The RLE requirement is rubbish

[MadelineB]

In the WPATH standards of care, RLE is absolutely not a requirement for anything, except in most cases for genital surgery. There are some primitive health care systems still around that endanger transitioning individuals by requiring RLE before hormones, but it is a cruel and medically contra-indicated practice.

The only requirement in the standards of care for hormones is a letter to the physician from a gender counselor; that requirement is waived for ethical reasons if the patient is already self-medicating because self-medication is such a danger to the physical health of the patient that to withhold professional supervision would go against medical ethics.

Most gender counselors want their clients to get hormones from a professional as soon as they are certain they want them, because for so many of us, actually taking the right hormones for the gender in our heads is a great clarifying, and transforming step-- either making us very sure that this is the right path for us, or leading us to look for other avenues to deal with the dysphoria we feel.

[Meshi]

I think it can be relevant for some that are not sure of having GID.  Yes, it can be cruel, but there are ways of not putting yourself at risk. When i was pre op, i would not go out at night as a woman just to safeguard myself.  There is no reason to put yourself in danger.

[Zumbagirl]

In short, for anyone who knows what they want / need but feel the RLE requirement will significantly ruin / damage their lives, they can be excused by an empathetic psychologist / surgeon. My US psychologist and my being 12 days post-op by Dr Suporn of Thailand can attest to that.

I went through the standards of care as it was written in the 90's and lived. It's not some unsurmountable obstacle and in terms of a gender transition a few thousand in shrink bills is nothing compared to the surgical costs. That being said I am beginning to think that the best way to weed out the lousy shrinks who write crackpot theories on gender and the whole DSM thing is to bypass it entirely and work with the surgeons and doctors directly on an informed care basis. I would be happy if the whole damn thing was removed from the hands of shrinks and it was enitrely de-listed, or at best call it something like "gender transition assistance" and treat it as a medical condition entirely and not psychological. As long as it' in the DSM in some fashion we will be targets for those who wish us ill.

[Gemma_D]

RLE before SRS seems totally reasonable to me, but the NHS route of RLE prior to HRT has me seriously contemplating self-medding (at least temporarily). There are private clinics that can prescribe but they are at the other end of the country so that's out.

I might be being naive here since I'm coming from a place of no experience, but I'm hoping I can start HRT and try to work things through with my wife to keep our marriage together. Changing my name and coming out to everyone before I can see how I feel HRT (I'm 99% sure it's for me, but there's always that nagging worry it won't be) seems more risky than doing it the other way and doesn't give us time to try and prepare.

[Nov413]

I went through the standards of care as it was written in the 90's and lived. It's not some unsurmountable obstacle and in terms of a gender transition a few thousand in shrink bills is nothing compared to the surgical costs. That being said I am beginning to think that the best way to weed out the lousy shrinks who write crackpot theories on gender and the whole DSM thing is to bypass it entirely and work with the surgeons and doctors directly on an informed care basis. I would be happy if the whole damn thing was removed from the hands of shrinks and it was enitrely de-listed, or at best call it something like "gender transition assistance" and treat it as a medical condition entirely and not psychological. As long as it' in the DSM in some fashion we will be targets for those who wish us ill.

You certainly don't need a therapist either, especially if you have RLE.
But I do agree that we should do away with both.

[Annah]

Honestly, RLE isn't as rough as some think it is.

However, ask yourself this: if you are planning on changing genders...wouldn't you want to look like the gender you are presenting?

Ive RLE for 4 years now and the first couple days was very nervous...but you get over that quickly.

But RLE, in my opinion, is important. If you cannot handle dressing in the gender you feel you are then that, to me, is hard to understand.

[GendrKweer]

Honestly, RLE isn't as rough as some think it is.

However, ask yourself this: if you are planning on changing genders...wouldn't you want to look like the gender you are presenting?

Ive RLE for 4 years now and the first couple days was very nervous...but you get over that quickly.

But RLE, in my opinion, is important. If you cannot handle dressing in the gender you feel you are then that, to me, is hard to understand.

It isn't as clear cut as that. Not everyone lives in an area where their safety is reasonably guaranteed if they are unpassable, yet they would benefit greatly from privately knowing their gender has been matched with their parts so to speak. In any case, the final thought should be: it is my body; if I am of sound mind, then I should be allowed to modify it as I see fit, without having to explain to anyone why I want to do that. A cisfemale can go to a plastic surgeon and get triple F implants even though they are purely elective; a biomale can get his penis bifurcated on a whim as a body mod without having to think much about the consequences. So if for no other reason than that, SRS could be considered simple body modification. Of course, it means more than that to me, and to most of us. But I will never presume to pass judgement on another or prevent them from doing as they like if his or her rationale differs from mine.

[Kevin Peña]

Honestly, RLE isn't as rough as some think it is.

I would like to reiterate that for HRT and perhaps FFS, the RLE requirement is rather unfair because it isn't exactly feasible for some of us more manly-looking folks to try and live as a female. For SRS, there is some merit to the RLE rules.

[Annah]

It isn't as clear cut as that. Not everyone lives in an area where their safety is reasonably guaranteed if they are unpassable, yet they would benefit greatly from privately knowing their gender has been matched with their parts so to speak. In any case, the final thought should be: it is my body; if I am of sound mind, then I should be allowed to modify it as I see fit, without having to explain to anyone why I want to do that. A cisfemale can go to a plastic surgeon and get triple F implants even though they are purely elective; a biomale can get his penis bifurcated on a whim as a body mod without having to think much about the consequences. So if for no other reason than that, SRS could be considered simple body modification. Of course, it means more than that to me, and to most of us. But I will never presume to pass judgement on another or prevent them from doing as they like if his or her rationale differs from mine.

So, say someone who was born a male now wants to live as a female....they will still dress as a male for fear of what someone would say or do? Normally, if one wishes to be a female, one would usually dress somewhat as a female to some extent.

Getting a vagina isn't going to make wearing female clothes any easier...no one sees through the pants. And if someone is unpassable now, getting a vagina will not make someone passable.

Also, you do not need therapy standards for FFS. You do not need a letter to get Boob Implants either. You need a letter for HRT and SRS and for a gender change on your license.

And SRS IS NOT a simple body modification. Your penis is removed, your urethra is redirected, your nerve endings are frayed, cut, and redirected, and a vaginal canal is created.

I went fulltime at Seminary.......Seminary. I stood in front of a conservative judge last week and was told I cannot have custody of my children until they are 18 because I'm transgender. If I could do this in women's clothes I think other people (who wants SRS) can step out of their comfort box and try to present to the world the gender that they say they are.

[Annah]

I would like to reiterate that for HRT and perhaps FFS, the RLE requirement is rather unfair because it isn't exactly feasible for some of us more manly-looking folks to try and live as a female. For SRS, there is some merit to the RLE rules.

A letter is not required for FFS. Also, I personally never met a transgender person who needed RLE first before HRT. True, some organizations require RLE first, but find a place that will give you HRT before RLE. If you cant find one locally, plenty will do phone consultations.

Also...for the record, HRT will not drastically change one's appearance as much as one thinks. If one considers themselves unpassable now, HRT will soften the skin and other things...but it will not drastically change your face.

[Kevin Peña]

A letter is not required for FFS. Also, I personally never met a transgender person who needed RLE first before HRT. True, some organizations require RLE first, but find a place that will give you HRT before RLE. If you cant find one locally, plenty will do phone consultations.

Also...for the record, HRT will not drastically change one's appearance as much as one thinks.

Well, I know that it is sometimes required in some countries if you go under a national healthcare system.  Plus, I'm aware that HRT isn't a miracle, but it can be the difference between coming across as a girly man or as a manly girl. Big difference.

[Annah]

it can be the difference between coming across as a girly man or as a manly girl. Big difference.

I don't know many homophobes who would be more relieved over a girly man or a manly girl or vice versa

[Kevin Peña]

Ok, let me word it like this: it could be the difference between people assuming that you're trans or just that you are a strange-looking cis person, which would relieve some hassle of the RLE.

[Annah]

i still don't agree. Sorry

But it is what it is

[Kevin Peña]

There's no real need to apologize for having a different opinion. I know that HRT doesn't change your face, skeletal structure, etc. drastically.

But how about this?: It's better than nothing for a hefty portion of the trans population.

[eli77]

Normally, if one wishes to be a female, one would usually dress somewhat as a female to some extent.

Well, I already knew I was abnormal. But, ya, I wore mostly boy clothes to work today. I think it's a bit odd to just go ahead and assume that wearing female clothes is inherently required to be perceived as female. To me, it doesn't seem that big a factor. For me starting RLE just meant that I went by Sarah instead of my birth name. I didn't even own any girl clothes the first day of my RLE.

And we all know that HRT is a dice roll. But for some people the effects are pretty extraordinary. I lost the ability to pass as a guy after about 4 months on the stuff. On the other hand I still have no boobs. You win some, you lose some.

[Annah]

just to play devil's advocate, I can see why HRT would need some form of "effort" on the part of the person desiring HRT.

HRT does permanent changes in the body that can never be replaced. If one is on HRT for 6 months to a year, one will be permanently sterile. There are other issues that are permanent too.

So I can see if a therapist wants to see their client being serious enough to do it.

Also, if someone is so unpassable they are scared violence may ensue, HRT will in no way change one's appearance to the point to make them passable. It's not how HRT or why HRT works or why we are given HRT.

[Kevin Peña]

Also, if someone is so unpassable they are scared violence may ensue, HRT will in no way change one's appearance to the point to make them passable. It's not how HRT or why HRT works or why we are given HRT.

Ow, my hopes and/or dreams. All 4 of them... 

[Apples Mk.II]

If one is on HRT for 6 months to a year, one will be permanently sterile.

Actually, that would be a a great improvement for humanity. I considered sperm banking at one time, but... I'm the kind of person that should not be allowed to have children. Even If I could financially support them.

[Annah]

Actually, that would be a a great improvement for humanity. I considered sperm banking at one time, but... I'm the kind of person that should not be allowed to have children. Even If I could financially support them.

That is an individual conviction only. I want children and I love the children that have