Am I the only one bothered by this?

[suzifrommd]

Am I the only one who is bothered by the terms "real life experience" or "real life test"?

* It doesn't feel like a test to me. Really just feels like living.

* It was introduced by Harry Benjamin as "proof" that we should have a physical sex change. I know some people find it helpful, but for others, seems like it's only there to please the gatekeepers.

* I'm almost halfway through mine. While it tells me whether I want to go on living as a woman full time (Yes, please!) it hasn't been the SLIGHTEST help in deciding whether I need SRS. That seems more a function of my relationship to my body than of how I'm living.

* It invalidates the experience of people for whom the need for social transition (i.e. living as their true gender) and the need to change their bodies feels completely separate.

[Danielle Emmalee]

I agree 100%

[Jenna Marie]

Yes, another agree 100%. Test of what? We don't make cis people "test" whether they can survive as their gender - or as adults! - so why this patronizing approach for us?

[Ms Grace]

Yes, 100%.

Plus it's tantamount to a human rights violation when someone is forced to live RLE for a year without HRT as a pre cursor to receiving HRT, as appears to be the case in a number of countries. My shrink once floated the idea and I gave him a very dirty look and rebuke... he backed down pretty quickly.

[TerriT]

Yes, 100%.

Plus it's tantamount to a human rights violation when someone is forced to live RLE for a year without HRT as a pre cursor to receiving HRT, as appears to be the case in a number of countries. My shrink once floated the idea and I gave him a very dirty look and rebuke... he backed down pretty quickly.

That is downright evil.

I also agree that RLE is a stupid idea that has long outlived its usefulness. I am pretty much opposed to any universal guidelines for treating so many different people with so many different situations.

[Anatta]

Kia Ora Suzi,

When I transitioned, I did so without having to go through any RLE/RLT...The reason being I had no interest (at the time) in having genital surgery, plus financially it was out of my reach...

When my endo applied for government funded surgery on my behalf, I have been living full time for around 4 and half years (I started HRT in 1998-went full time in 2000 ie 24/7/365 and had surgery in 2005) , so Real Life Experience was of no importance...

I think back then,(well in NZ this seemed to be the case ) one was not really pressured into going full time, you saw a doctor who started you on a low dose of HRT before referred you to a psychiatrist who gave you the stamp of approval ( I know I'm not nuts, I've got a psych letter to prove it  ) and that was it-in your own time and at your leisure...

However I personally feel that 'screening' potential genital surgery clients by a RLE/RLT period is important, after all one can't stick it back on once its been cut off and sliced up so to speak, but HRT should be made available prior to starting it...But then this is my personal opinion, I've come across a few trans-women who rushed into having surgery in Thailand, without really having any real life experience in the 'real' world, and have come to regret rushing into it... 

Metta Zenda

[KabitTarah]

I thought the Benjamin stuff was from the 50's - 60's... I mean... we're not required to do RLT before HRT anymore!! This stuff has evolved.

Benjamin was the guy who said that maybe this stuff is real, and not just a psychosis. He was the good guy... and his ideas made a lot of sense back when he had them.

It sucks that our sisters lives were so affected by the evolution in psychology and neuroscience... but I'm thankful those ideas were hashed out and gatekeeping is slowly disappearing.

[Ms Grace]

I thought the Benjamin stuff was from the 50's - 60's... I mean... we're not required to do RLT before HRT anymore!! This stuff has evolved.

Sadly not in some countries.

[KabitTarah]

Sadly not in some countries.

Sorry to hear that. I thought the DSM was an international standard. I didn't realize it was an American standard.

Still... you can't blame a researcher from the 50's and 60's for the problems you have today. Modern transgender science is still not as good as it could be, but we're way, way beyond the initial "hey we can't just electroshock these people" ideas.

[suzifrommd]

However I personally feel that 'screening' potential genital surgery clients by a RLE/RLT period is important, after all one can't stick it back on once its been cut off and sliced up so to speak

I agree it's a big step, and requires deliberation and knowledge.

My question is, how will RLE tell someone whether she will be more comfortable with a female bottom?

RLE is about living as a female, right? That tells you what roll you might want to play in society, but does it tell you what the shape of your body should be? If it did, why would there be non-op women living 100% as female, but perfectly willing to spend their life with the parts they were born with?

Likewise, if you didn't have RLE before SRS, for example, and then later realized that you don't want to live like a woman, wouldn't the option still be open to live as a male while having a female bottom? Aren't there hundreds of members of Susan's who do just that?

So I'm still struggling to understand: How will RLE help someone decide what shape her body should be?

[Ms Grace]

You're struggling to understand something that actually doesn't make sense. And you're right, living as a woman isn't going to give any indication of whether one is going to cope with corrective surgery. There are some (I don't know the number/percentage) who have regretted their surgery - not because they weren't trans* but because the surgery created a separate level of dysphoria...they might have hated being a man and hated their penis with a passion but losing it through surgery was akin to losing an arm or leg and suddenly they felt "wrong". RLE wouldn't pick that up, not in a million years let alone two.

As for having a "female bottom", the HRT has already given me one of those - don't need surgery for that!  Genitals though, that's a different story!

[Anatta]

So I'm still struggling to understand: How will RLE help someone decide what shape her body should be?

Kia Ora Suzi,

Sadly it won't/can't...However, it is in the most practical sense just to prepare the trans-person for role shift long term, 'psychologically' and can be liken to "Running the social gauntlet" if you survive it, then you're good to go-mentally you have proven that you can hold you own in society-which is a bonus and one less obstacle in the way of becoming your true self...

When it comes to the RLE and genital surgery...Though not perfect, it's the only screening tool any caring and compassionate mental health professional has got to work with, and as we all know, sadly it's not foolproof and can at time in itself become a hindrance...Such is life ..."One [wo]man's meat is another [wo]man's poison"...

Metta Zenda  

[LizMarie]

Transsexuals are rare to begin with. Transsexuals who wish to change their bodies but continue living in their birth gender are extremely rare. Consequently, most transsexuals who do want gender surgery are going to live in their expected gender.

So the goal of RLE is to help ensure that the patient is really sure of what they are doing, that taking this irreversible surgical step is the right thing to do. Before these checks were put in place, reports of post-operative regret were higher. While not perfect, these checks have reduced post-operative regret so are good in that sense.

The question I would ask then, is if we don't have RLE as a check to help ensure certainty, how can we help the patient be certain this is for them? Remember, every single person who has gotten surgery has done so voluntarily and believing that they needed and wanted it. Yet a small percentage of patients do end up regretting the decision.

I suspect the concern for medical practitioners is how do they keep that post-op regret issue as small as possible?

And honestly, I really don't have a good suggestion other than the RLE.

[Jill F]

I hate this one-size-fits-all approach imposed upon us by people who are not even transgender.  How do they know better than we do about how we should be dealt with once we get past the initial confusion and accept who we are?  There are as many ways to be transgender as there are transgender people, yet this protocol persists.   Some of us can simply wear a different set of clothing now and again do deal with it, and some of us will need the whole shebang either installed or removed.

I simply stopped dressing in guy clothes because I no longer felt I had to meet that expectation, not because of some requirement.  I'm not ever going back to my old hormonal profile nor wardrobe.  Can I just get my walking papers yesterday?

[RavenMoon]

The problem with RLE is, if you are not yet passible, you probably won't have a very good experience. So you aren't really living as a women. And it can be dangerous. So what are you setting yourself up for?  It's probably not going to be a wonderful life changing experience, and might involve a lot of challenges. For many it is a good thing. Some don't even care about passing (which I don't get), and then in that case why the need for RLE?

I understand that having surgery (and HRT) is serious, and mostly irreversible, but the whole idea that you should try and live full time, especially when you might need FFS to pass, is absurd. It's like throwing someone into the middle of the ocean that can't swim, as a test before they can take swimming lessons in a pool. It's just stupid.

I feel Harry Benjamin's ideas are way out of date, and so is the Standards Of Care, which never even discusses FFS. These people (WPATH) are out of touch with reality and shouldn't be telling people what to do. Many doctors and therapists feel the same way.

I'd love to live full time and present myself as female now. But at this stage I won't pass, no matter how great my legs are, and that's not the experience I want. I'd like to go to the supermarket and not create a scene. lol  Sorry, but I'm vain. Some people are lucky, in that they are already very female looking. Most are not.

But for myself, that day will only come when I can look at myself in a mirror and be happy with what I see. So that will mean HRT and FFS before going full time. Oh and the voice too. IMO, and for me, that's the only way it makes sense. I'm not setting myself up for disappointment by not passing, and I'm also not delusional in thinking I look fabulous. lol

Sorry for the rant! 

Raven the grumpy

[LordKAT]

The SOC doesn't say anything about RLE before HRT or even FFS. You can do them in any order.

[RavenMoon]

The SOC doesn't say anything about RLE before HRT or even FFS. You can do them in any order.

You are correct. I just read through the most recent version.

They do suggest 12 months of RLE before SRS.

[Jennygirl]

The problem with RLE is, if you are not yet passible, you probably won't have a very good experience. So you aren't really living as a women. And it can be dangerous. So what are you setting yourself up for?  It's probably not going to be a wonderful life changing experience, and might involve a lot of challenges.

Yes, kinda agree.

The only part I don't agree w/ is the not really living as a woman bit. Passing is not the definition of living as a female. Being female is the definition of being a female

But the relation to RLE requirement I do agree with. For some, who do care a lot about being passable before starting this ridiculous RLE, it could be downright traumatizing. Not helpful at all.

Bottom line. RLE = totally bogus! If I try to imagine having to go through that in my own transition, basically add a whole slew of discomfort, fear, and anxiety that would not have needed to be there.

Informed consent is the future

[wallflowerXo]

hmmmm

I'm quite possibly not as qualified to reply to this as everyone else i havent begun my transition yet (still trying to find a decent doc/therapist) but the more i read about everything, the more i spot terms and phrases that 'bother' me, "Real Life Experience" is one that's directly tied to another "pass" or "passing", i understand that people want to "pass" as female or male. i get no one likes to be mistaken for the wrong gender but i think the term should be to blend... even Cys-Women and men don't "pass" for female or male 100% of the time, in my opinion physically androgynous people make up possibly 1/4 of the planets population or so, why do you think you see so many scrawny little guys getting tattoo's and piercings all over their face and body? they know they're built like 14 year old girls, and they're trying to "muscle up" their appearance a little because they're self conscious about it.

RLE and passing are both a bit silly to me personally, because i can technically walk out of the house all clean shaven with my hair in a pony-tail, a singlet and old bike shorts and feel like i'm walkin the town in girl-mode, just out for my afternoon stroll, getting my exercise like most women, i'll stop and buy dinner then i'll come home and do all the cleaning in the house, wash the dishes do my laundry, and my brothers laundry, exercise and go to bed i mean, does that all count as RLE or do i have to be wearing a skirt and on hormones while doing so before it's considered RLE by a psych lol

The ideal to me is to to be indistinguishable from your preferred sex emotionally, mentally and physically, not to pass some style or spoken exam you feel you need to take in front of every stranger. i live in a somewhat eclectic area of Australia (beaches, farms, cities, mountains, we've got the lot) I've noticed women are just as diverse if not MORE so than men are in their occupations, appearance, style, mannerisms, hobbies etc. i know women from SO MANY different fields of work its crazy;
hair dressers, optometrists, electricians, mechanics, police, ambulance workers, nurses/aged care, barristers/legal secretaries, horse trainers, like the list just goes on... and i wont even get into the hobbies list i'd be here all night, now for me personally that crowd wont be especially hard to "pass" or "blend" into after all who's going to question the 5'10" arty looking brunette when there's a 6'5" Maori policewoman with a voice like thunder standing nearby or a blonde painter hauling 10 liters up a 2 story ladder and telling the "dudes" down below how he's supe'd up her mazda lol

but that's just my view.... 

[Cindy]

Yes, kinda agree.

The only part I don't agree w/ is the not really living as a woman bit. Passing is not the definition of living as a female. Being female is the definition of being a female

But the relation to RLE requirement I do agree with. For some, who do care a lot about being passable before starting this ridiculous RLE, it could be downright traumatizing. Not helpful at all.

Bottom line. RLE = totally bogus! If I try to imagine having to go through that in my own transition, basically add a whole slew of discomfort, fear, and anxiety that would not have needed to be there.

Informed consent is the future

That is the crux of the problem for me. What is the definition of informed consent and who makes that definition?

From many transgender peoples view it is  'I will make the decision' from many therapists (inclusive of all concerned in the process from client, psych, endo and surgeon) is can the client make that decision? In my opinion I can make that decision. But to be honest I needed help and guidance.

I suppose the real question here is 'does a one size fits all' protocol work? If not what should be in place?