Real Life Experience - Test or Torture?
It is surprising that there is very little research evidence supporting the use of the RLE, and there is very little information to back-up the time-frames specified, yet it remains an important component of treatment. Clinicians argue that it makes sense to allow the time to try to ensure that correct decisions are made but the RLE has attracted criticism from some of the transgender community.
More recent research by Lawrence (2001) studied a small number of post-operative transsexuals who underwent less that 12 months of RLE before surgery and found no evidence of regret.
A review of the literature by Rachlin (2002) found that the incidence of post-operative regret is generally very small, perhaps only 1%, with no relation to the length of RLE prior to transition. Negative prognostic factors tend to be associated with psychological readiness and stability, poor emotional support and social isolation rather than to the RLE itself. However the specialist services argue that, without the RLE, many of these factors associated with poor outcome can remain hidden until too late and feel that the RLE is a central requirement to protect transsexuals in their decision-making.
More recent research by Lawrence (2001) studied a small number of post-operative transsexuals who underwent less that 12 months of RLE before surgery and found no evidence of regret.
"There is surprisingly little empirical evidence that a one year RLE, or indeed any RLE, is either necessary or a sufficient condition for achieving favourable outcome after sex reassignment surgery." (Anne Lawrence).
A review of the literature by Rachlin (2002) found that the incidence of post-operative regret is generally very small, perhaps only 1%, with no relation to the length of RLE prior to transition. Negative prognostic factors tend to be associated with psychological readiness and stability, poor emotional support and social isolation rather than to the RLE itself. However the specialist services argue that, without the RLE, many of these factors associated with poor outcome can remain hidden until too late and feel that the RLE is a central requirement to protect transsexuals in their decision-making.
What are your own experiences of the RLE? Do you think it is necessary? How long should it be? What helps and what hinders the RLE?
Please let us know your own views and personal experiences!
Please let us know your own views and personal experiences!
posted by Transgender Explored at
7:11 AM
15 Comments:
I had 2 years of the RLE before I could have hormones. I couldn't have been more sure before starting the RLE. I felt it was more about proving what I wanted than helping me with my decisions.
I have been on hormones now for a year and have to wait for my surgery. I think it is too long, especially because I will be 50 this year!
Janet
I am a FTM and I have known since I was 4 that I was a man. I have always dressed and acted like a man. Why do I need to do a RLE test? I have been doing it all my life. I think it's a waste of time and 2 years is a long time to wait.
Iain (26), Cardiff
I think the RLE is a good idea, but 6 months is enough time.
Eleanor (61)
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Me and my transmen friends think that it should be shorter for FTM's. All the transmen I know have always felt like they have been in the RLE and have not had to "switch over", so it can feel a bit like an unnecessary nuisance.
Jack, Jason and Ade, :-)
The RLE should be different for transmen. I started hormone injections after 3 months RLE, but I have always been known as Adam by all my family and friends, so it didn't feel like it was that important to me
I am 1 year through the RLE and I still live with my wife. I have 3 children ages 10, 14 and 16. They have needed a considerable amount of time to adjust. It is putting quite a strain on the family, but they are all supporting me. I plan to have to operation in 2 years time. I don't think my family would cope so well if it hadn't been slowed down. I know everyone is different, but I do not think the RLE is anything that can be rushed.
My dad (well, now my other mum), had to do the RLE for 2 years and she got really depressed for about a year when she had to change-over with her job (in a factory) and the family were really worried about rushing into getting the operation and stuff.
The doctors said they might make the RLE longer, but as it happened, things were OK. I'd have been worried if the RLE had been shorter, especially if she'd had to face the surgery when feeling so down.
I think the RLE should be at least 2 years and I am pleased things aren't done quicker.
Who came up with the name Real Life Test? For trans people, life is real from birth. It's a shame that medical services do not acknowledge this
The specialist services do acknowledge it, Jonnie. When I went through the RLE I needed as much support as I could get. I don't think it is as clear cut as you are saying.
That's why it's important to get referred quickly. My family doctor needed to be hassled quite a bit but once I got seen by a local psychiatrist, I was seen at the gender identity disorder clinic within 6 months and started the RLE straight away. They even back-dated it 6 months from when I changed my name by deed-poll.
As a friend and ally, I have noticed that for almost everyone these arbitrarily timed "RLE's" have just been one more in a long list of hoops to jump through. However, I do know one individual, not personally, but through work, who was transitioning hormonally from MTF for more than a year, has recently resumed his male identity. I would say in his case that it is lucky he didn't have surgery. But I also think his switching back to his male identity is related to some other areas of instability in his life which have been revealed in, for instance, a deep fascination first with wicca, then satanism, then Islam.
I am 40 this year and have been trying to repress my real feelings of wanting to be (a girl then, and woman now) since aged 9.
The RLE is the part that I am petrified about the most; primariliy because I don't want to be judged or laughed at. I am extremely sensitive and this could destroy me mentally as I am already lacking in self-esteem and confidence. Having said that, my inner urges to be Annemarie - in every context of my life - are so powerful and surface all the time, so I feel that like it or not this is a process I have to go through. I can only hope that it won't be as bad as I imagine it to be.
I have seen transexuals in public when shopping for example, and I have nothing but admiration for them. After all, who really, would want to put themselves in such a vulnerable position around others? The body/mind is clearly trying to tell you something.
Annemarie.
All the opinions I've heard on this subject leave me with one major conclusion - Different people need a different amount of time, and the RLE should be assessed on an individual basis; preferably with that time reconsidered every six months or so.
I know in my own case, now six months into my RLE, that I need some time to transition. I've come a long way in that six months, and I couldn't honestly now say what would be an appropriate time for me.
I now think I'd be ready for SRS by the time I've completed a year, but whether I will think that when I reach that point, I couldn't say.
Of course it's not like completing the RLE gets you an immediate operation. You could have to wait a year or more for that.
Agree with the comments re RLE. Tankfully my therapist as allowed me to start hormones before i start RLE as know at the moment i would not pass as a woman (I am MTF). However, i cannot wait to start as becoming the real me is something i have wanted for approx 30 years (i am 36) and feel i have been living a lie for all this time
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