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.

"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!