Is 2 years therapy acceptable?

[lilacwoman]

With the news item about Switzerland dropping the 2 years RLE requirment can I ask if other people think a very short, 2 years or a longer period of RLE should be mandatory?

In UK srs is now provided after perhaps 1 years RLE.

I'm a bit uneasy about it as there is good evidence that short RLEs does not give a person enough time to get used to the idea of living completely as other sex.   
On the other hand there are lots of people who want their genitals changed but who are not TS by any means.

so less than 2, 2, more than 2?

[Cruelladeville]

The issue should not be a one-size fits all policy....

If a kid at 4-5 presents as uber-dysphoric..... then goes on as a teen (as the opposite gender) then through the puberty hold..... and then at 18 has the surgery.....

The 2 year RLT is irrelevant....

The problem with the adult presentations....especially if someone's say lived male for 40 years or so....is that the medics are far more cautious and wary.... as lawsuits for malpractice can hurt....

(Ideally common sense should prevail)

However I would put more onus on the (adult) person whom signs a consent form.....to blame other for what you do is extremely petulant and childish in my view....

Unless of course you've suffered through someone gross professional negligence which is a whole other issue....

[lilacwoman]

UK court case against the phychologist who has helped thousands of TS through to surgery ignored all this work but let him be sued on the word of 3-4 who either weren't TS  or rushed through the RLE.
The fact that they had claimed to be TS and some agreed and signed to say they want srs and were happily living as women when they weren't was ignored as ultimately he was the shrink and should have known that surgery wasn't in their best interest.
The jury even took the side of the guy who clearly had no history of being TS but on the high of crossdressing for a few months went off and got srs and then blamed the psychologist for letting him.

the whole case was  stinking mess.

[rejennyrated]

The issue should not be a one-size fits all policy....

If a kid at 4-5 presents as uber-dysphoric..... then goes on as a teen (as the opposite gender) then through the puberty hold..... and then at 18 has the surgery.....

The 2 year RLT is irrelevant....

The problem with the adult presentations....especially if someone's say lived male for 40 years or so....is that the medics are far more cautious and wary.... as lawsuits for malpractice can hurt....

(Ideally common sense should prevail)

However I would put more onus on the (adult) person whom signs a consent form.....to blame other for what you do is extremely petulant and childish in my view....

Unless of course you've suffered through someone gross professional negligence which is a whole other issue....

Yeah - What she said 100%

No two people are alike. These need to remain guidelines and never become rules otherwise you get in to formulaic behaviour in which the doctor ends up treating a set of rules rather than an individual patient.

Besides what constitutes an RLE really all depends on how you look at things.

If you apply the most rigorous definition by the time I was treated in the mid 1980's I hadn't even done a year of RLE. However if you look at it in a more flexible way I could also be said to have done about 20 years by then. Happily my second doctor went with the second view and not the first.

Oh and Lilac my doctor WAS the doctor you mention. As he is a very close personal friend I gave evidence in his defense.

In my opinion the charges were trumped up by a set of professional rivals seeking revenge and a couple of patients who were, at least in part, seeking a way to gain money from him. To say they were not TS is a bit of a leap though. I think maybe they were but are now embarrassed by it and seeking to justify their actions by blaming someone else, with the added advantage of being able to try and get money from a man who worked hard and became reasonably well placed financially.

So it all depends on who you are and how you look at things. This should be about medicine and not law!

[Nicky]

2 years seems excessive to me.

[Carlita]

I totally understand why doctors are nervous to proceed with SRS without very clear evidence that the patient really wants and needs it ... those post-ops women who ecide they don't like it then turn round and sue their therapists or surgeons have made life very hard for everyone else ...

But my problem with RLE is that it isn't really real! Maybe this is my hangup, but the thought of spending time in a halfway house, living fulltime but still possessing the most obvious anatomical evidence of being male fills me with dread. I will have to have FFS before I go fulltime, just to make myself remotely passable (or at least, passable to what I would consider an acceptable standard) and I will already have been on hormones for at least 6/12 months, by which point man of the side-effects will be permanent ... so by that point the die will be cast anyway and detransitioning will be very difficult indeed. Why should I - or anyone - be made suffer a year, or more, before getting the operation that is for me (and I know this isn't true of everyone, by any means) the whole point of the exercise?

I am an intelligent, sane, adult individual who is willing to take full responsibility for my actions and their consequences. If I make mistakes I blame nobody but myself. So why can't I make the decision about which procedures I want, and am willing to pay for, and when I actually want them?

[Nathan.]

I don't think a single RLE time will fit all. Some of us will need a year or two while others probably don't need RLE at all.

I feel 2 years is too much though. I'll be about 1 yr 6 months RLE when I get my first surgery but I didn't need that long, it's only that long because i'm transitioning on the NHS.

[Julie Marie]

Therapist:How long have you felt like this?

Client: About 20 years. (or 30 or 40 or 50...)

When does the time clock start?

Another question:  It's your life, your body, why does anyone else have a say so in what you do with it as long as you aren't hurting anyone else?

And why don't we require letters for FFS?  Your face is one of the first things people look at to gender you.  You go out and get surgery to feminize your face, most of the procedures are irreversible, then you go out into public and the world sees a female face.  But wait, what's in your pants?  No one knows until you pull them down.

It's all about the sacred penis.  Thou shalt not harm the sacred penis!

A woman who got a bad boob job sues the doctor.  The judge finds the surgery was done according to the instructions of the patient, no complications arose out of the surgery, it's just that the patient had regrets.  Case dismissed!

A man who got a penectomy sues the doctor.  The judge finds the surgery was done according the the instructions of the patient, no complications arose out of the surgery, it's just that the patient had regrets.  The court finds for the plaintiff!  The doctor obviously has no morals!  I mean, c'mon, removing a man's penis!

Plastic surgeons are sued for face lifts, nose jobs, boob jobs and all other types of cosmetic surgeries.  I don't hear anyone calling for people to do a RLE to see if they like looking younger, more attractive or more buxom.  So why RLE before GRS?  Like I said, it's the sacred penis.  Viagra?  Yes!  Penectomy?  NO WAY!!!

But as Carlita said, RLE isn't real.  It requires the imagination of everyone involved.  Everyone, including you, must pretend you are female with the anatomy to prove it.  But everyone knows that's not true.  That is not a very real life experience.  It's make believe.

It's been 2-1/2 years since I went totally full time, and 19 months since GRS.  My RLE is not 2-1/2 years old, it's about 16 months old.  I didn't start to feel female until after I had healed from GRS and was able to live somewhat normally as a woman.  No matter how hard the "experts" try to convince themselves that RLE is a necessary step, the truth is it is more a fantasy experience.

And then there's the part about living full time...  Now everyone knows you are trans.  They have seen you in full female presentation.  They have passed judgment on you.  Some have left you.  You may have lost your job because of it.  You may have gotten divorced because of it.  This is all irreversible.  What do you do about that?  Who do you sue when this part of your life is ruined?

[Miniar]

As they've covered quite well, there's no way a "one size fits all" approach to transition is gonna work.

For me, personally, the two years RLE would seem, well, stupid.
I've known this is where I'm headed for far more than two years.

The two years RLE is supposed to apply to "documented" RLE, under supervision. For me, I've been "me" for pretty much all my life, I've just, put on a facade before leaving the house for sake of minimizing discomfort for myself and others (due to fear of hostile reactions).
I've been "he" in the eyes of trusted friends for years, some have seen it longer than I have admitted it to myself.

I put my own transition on hold while I was getting my life in order. I made myself wait before I did "anything" about it.
The thing is, I reached a point where I just could not wait any longer, I "had" to go and act on this because I could not take any more pause.
I have spent most of my transition so far... waiting.
Waiting will doctors go on vacations.
Waiting because there's a "mandated waiting period"
etc, etc, etc,

The waiting's been killing me.
It's been driving my stress-levels up and making it harder to get through each day.

Anyone with less support, less responsibilities to feel a need to stick around, less ability to take the stress,.. would have gone "oh.. f-this" and ended it all or cheated, cut corners, by now.

[Janet_Girl]

...

And then there's the part about living full time...  Now everyone knows you are trans.  They have seen you in full female presentation.  They have passed judgment on you.  Some have left you.  You may have lost your job because of it.  You may have gotten divorced because of it.  This is all irreversible.  What do you do about that?  Who do you sue when this part of your life is ruined?

emphasis is mine.

The price many pay is of course suicide.  And that is irreversible.  But if one knows very early, how do they prove to the doctors that they indeed want and need the surgery.

I have made it through their little test.  But I still need two other 'professionals' to say that I have completed their little test.  I still feel incomplete.  and it all comes down to the sacred penis that is still present.

[Carlita]

RLE isn't real.  It requires the imagination of everyone involved.  Everyone, including you, must pretend you are female with the anatomy to prove it.  But everyone knows that's not true.  That is not a very real life experience.  It's make believe.

It's been 2-1/2 years since I went totally full time, and 19 months since GRS.  My RLE is not 2-1/2 years old, it's about 16 months old.  I didn't start to feel female until after I had healed from GRS and was able to live somewhat normally as a woman.  No matter how hard the "experts" try to convince themselves that RLE is a necessary step, the truth is it is more a fantasy experience.

Than you and bless you for saying that! Not having started RLE I was really worried about stating an opinion on it ... but every instinct I have tells me you must be right ... and I know from my own experience of cross-dressing that it was deeply unsatisfying because I knew that however much I was trying to look like a woman, my body was still male and that was almost more frustrating than my normal 'male' life ...

For me, it has to be all the way, or nothing at all ...

[lilacwoman]

I'd say forget the RLE if the person is living in a country where they have to pay for their own surgery and if they make a mistake and realise they shouldn't have had surgery then they cannot do anything about it but in countries like the UK where there is a national helth service providing free surgery and at the same time any one who has made a msitake can sue to have a very expensive restoration done then I'm inclined to say a long RLE is essential.

[lilacwoman]

OK Julie Marie  now tell  us how getting a vagina magically transformed you into a woman?   
You should have been a woman before getting a vagina.
According to your theory any Fred Flinstone can get a vagina and suddenly become Betty Boop.   T'aint so.

[rejennyrated]

I'd say forget the RLE if the person is living in a country where they have to pay for their own surgery and if they make a mistake and realise they shouldn't have had surgery then they cannot do anything about it but in countries like the UK where there is a national helth service providing free surgery and at the same time any one who has made a msitake can sue to have a very expensive restoration done then I'm inclined to say a long RLE is essential.

Which would all work fine EXCEPT that the majority of people going through in the Uk don't bother to wally about with the (in my view) pretty useless NHS GIC's and we fund our own treatment.

We always have done - even as long ago as my day. The trouble is the rules that are applied to the NHS have a nasty habit of then being wrongly applied to private patients too because the same doctors work in both sectors.

That's why I personally don't much like politbureau style social medicine. Unfortunately it tends to put either doctors or faceless bureaucrats in the driving seat. As a private patient I am the customer and the doctor is my servant, not my master.

[Carlita]

As a private patient I am the customer and the doctor is my servant, not my master.

Well said! And as an adult I am responsible for my own life choices ... the trouble is, some people refuse to be responsible for theirs and by seeking legal recompense for every one of their own mistakes they force professionals of all kinds into an ultra-cautious, defensive, risk-averse, box-ticking corner and thereby create a far worse climate for everyone else ... hence 2 years RLE

[katgirl74]

I did 12 months and a handful of days prior to surgery, and it seemed like and eternity. The last few months were agonizing, but now all is as it should be. Two years RLE would have been absolute torture. But, that are many who do a period of time and realize they aren't TS, and go back to living in the gender they were assigned at birth. So, there is still a benefit for some, for others it's just more time we have to wait.