from the state-specific viewpoint of New York. Finding that the lack of legal recognition of same-sex couples "hinders LGBT survivors from protecting themselves from domestic violence and its effects," and that whatever "fragmented relief" that is therefore available is "neither efficient nor effective" and is not without consequences for the victims, she advocates for more "holistic legislation" to redress the shortcomings.