This study is a grounded theory study of the sexual identity development of 11 female-to-male (FTM) transgender people. Data collection included semistructured interviews with participants. A three-member research team conducted axial and selective coding to identify salient interactions between participants’ gender identity and sexual identity development. A model of these interactions is provided, in addition to thick descriptions of participant voices. The model describes the antecedents and consequences of sexual identity development. This includes the interactions between sexual identity and gender identity. Implications for research and theory are discussed.