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Thread: RLE before HRT?

  1. #1
    Transgender Member Dianne S's Avatar
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    RLE before HRT?

    A post on the Second Therapy Session thread caught my eye:

    Quote Originally Posted by Jorja View Post
    Progress into living 24/7 for a year or two before making any major decisions about what path you need to follow.
    I have gone out presenting as a woman, but I could not imagine going full-time before the body changes caused by HRT. Body-hair management and getting the right shape would take up too much time... so just wondering, what's the "typical" sequence? HRT and then RLE, or vice-versa? Interested in experiences from those who've done it either way and what they think the pros/cons of each are.

  2. #2
    Silver Member Angela Campbell's Avatar
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    For me there was no question...HRT for a while and at least for me ffs before going full time. Going full time before you can get the look right would be much more difficult.
    All I ever wanted was to be a girl. Is that really asking too much?

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    Member Aimee20's Avatar
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    Agreed, starting hrt will not cause any immediate, drastic, or permanent changes in a short amount of time; going full time however will. Typically during your first year with hrt you are building up more and more to fulltime and during that period you will generally hit the brakes and go a different direction if a complete transition is not right for you.

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    I've made it and love it Jennifer-GWN's Avatar
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    Dianne;

    Thanks for asking this question as this is one topic I have been struggling with as well. My impression is that the establishment would like us all to follow one particular path. There are good arguments given the medical and physical ramifications that come with HRT but which comes first should be a personal choice and one that works best for the individual and their particular situation.

    I'll leave it at that at this point as I'm new here and want to ease in at this point and listen.

    Cheers...Jennifer

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    Back in 1980 when I transitioned, RLE was a requirement prior to issuing HRT. Over the years RLE has become looked at as a cruel and medically contra-indicated practice. It is not required these days. However, even if it was cruel, it helped thousands make the decision whether or not to continue down the path and did a damn good job of sorting out those who wanted to continue on or quit.

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    Nothing like a bit of cruelty to separate the girls from the boys.
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    Living MY Life Rachel Smith's Avatar
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    I didn't go RLE 24/7 pre-HRT and frankly don't know how you could go RLE 24/7 before you decide to transition and why would you start HRT if you are not going to transition. 24/7 to me means work and every where else. That means risking a lot before you have even decided if transition is right for you. So do I have this wrong Jorja? Did you decide transition then do RLE then start HRT?

    What I did was live 2 years of RLE everywhere save work, there I was still the male me. I would go to work as Rachel save makeup, then change to Randy for work. After work I would change into Rachels' clothes and do my makeup for the drive and all stops on the way home. All days off were lived as Rachel. At this time I was also doing my due diligence with my therapist(s). The main question I kept asking myself during this time was "is it just the thrill or am I really TS. All 3 of my therapists had told me they thought I was but it took me 1 1/2 years to make MY decision which I didn't make until one attempt at ending it all. The pain I caused my family and friends by doing that told me what I needed to do. Then it was 6 months until I came out at work and to my family.
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    Back in those days there was no decisions Rachel. If you wanted to transition you did it their way or no way at all. RLE for 2 years then HRT would be prescribed. If you were extremely lucky, your therapist could sign off after 1 year if they thought you were really really serious about it. Thank God I was really really serious about it. You girls complain about the gatekeepers. You don't know how good you have it.
    Last edited by Jorja; 09-19-2014 at 09:45 PM.

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    Member Kimberly Kael's Avatar
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    I chose to transition socially before anything else, so yes I started my RLE without HRT entirely voluntarily. I had done laser hair removal and had a fair bit of practical experience for brief periods of time. I had zero doubts about my path but I didn't want to believe that my womanhood was predicated on medical intervention. I wanted to approach any decisions on their own merits, not because I was afraid to live openly and honestly. Of course I don't pretend that what I thought was important for me applies to anyone else so take all of the above as a purely personal decision-making process.

    After two years I finally took the jump for my own reasons and on my own schedule.
    Last edited by Kimberly Kael; 09-19-2014 at 11:46 PM.
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  10. #10
    What is normal anyway? Rianna Humble's Avatar
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    I began my social transition well before I got an appointment with the Gender Identity Clinic. I could not have continued living and having to present as male. In the end it was nearly 18 months before I got the prescription, but living an authentic life and becoming accepted for who I am simply could not wait.

    The only place I ever see any suggestion of a rigid one-size-fits-all approach from the medical community is here, generally from people who don't like the fact that the doctors treating them actually have standards for giving you the best care that they can.
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  11. #11
    In transmission whowhatwhen's Avatar
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    I started HRT before doing any "real" work towards social transition for one big reason.
    I still look like a man.

    IMHO I have to at least try to meet people half-way. Sure, I could probably get by if I wore makeup but I don't want to so my physical transition will take longer.
    Sure I can say "my name is Corinne, please use she/her/hers" but if I still have beard shadow and masculine features it's asking too much of a society that is barely just coming around.

    By the time it came to start HRT I was already looking fairly queer and I had stopped actively hiding and specifically putting forth a male image.

    So if I had to do RLE first that would mean that I'd have to cake on the makeup to maybe not even pass and take more shit than necessary for over a year.
    Actually I've gotten off light on the shit so far, that tells me that I'm so early I'm not even being read as trans that often.

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    I think that it really is a case of what suits you, I cannot answer for the UK NHS requirements because I was 24/7 before even seeking any "professional" interaction. I do know that RLE is a requirement prior to SRS on the NHS route, however, not too sure about RLE prior to HRT.
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    Not sure if its the case now, but under the protocols in place with the UK NHS I had to be at least three months into RLE before I could be prescribed hormones. It was seen as a sign of "committment" !?! (This was in 2010) I then started on a low dose while my bloods were monitored. They were increased after the first blood tests showed good results.

    To be honest, I was just finally happy to get on with my life and hormones were a welcome addition, but how long do some of yo expect to be on hormones before you start the RLE? Hormones do not do everything, your own postivie attitude to life helps.

    Nigella, Kimberley & Rianna were living as their true selves long before they started on the "magic" pill. The hormones just help on the path.
    Last edited by Nigella; 09-20-2014 at 10:43 AM. Reason: Dosages are not allowed

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    Silver Member Angela Campbell's Avatar
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    Quote Originally Posted by LeaP View Post
    Nothing like a bit of cruelty to separate the girls from the boys.
    Yes but that is what the electrolysis is for not RLE.

    I did start hrt well before I was full time but at least 7 months of that I was living as a woman everywhere but work. For me "full time" was when my name and ID was changed and I never again attempted to look or appear as a man for any reason.

    I'm not sure if my therapist ever saw me as a man.
    Last edited by Angela Campbell; 09-20-2014 at 06:40 AM.
    All I ever wanted was to be a girl. Is that really asking too much?

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    Silver Member Kathryn Martin's Avatar
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    Under the Standards of Care RLE is not required for hormone therapy. You have to have at least three assessment session over a minimum of three months with your psychologist.

    RLE is required for SRS. The purpose is to demonstrate that you can live your life before making substantially irreversible alterations to you body. It used to be 2 years.

    In the UK 2 years of RLE was required to do any intervention whatsoever. But you even had to be cleared for RLE to slot into the gove that the psychiatrists insisted on. I have seen some videos of therapy session in the 1970s. Let me tell you about gatekeeping, holy smokes. The psychiatrists completely controlled your life and were nasty about it too.
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  16. #16
    Gold Member Kaitlyn Michele's Avatar
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    I think your view of RLE is a bit more hopeful than realistic.. It can easily be an awkward time... body changes happen slowly and can be more subtle than meaningful and hair removal can go on for well into transition...

    When I went full time I was much more weirdly androgynous than feminine... and there were some very awkward moments...remember it also takes time before you can change your name for example..
    you just have to deal it...

    HRT is best when you are simply ready to have HRT improve your quality of life...

  17. #17
    Transgender Member Dianne S's Avatar
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    Thanks for all the replies.

    I'm about 8 months into laser hair removal and a month on spironolactone. My hair and skin are the perfect candidates for laser, so I'm going to keep going on laser until it makes no more difference; I'm hoping there won't be too much left for electrolysis.

    I like to go out presenting as female, but the issue for me going full-time is simply the amount of time it takes me to look presentable. There's no way I could keep up a normal work schedule with all that preparation.

    Here in Canada, there's no RLE requirement for hormones, but I believe you have to be one year full-time to qualify for SRS, which frankly isn't even on my radar yet... for various reasons, I think stopping at hormones and full-time presentation might suffice for me.

    I'm starting to present female more and more on weekends and plan to progress to full-time-except-for-work like Angela did.

    Thanks again to everyone for sharing their experiences.

  18. #18
    Silver Member I Am Paula's Avatar
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    I went full time except for work before HRT. When I went full time, I was still kidding myself this wasn't going any further. Very quickly I decided I needed to transition fully. When my therapist gave me my HRT readiness letter, I said to make a note that I was officially starting RLE. She looked at me a bit strangely, and said 'Your RLE is done, call me when you need the letter'.

  19. #19
    Silver Member Kathryn Martin's Avatar
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    Quote Originally Posted by Dianne S View Post
    I like to go out presenting as female, but the issue for me going full-time is simply the amount of time it takes me to look presentable. There's no way I could keep up a normal work schedule with all that preparation.
    Seriously that is the weirdest reason for not going out I have ever read

    When I started it took me 1.5 hours. Now, with shower, hair, makeup and dressing 30 minutes which is a normal morning routine. And I look fabulous as my friend Art keeps saying.
    "Never forget the many ways there are to be human" (The Transsexual Taboo)

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    It will take less and less time, I am sure. Losing the beard will be the biggest difference, and noticing that most women do not look they are going to a ball everytime they step out of the house.

    Starting any sentence with "here in Canada" can be problematic. Each province has its own thing going on in regards to standards of care and what is covered or not by health insurance. It's evolving continuously. For instance, SRS is no longer required by law for a gender marker change in Quebec, but it is by the agency that emits birth certificates and grants gender modification certificates (Bureau de l'état civil). So SRS is sill required until the agency changes its rules to follow the law.

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    Quote Originally Posted by Kathryn Martin View Post
    Seriously that is the weirdest reason for not going out I have ever read


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  22. #22
    Silver Member I Am Paula's Avatar
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    Quote Originally Posted by Kathryn Martin View Post
    Seriously that is the weirdest reason for not going out I have ever read
    I really had to chuckle at this one. One half the world's population manages to get out the door in a timely manner.

  23. #23
    Transgender Member Dianne S's Avatar
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    Hi, Frances,

    Yes, I know that in Canada it varies province-by-province. But I'm not aware of any provinces that require RLE before HRT.

    From now on, I'll be more precise and say "Here in Ontario"

    LeaP said: There are many ways of measuring intensity. One is apparently one's preparation horizon.

    Well, true. I think going full-time when I'm not confident I'm ready may actually make things worse. I won't be deterred by negative reactions, but at the same time they're quite painful and I certainly do my best to avoid them. I feel that more hair removal and at least half a year on HRT is required to build my confidence.

  24. #24
    Gold Member Kaitlyn Michele's Avatar
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    Its just the way it is that the people that have transitioned will arch a brow when we hear that you won't go full time because it takes too much time to get ready...

    HRT is not going to make it take less time to get ready and I transitioned in 2009 and I still shave every other day. (after laser AND almost 300 hrs of electroylysis...I got screwed on that one)

  25. #25
    Member Kimberly Kael's Avatar
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    So true. Anyone holding out hope that HRT will do anything about facial hair hasn't done their homework. Laser / electro will do far more for being read as female than any of the subtle effects of hormones. Getting your morning routine down to the point where you can do it in your sleep makes a real difference, but between hair and fairly basic makeup that's still half an hour out of every single day that you have to appreciate isn't the unique province of a trans woman. Other women are under the same pressure to look like our society expects women to look.
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