Real life experience
Encyclopedia
Real-life experience is a process where transsexual and transgender
people live full-time in their preferred gender identity
for a period of time, in order to demonstrate that they can function as a member of said gender. Functioning in their preferred gender includes some or all of the following abilities, as reviewed by the person's clinician:
Historically, this process was a prerequisite to receive permission for hormonal treatment and sex reassignment surgery
.
A minimum requirement of RLE is no longer part of the World Professional Association for Transgender Health standards of care
(SOC) requirements for hormonal therapy. Either three months of RLE or a specified time in psychotherapy (usually at least three months) now suffices. The current SOC states: "Although professionals may recommend living in the desired gender, the decision as to when and how to begin the real-life experience remains the person's responsibility."
With respect to genital surgery, a continuous 12 months of RLE is a requirement. A year containing intermittent periods of returning to the original gender are not considered to fulfill the RLE criteria for surgery. The SOC states: "Individuals cannot receive genital surgery
without meeting the eligibility criteria.... The SOC provide for an individual approach for every patient; but this does not mean that the general guidelines, which specify treatment consisting of diagnostic evaluation, possible psychotherapy, hormones, and real-life experience, can be ignored."
However, clinical practice in many places may be more or less stringent. In the United Kingdom, most National Health Service
trusts will require 24 months before surgery, whereas in Thailand
, some surgeons do not require the completion of the RLE.
Transgender
Transgender is a general term applied to a variety of individuals, behaviors, and groups involving tendencies to vary from culturally conventional gender roles....
people live full-time in their preferred gender identity
Gender identity
A gender identity is the way in which an individual self-identifies with a gender category, for example, as being either a man or a woman, or in some cases being neither, which can be distinct from biological sex. Basic gender identity is usually formed by age three and is extremely difficult to...
for a period of time, in order to demonstrate that they can function as a member of said gender. Functioning in their preferred gender includes some or all of the following abilities, as reviewed by the person's clinician:
- To maintain full or part-time employment
- To function as a student
- To function in community-based volunteer activity
- To acquire a (legal) gender-identity-appropriate first name
- To provide documentation that persons other than the therapist know that the patient functions in the desired gender role.
Historically, this process was a prerequisite to receive permission for hormonal treatment and sex reassignment surgery
Sex reassignment surgery
Sex reassignment surgery is a term for the surgical procedures by which a person's physical appearance and function of their existing sexual characteristics are altered to resemble...
.
A minimum requirement of RLE is no longer part of the World Professional Association for Transgender Health standards of care
Standards of care for gender identity disorders
The Standards of Care for the Health of Transsexual, Transgender, and Gender Nonconforming People are non-binding protocols outlining the usual treatment for individuals who wish to undergo hormonal or surgical transition to the other sex...
(SOC) requirements for hormonal therapy. Either three months of RLE or a specified time in psychotherapy (usually at least three months) now suffices. The current SOC states: "Although professionals may recommend living in the desired gender, the decision as to when and how to begin the real-life experience remains the person's responsibility."
With respect to genital surgery, a continuous 12 months of RLE is a requirement. A year containing intermittent periods of returning to the original gender are not considered to fulfill the RLE criteria for surgery. The SOC states: "Individuals cannot receive genital surgery
Sex reassignment surgery
Sex reassignment surgery is a term for the surgical procedures by which a person's physical appearance and function of their existing sexual characteristics are altered to resemble...
without meeting the eligibility criteria.... The SOC provide for an individual approach for every patient; but this does not mean that the general guidelines, which specify treatment consisting of diagnostic evaluation, possible psychotherapy, hormones, and real-life experience, can be ignored."
However, clinical practice in many places may be more or less stringent. In the United Kingdom, most National Health Service
National Health Service
The National Health Service is the shared name of three of the four publicly funded healthcare systems in the United Kingdom. They provide a comprehensive range of health services, the vast majority of which are free at the point of use to residents of the United Kingdom...
trusts will require 24 months before surgery, whereas in Thailand
Thailand
Thailand , officially the Kingdom of Thailand , formerly known as Siam , is a country located at the centre of the Indochina peninsula and Southeast Asia. It is bordered to the north by Burma and Laos, to the east by Laos and Cambodia, to the south by the Gulf of Thailand and Malaysia, and to the...
, some surgeons do not require the completion of the RLE.