Does RLE Make Sense When ...

[LeaP]

You've had FFS, BA, orchie, and possibly additional plastic procedures performed?

After all, if the point is to avoid irreversible changes, then that purpose is undermined quite a bit by the above!

The thought was triggered by Misty's "point of no return" thread. 'Cause I have to tell you, she is past the point of no return. I understand that some of those procedures are theoretically reversible, at least the implants and soft tissue changes. But the bone work is not & the soft tissue work is by no means certain.

So, in such a circumstance, what is the point of RLE?

[Angela Campbell]

To reduce legal liability most likely.

I have found that in Thailand the law says they have to have 2 letters one from a therapist (MS) and one from a psychologist (PHD) stating you have been on hormones a year and living in your desired gender for a year.

[Inna]

I hope I do understand your question, if I do NOT then please excuse me.

However you do mention all the Surgical intervention and then a RLE (Real Life Experience) which at least by the Harry Benjamin s suggestions was a good way to make sure a Transsexual person would not make the mistake of exactly what you point out and end up transitioned yet stuck in the new avatar without prior weeding out of Fetishism.

So in other words RLE comes way before any script for surgical intervention!!!

Personally as well as many therapist, do voice a discontent over the practice of RLE, because of its barbaric connotations. I feel as though a person who is already acutely dysphoric now is asked to make a display of them selves in front of everyone they can come across and inevitably get more heat and discomfort while doing so. Instead I am for the SMOOTH approach, and gradual immersion of gender fixed mind into the ever changing and transforming body.

[Angela Campbell]

It is better than it could be. Some still want you to do a year of rle before hormones.

I personally plan to have some ffs and BA next spring which is before a year is complete.

[Kathryn Martin]

The requirement is to have RLE of at least one year before you have major surgical intervention of any kind. The issue is whether you can successfully interact in a social and professional environment which is the reason why RLE conditions either have you working or volunteering heavily. The point is to experience the push back and to make sure that you can both navigate the push back and assert yourself appropriately in these environments without running for cover when the going gets tough.

When you can meet these conditions and have no mental health issues you can have the bridge burning procedures.

[PaulaAnn]

I can only speak of my own slant on this.....All I know is this ,I WAS going to live the rest of my life as Paula weather or not I had the SRS and/or HRT. I'd reached the point where I was going to live the "RLE" regardless.Luckily I was able to contact a caring Doctor and had wonderful friends who guided and supported me when I started HRT. I've lived as Paula and been on HRT for nearly a year now.....awesome experience ;never been happier.
I'm on the long waiting list for SRS,have my first visit with the Psychologist in five days....My previous doctor(in Sask.) and my current doctor will submit the necessary letters when needed.
Bottom line....if I had none of the medical and mental support(Medical) I mention ,I STILL would have made the the decision to go the RLE route.I still would have the support of my friends but it would have been a much bumpier journey.
Again ,just my own vision;I'm doin' fine.
PaulaAnn

[Beth-Lock]

Much the same with me Paula Ann. I got frustrated with the muddle in professional advice, roadblocking, etc., and actually started my RLE, (that is 24/7), all by myself. I soon got into emotional problems and then found a new counsellor, a specialist in transition, and was back on the official track as she cleared up the emotional crisis as well. Two years later I had a small party in a nice restaurant to celebrate that seeming milestone with champagne, but it was more than a year later before I got SRS.

...RLE comes way before any script for surgical intervention!!! Personally as well as many therapist, do voice a discontent over the practice of RLE, because of its barbaric connotations. I feel as though a person who is already acutely dysphoric now is asked to make a display of them selves in front of everyone they can come across and inevitably get more heat and discomfort while doing so.

While CAMH in Toronto was still insisting on RLE before HRT, Ottawa therapists had stopped insisting on the RLE, since the facial feminization of HRT was in itself, something that made TS easier to pass, or so the TS themselves thought. At least the physical effects of 6 months or so of HRT is reversible normally, so it is a logical point to compromise on. Oblivious to all this, I decided when I took on transition by myself, to go for the full two year RLE, (the gold standard anyway), though it was considered here, obsolete. Add several more years,before RLE started, experimenting on how to pass in public, CD'ing mtf, by adjusting mannerisms and getting make-up and style right, and I was just about as well prepared to pass as much as physically possible for me, without HRT or FFS,by SRS time, and was getting comfortable being dressed as a woman in public. And you don't need a letter from a doctor to prepare that way, and see if you are going to be comfortable with presenting as a woman and assuming the role at least enough to pass. It is also relatively inexpensive.

Footnote: CAMH is the centre for TS counselling and approval for OHIP medicare funding of SRS. CAMH=Centre for Addiction and Mental Health, (treatment of, that is).

[I Am Paula]

After getting my HRT readiness letter, I asked my therapist about RLE. She just said that I had been full time long enough now, and my RLE was over. I didn't even know it had begun, I was just being me!

[KellyJameson]

I often wonder how much of an influence being born feminine looking affects the development of a female gender identity forming and corresponding gender dysphoria that propels the person into transitioning.

Would GID have become so strong in me if people had not always told me I look " pretty" like a girl when I was a child and teen even though they were being cruel about it at the time.

I have seen many of these same physical traits in other transsexuals including many on this forum.

I think RLE is redundant when you not only already appear feminine but through electrolysis, HRT and subsequent breast growth you MUST present as female.

RLE is more important when the difficulties of transitioning are greater because the difficulties of passing are greater.

I watch for stories of those who have detransitioned or committed sucide and I have never seen this happen with someone who passes easily except for one where the church was involved and paid for the reversal.

Those who transition who have masculine features may benefit from RLE so that they are fully aware of how society is going to respond. It may give them the time to develop that thick skin they will need.

For those who were tortured in childhood because they appeared feminine, their transitioning may be easier because they will probably pass where the ones who were able to play the role of the masculine man in appearance and behavior will now possibly have a more difficult path to walk and in this instance RLE could prepare the person for a more difficult passage.

Society can be very cruel to those who do not "measure up"

[Rianna Humble]

I have to wonder what several posters in this thread understand by the term RLE.

As I understand it the Real Life Experience is about living 27/7/365.25 as a woman (for MtF or a man for FtM). As Kathryn says, it is about living and working in your correct gender role.

The point is to experience the push back and to make sure that you can both navigate the push back and assert yourself appropriately in these environments without running for cover when the going gets tough.

In these terms, I don't understand why people think that this experience would be unnecessary simply because you had been teased as a child for having slightly feminine features or even why the OP wonders whether it is necessary to live as a woman after FFS, BA etc.

The only way that these questions would make any sense to me is if RLE is not being used in the WPATH terms so well explained by Kathryn but in the sense of "RLE = gatekeepers trying to prevent me being a woman by insisting that I live as one"

[bas1985]

In the ONIG standards of care (ONIG is the Italian official standard for Transsexuals, which is a bit different from WPATH), the RLE is thought in this way. In Italian there is a proverb which says: "You wanted the bike, now push the pedals!".

(That means that you cannot have a motor, you wanted the bike and a bike won't run if you don't press the pedals ( = effort)).

So RLE means to test that you can FUNCTION as an active member of society, work, play, talk, as a REAL member of the opposite sex.
Not only in TS support groups, but in everyday, cis-people life.

[Angela Campbell]

No one who is on this path wants to be held back by the gatekeepers, that is natural. I do see it as important. Then again the FFS, BA, and orchie can be part of the RLE. In my case I plan to get some facial surgery as I begin my RLE.

[emma5410]

I have found my RLE tough but I am glad I am going through it. I am learning a lot about myself and what it is like to live as a woman 24/7. An earlier thread discussed de-transitioning. Skipping RLE would make that more likely in my opinion. Sometimes we think we know what is best for ourselves and we are wrong.

[Kimberly Kael]

I find the whole premise confusing. As has been pointed out, RLE is generally required before surgery, but more to the point: how are the stipulations of RLE in any way a problem for a transsexual? Isn't that the goal in the first place? To live openly as your identified gender? It shouldn't be a hardship (which isn't to say it's easy!)

[LeaP]

The topic or premise seems confusing to many. Let me try it a different way.

If one of the major points of living in your target gender for at least a year is to head off making an irreversible surgical error (SRS), then what do I make of the common situation of STARTING RLE with FFS and other procedures? How meaningful is it to start the clock for one irreversible procedure when you initiate it with another?

[Badtranny]

Using myself as an example, I started RLE with boobs and FFS. Which is Lea's point. Why should I wait a whole year to get the 'final cut".

It's a good question, but I think changing your primary sexual characteristic is probably worth a year of refection before you do it.

[LeaP]

Maybe, Misty, but mileage varies. I'm in my 50s and we already have six children (all grown). The gatekeeping is starting to look to me like a validation of the (false) notion that FFS is cosmetic - and therefore of little serious medical concern - and an overwrought concern for fertility.

[Kaitlyn Michele]

I did the same as Misty... I started my RLE in july and had ffs in September.. I was 48 at the time

...I viewed ffs as no less conforming than grs

[Angela Campbell]

I find the whole premise confusing. As has been pointed out, RLE is generally required before surgery, but more to the point: how are the stipulations of RLE in any way a problem for a transsexual? Isn't that the goal in the first place? To live openly as your identified gender? It shouldn't be a hardship (which isn't to say it's easy!)

To answer this will not sound rational but it is the way it is. The closer you get the faster you want it to go. The more you want it. To live openly is the end result but you still know you are not right even if no one else does. I clearly understand the purpose and I intend to go through the hoops and wait, but if I could go in tomorrow I would be sitting at the door all night waiting.

[Inna]

I am sorry but this question is irrelevant.

RLE is a "REAL LIFE EXPERIENCE" TEST! It is there to qualify a patient and make sure about their intention and resolve in embracing their perceived self. I stress on "Perceived" because we do not have yet a definite technology to show to the therapist that Transsexual person is really a Transsexual, however we are getting close.

So RLE is simply a testing ground for such person. Living as a woman and actively transitioning while at it, is simply just life going forth. It is either already past the therapy or a decision of an individual to do it anyway, on their own!
But at that point it simply just becomes Real Life transition as suppose to Medical term of RLE.

[emma5410]

The topic or premise seems confusing to many. Let me try it a different way.

If one of the major points of living in your target gender for at least a year is to head off making an irreversible surgical error (SRS), then what do I make of the common situation of STARTING RLE with FFS and other procedures? How meaningful is it to start the clock for one irreversible procedure when you initiate it with another?

The same could be said of HRT. Some aspects of which are irreversible. Maybe HRT and FFS should not be allowed until after RLE. Of course that could make the RLE almost impossible and doomed to failure.
If you use the NHS in the UK then they expect you to live the first 3 months of your RLE without hormones. You could say they are setting you up for failure.
I think the attitude is that SRS is the most drastic of all the procedures. Once your penis has been removed then it is impossible to replace it in its present form.

We all know that some people believe that they are TS only to find being a woman is not what they wanted or expected. If they do the RLE then maybe they would realise that before SRS. Of course, those who are convinced they are TS find that restrictive and want SRS on demand. Everyone is sure that they are in the second group and not the first until the moment they find themselves in the first group and de-transition.

I am not sure that this question has an answer. At the end of the day we are all responsible for our own lives. Or should be, but increasingly we live in a blame culture. If we make a bad decision then it must have been someone else's fault. Maybe that is what makes the medical profession reluctant to sign off too quickly on SRS.

As I said earlier I have found my RLE invaluable. But then, I was already on HRT beforehand so I have already changed my body in some respects. In that sense I am in the camp of not waiting fully for RLE to do its work. But I still feel that SRS is the biggest step of all and should have some gate keeping around it.

[sandra-leigh]

As far as my local trans health clinic was concerned, I had started RLE years before I asked for hormones.

I have never asked, so I am not positive, but the indications I've seen from my trans health people and therapist are that they would clear me for SRS if I asked. But my therapist would first want to know what I was going to do about my relationship. I don't think any of the people involved would be asking for more RLE from me. But to be sure, I have no intention of considering SRS seriously until I have at least done a legal name change (and so essentially "come out" to the rest of my relatives and friends) and lived with that for awhile.

[Kimberly Kael]

To live openly is the end result but you still know you are not right even if no one else does.

No amount of surgery is guaranteed to change your self-image, nor is practical experience a cure-all for that matter. Where it gets sticky is that for some it's next to impossible to be perceived as female without at least some intervention, which muddies the water. Finding a path forward with minimal risk where you can still start to see some success and determine whether it feels comfortable or not should be the real goal. I think that's how many gatekeepers are starting to reinterpret the guidelines.

For me that was possible without surgery or HRT and I found that initial approach very rewarding. I've been able to approach subsequent decisions as any other woman with a hormone imbalance and other genetic challenges. YMMV.

[Badtranny]

On the one hand, I agree with LeaP, on the other hand Sandra-leigh throws a curve ball by believing she is in RLE when she hasn't even changed her name or come out to relatives.

How can one be living full time as a woman and yet not be out is beyond me, but I guess my idea of what a Real Life Experience is may be different than others.

I think living and working full time as your intended gender for a scant 12 months isn't very much to ask of someone before SRS is cleared. My first year flew by before I knew it.

[Angela Campbell]

This is a psychological thing and it is common for some to convince themselves prematurely this is the right thing and the possibility for making poor decisions is a concern. The medical community really does not know enough about this to diagnose so they tend to err on the side of caution. Sometimes too much, sometimes not enough. Of course anyone who desires SRS wants it NOW, and will be in many cases willing to just jump off the cliff when they are not ready. Having an outside point of view of your progress is necessary because self judgement is easily blurred by desire.

There is nothing magical about a year. Is a year sufficient but 364 days is not? Well if 364 days is ok then is 11 months ok? It is just a guideline and a way to just slow things down. Even this is not really standard everywhere. I have heard of the minimum 3 months before starting HRT and I have heard of wanting you to do RLE before HRT. I know some doctors do not want to do SRS until you have been on hormones for at least a year. That I can easily understand. The RLE seems to be in the spirit of getting a learners permit before getting the drivers license. No one wants to wait but it is a good idea.

I have also heard about time limits before BA. I am not sure but do you still need a letter for BA or does a legal name and gender change make this not necessary? There are hoops to jump through all the way and in some places they are different from others. Can you really say though, that there are not some out there who need to have the reins pulled back and be required to have the RLE before a major surgery? Yes there are some who likely do not need this, but judging from just what you see here on this forum could you in clear conscience say that unlimited access to SRS is a good idea?