HRT and RLT....

[Vexing]

Never seen reluctance.... that goes against thier medical oaths... but determination to make sure the diagnosis is totally correct? sure.

And no doctor has ever gone against their medical oaths, amirite?

Nitpicking is not really the point...

No, the point is that doctors are ordinary people who have bias and can discriminate against others, despite the Hippocratic Oath.
I'm in IT. If I get three electric shocks plugging in three servers of the same model, I'm going to try to get out of working with that model ever again or make sure it is thoroughly checked out before I go near it.
If a surgeon has three lawsuits put against him by trans people for performing SRS when they were not ready for it, it stands to reason that he will be VERY cautious about future surgeries, yes?
If a psychologist is sued for okaying SRS, they are more likely to deny future surgeries.

But calling it nitpicking is a much more convenient way of ignoring common sense, amirite?

[Rachael]

You could just dry your hands you know?

[Vexing]

You could just dry your hands you know?

Fun fact: pure water is not actually conductive.

[Alyssa M.]

Wow. I just saw this.

Not only is RLE absolutely not a prerequisite for HRT -- it's not even a requirement that the patient want to transition at all!

Can Hormones Be Given To Those Who Do Not Want Surgery or a Real-life Experience
yes, but after diagnosos and psychotherapy with a qualified mental health professional following minimum standards listed above.* Hormone therapy can provide significant comfort to gender patients who do not wish to cross live or undergo surgery, or who are unable to do so. In some patients, hormone therapy alone may provide sufficient symptomatic relief to obviate the need for cross living or surgery.

I would drop  in a second any power-tripping therapist who wouldn't repsect me as a client or patient at least to the level suggested by the SoC. There's prudence, and then there's the "Father Knows Best" mentality.



See: http://wpath.org/Documents2/socv6.pdf -- it's a good read, and short too.

*"minimum standards listed above" are, roughly, Eligibility: 18 or older, knows risks and benefits of hormones, has been in therapy OR in RLE for 3 months -- AND -- Readiness: RLE or therapy confirm desirability, patient isn't nuts or is becoming less so in other areas of life, patient will be responsible -- OR -- special circumstances, e.g., already self-medicating.

[Rachael]

You could just dry your hands you know?

Fun fact: pure water is not actually conductive.

Ill go out on a limb here and assume that your not working in a lab before handling servers pure water does not exist naturally, it has to be produced.

Alyssa M : indeedyBUT SOC are for transition, if you want to  transition, you need to follow your country's soc for that... if thats rle before hrt... its just how it goes, as cruel as it may be.

[Vexing]

Ill go out on a limb here and assume that your not working in a lab before handling servers pure water does not exist naturally, it has to be produced.

Okay.
Can you let me know what your problem is with me, and then bog off?
Thanks in advance 

[Alyssa M.]

Edit, for attitude:
SoC is for more than just transitioners, and right practice does not depend on one's nationality, even if access does.

[jenny_]

Not only is RLE absolutely not a prerequisite for HRT -- it's not even a requirement that the patient want to transition at all!

Whether or not RLE is necessary has nothing to do with what's in the WPATH SOC.  Whats important is your therapist's interpretation of it and what they think is right.

And private practice can be just as restrictive in treatment as any public health service.  And in England most places follow a far stricter version of SOC than other countries, so country does make quite a difference.

[Sephirah]

Okay, after recieving complaints about this, I feel I should say something.

Can people please keep on topic, and discuss the issue at hand, rather than using the thread as a battleground for petty squabbles and ad hominem attacks. That solves nothing.

Thank you.

[Patriciaz]

I am hoping that the woman and the therapist will come to some reasonable conclusion on how to proceed. If HRT is a means to making transition easier and less stressful and it is decided that it would help integrate the person better into her new role, then that should be what determines the method.
Is this more idealistic than realistic?

[aubrey]

I am hoping that the woman and the therapist will come to some reasonable conclusion on how to proceed. If HRT is a means to making transition easier and less stressful and it is decided that it would help integrate the person better into her new role, then that should be what determines the method.
Is this more idealistic than realistic?

I should hope not but In my experience it was. I didn't get approval until I just started doing things on my own, if I hadn't I would have kept getting the runaround. I tried to explain things just as you stated but it didn't matter. It would be nice if everyone used their commonsense and heart in these situations but some just use dollar signs and fear of lawsuits. I hope it is not the norm but suppose it is. I hear of ppl doing 2-3 years of therapy beforehand and wonder why, if they just fell for the same lines and trusted their doctors too much.

[glendagladwitch]

Rumors:  If you are already self-medicating, then they can prescribe your meds under "least harm."  If you are hooking, then they can skip RLT under "least harm."  If you have already scheduled the surgery in Thailand and are about to wire the money, then they can skip RLT under "least harm."  Or so I've heard.  "Least harm" shields them from potential liability, or so I've heard.

[aubrey]

Yes Glenda, and isn't it amazing how they all of the sudden are o.k. with it all? Because they are safe.

[Mari]

I always thought RLE before HRT is "just somewhat" cruel, not mention unneccesary... Anyway, reading this topic i remembered a report, or a short doucmentary, i saw on youtube about canadian transwoman who was also required to "live as desired gender" before HRT. And although i have seen many videos and reports on transwoman, this one was something i particulary remeber. So take a look...

Part1:

Part2:
http://www.youtube.com/watch?v=l6Te6hhWh8o&feature=related

Part3:
http://www.youtube.com/watch?v=eX7-KDbHqkI&feature=related

[Rachael]

good god....

not even wearing a wig or TRYING to pass?

thats hardly living as the desired gender? thats living in thier clothes and pronouns...

[Ms Jessica]

...living in thier clothes and pronouns...

Sadly, that's how I feel some days. 

[glendagladwitch]

I used to think RLE should be a requirement.  But I met a lot of folks who had surgery, and some who turned back before surgery.

One person did RLE and had her surgery date and everything paid for and then backed out days before the surgery.  I don't think it was RLE that convinced her to back out.  I think it was the looming prospect of surgery. 

Another I know is a MTF post-op person who skipped RLE, went to Thailand, and still lived as male afterwards.  She had no regrets though, and was very happy.

Why should it be necessary to conform to some gender stereotype to have control over one's own body?  I can't see it.  RLE before SRS seems like a good idea for most.  But I'm not convinced it is a predictor of outcome in terms of post-op satisfaction/regret.  The people who regret surgery seem to all have gone through RLE, and several had other types of surgery first, and lived in the new gender for years before expressing regret.

[Rachael]

glenda just expressed something i feel is key here... Gender has a lot more to it, than gender roles...

Rlt is there to try and teach people that, more than anything. There are some parts of being a woman that are as non optional as some parts of being  male... its why the two sexes are different. After all, if they were the same, we wouldnt transition or feel so much pain of difference?

Gender steriotypes is a phrase bandied around here, and too often  imo, mostly by transwomen complaining about things, things they feel are 'degrading' or 'too steriotypical' erm, did you ever consider things are a steriotype in some caes, because they just are fact? that they DO happen most of the time?

Ill tell you one thing, for most transwomen, you cannot afford to rock the boat by breaking the norm, yes... normal does exist... and im afraid normal is a forgotten concept here, its the huge part of passing, and what rlt tries to teach ive begun to find. It tries to settle the person  into thier... for want of a better word, and forgive the use, desired sex... lets face it, you werent raised it, you dont know how to be it... theres a lot more to being female or male than being it in your head, if you dont know how to be it outside, you're screwed, and rlt is there as a prooving ground for you in the world... to try and let you learn to interact normally with people... to become a normal, cohesive happy person. Some parts of normality apear steriotypical to some here. I'm affraid that its just tough, they cry about not fitting in, and then talk about shunning gender steriotypes, and dont quite know themselves what a steriotype is...
its like the fisherman who belives 90% of the fish is skin and bones, and removes that, his meal is not fulfilling, and he is left wanting.

[jenny_]

I agree with what you said Starbuck.  I think that RLE is a necessary part of transition (for a transsexual anyway).

But still that isn't the same as making it a requirement for HRT particularly or even surgery.  It might be necessary if you are ever gonna fit into the world we live in, and to have a decent life.  But why should it be necessary for HRT/surgery?  The ability/willingness to live as a functional part of society isn't a requirement for most other medical treatments.

[Northern Jane]

The ability/willingness to live as a functional part of society isn't a requirement for most other medical treatments.

I think it would be very difficult to find a doctor who would perform any procedure that would have a NEGATIVE impact on a person's ability to function as a part of society.