Real-life experience (RLE) 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:[1]
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."[2]
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.[3] 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."[4]
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.[5]
|
||||||||||||||||||||