The Harry Benjamin International Gender Dysphoria Association's Standards Of Care For Gender Identity Disorders (hereafter SOC), Sixth Version. February, 2001 

I have some serious concerns with one of the elements in the SOC, specifically The Real Life Experience.

The criteria in the SOC makes living full time in the preferred gender mandatory.   

After the diagnosis of GID is made the therapeutic approach usually includes three elements or phases (sometimes labeled triadic therapy): a real-life experience in the desired role, hormones of the desired gender, and surgery to change the genitalia and other sex characteristics.

 

An example of an eligibility requirement is: a person must live full time in the preferred gender for twelve months prior to genital surgery. 

The issue that I have with the SOC is not its requirement for success in living full time as the preferred gender, I would like nothing more, but its lack of definition as to what constitutes living full time as a female. 

There are many potential arguments but I will only list those that impact on me directly.

1. Clothes
2. Make up
3. Recreational Activities 

In particular, clothes or dressing as a female is not defined in the SOC. We are not given any indication about what constitutes dressing as a female for the transsexual female. Further, in any role of advocacy for sexual transition, the way this particular eligibility criteria functions as unnecessarily oppressive and dictatorial must be acknowledged. 

My argument is: there are an infinite variety of ways in which a person can present as female. The range of female types is unlimited and extends from cis-femine to uber-masculine. Therefore, The Real Life Experience is not only irregular, subjective, and undefined but also dismissive.

What this means is that the element of female presentation in the SOC is arbitrary and as such it is redundant. I would encourage others to lobby for a natural, uncontrived and more realistic acceptance of transsexual females in a variety of guises other than the current presumptuous stereotype. 

It is time, I think, for a socioethnic framework of transsexuality that understands the existential and postmodern issues faced by those with GID.

 

Regards

Chalice Brendale

*^_^*

This post was edited by Former Member at March 11, 2013 8:28 PM GMT

Chalice,

Most transsexuals wish to distance themselves from their past life as much as possible, which is why we no longer dress in male clothes and why we change our documentation so that when we work we do so as females (or males if you are going in the other direction).

The fact of being regarded as a male was absolutely abhorrant to most of us and so we tended to move as far away as possible from being thought of in that way ever again.  This does not mean I did not wear jeans or T-shirts or jumpers when I presented myself during my RLE or subsequently in life - in fact in winter I rarely wear anything else other than jeans and a jumper unless I am going out somewhere special.

The Real Life Test is about you working in the gender role that you identify with and being treated by other people as belonging to that gender.  For instance, if you continue to work as a male, but turn up to your psychiatric appointments (or even worse change when you get there) as a female, this will soon be discovered and you will not progress any further.

What they are looking for is not whether you dress up like a drag queen, but proof that you are living and working in the gender role of your choice.

Thanks

 

But I am not most transsexuals I am just me.

I think it is important to be able to consider someone else's perspective because that makes dialogue possible. I understand your perspective and the gist of my objection is that it is 'old school',  if I can say that respectfully.

 

There is one major difference in my function at work which I think is totally arbitrary. Namely, a change of name. Here in Australia adolescent boys are often addressed with female names like Shirley, especially if they don't fit the macho image of masculinity. My point is many of the criteria which you and the SOC would strictly enforce are very superficial here.

 

I don't find the idea of being male abhorrent at all, I don't hate myself. On the contrary, I am aware of who I am and my aversion to masculinity is simply a strong wish not to have a male appearance. I cringe and retract from many of the male presentations around me.

 

So I don't think you have advanced a new direction, or argued for a reconceptualisation of the SOC.

 

Respectfully

Chalice

What is "just me" Chalice?? What do you want??
To have an SRS and still keep living as a man??
You have mentioned that in 7 years time you can retire and start drawing your pension - why not wait until then and then transition into whatever and however you want to live.

All the RLE wants is to make sure that you are a much happier individual in your chosen gender role, it has nothing to do with clothes or makeup.

What is wrong with the safeguards that the present SOC brings with it, it has been shown fairly conclusively that the regress rate for those that have undertaken a proper RLE are very, very small whereas those that have either skipped the RLE or cheated have a fairly high regression rate. Once the surgery is done it can NEVER be undone.

If the regression rate was as high for those who had done the RLE than those who hadn't, then I can understand the logic for scrapping it, but it isn't. Also, if the regressions were the same then I would also think that many surgeons might turn their backs on this type of surgery altogether.

Why are you such a special case that the whole concept should be turned on its head just to suit your own personal circumstances??

Carol 

There really is only one response to your support and advocacy of the the RLE in the SOC. Would you get real! 

The recent, tragic death of Lucy Meadows is not the one dimensional 'monsterification' by the media as you have suggested elsewhere, Transgenderism is multifaceted. And, there are several parallels between Lucy's predicament and my own situation to which I recently made this comment in reply to a wall post by Katie Glover.

I am a teacher and I keep getting told that I have to step into the Real Life Test and come out at my place of employment as fully transitioning.

Maybe now those who like to poke the needle of arrogance might pull their head in and accept that others just might have more insight and a greater feel for the recklessness of some decisions which can simply end in tragedy.

Notwithstanding, I shall continue to insist that the Harry Benjamin Standards of Care has some attributable fault and that there are elements in it such as The Real Life Test which is already archaic, anachronistic, atrocious and blatantly irresponsible.

The RLE only serves the interests of the Doctors who seek to protect their own arses. I work with adolescents, some who are gay, and others gender variant. I can confidently tell that you that their view on the Harry Benjamin SOC, RLE would be it is simply 'nutso'. There are a lot more "Style Me Querky" identities here than Shirley Temple kind of Good Ship Lolly Pop ones. Here we have a much more Velvet Underground type culture. And, they have the clarity of thought, as I believe I do, that we do not need a dichotomy of sexuality which tries to replace uber-masculine identities with cis-feminine ones. 

Put simply, Gender is a social hegemony which serves the oppression and exploitation of a small proportion of Society whom have a vested interest in reinforcing and perpetuating the status quo. 

I have been a Feminist of sorts for over 25 years, and a transsexual for at least 40. I still don't use a female name or wear make-up. Not only are those things redundant, but I could have the ultimate surgery and everyone would be none the wiser. At least I would still be alive.

 

Regards

Chalice.  

This post was edited by Former Member at March 23, 2013 1:27 PM GMT

I've read this thread withinterest, and I'd like to ask, Chalice, if you think the RLE 'test' is totally redundant.  If you do, what would replace it with, or would you replace it at all?

 

You see, my concern is thatthe RLE gives people a chance to think, to re-evaluate themselves and test out the waters to see if the really can live in their preferred gender.  Is it possible that a few bad decisions are avoided that way?

Amanda

 

I question the re-evaulation of living in a different gender.

In my past consultation with the gender surgeon Dr Simon Ceber (due to retire) he reliably informed me that they have completed many procedures in which males have continued to present as male after SRS.

 

You see, gender can't be both fluid and static. 

 

IMO. The RLE has had its day. 

A new paradaigm is dawning. 

 

Hallelujah to that. 

This post was edited by Former Member at September 2, 2014 11:58 AM BST

Chalice - thanks for the reply.  However, I did ask two questions of you, which, if you are happy to answer may give me pause for thought.

 

1. What would you replace the RLE with, or would you replace it at all?

 

2. I think that the RLE gives people a chance to think, to re-evaluate themselves and test out the waters to see if they really can live in their preferred gender.  Is it possible that a few bad decisions are avoided that way?

 

and finally,

 

3.  Would you prefer a situation where individuals will be able to access hormone treatment and surgery without any chance to find out what it is to live in their preferred gender, come straight out of surgery and be able to say look, now I'm a woman (or man) and just get on with it?

I know you have very strong views about this, and I am sure that there are very strong people like you who believe that the RLE issue is a waste of time. I suspect however that they are in a minority.

 

 

 

 

 

Amanda

 

I have time to reply so I will go over what has been threshed out before. 

 

I don't see the need to replace RLE with anything. It was a reasonable practice in its day but now its simply a mistake. Today the RLE is anachronistic. One reason is that it 'grafts' a perception of people in transition as crossdressers. This is not what is going on. There isn't any need to replace the RLE with anything. It just needs to be removed.

 

I think the RLE places people in shackles. For example, who is the arbitrator of what people in transition should wear. There are an infinite number of fashion styles and an emphasis on any particular description of female attire is simply erroneous. People can re-evalute themselves without being forced to jump through hoops which really are someone else's idea of what a woman should be. Not to mention that going cold turkey when changing sex is a bad idea. 

 

There is a confusion about the need for hormones, permanent changes to a person's appearance and the ultimate step of surgery. Being male or female requires a procession through developmental stages. Clearly, the developmental stages of a person's old/previous sex are detrimental to the transsexual. Transition requires a change in growth and development as well as social adjustment. However, these things are dependent on the reversal and establishment of secondary sex characteristics. Dressing as a female, or the opposite sex in order to appease someone else's idea of what it means to be transsexual is inarguably putting the cart before the horse.

 

Having said that, I accept there are those who will always maintain that the path to changing sex requires all transsexuals to live as a cross dresser for one or two years.

 

Regards

Chalice  

   

Amanda Bruce said:

I've read this thread with interest, and I'd like to ask, Chalice, if you think the RLE 'test' is totally redundant. 

If you do, what would replace it with, or would you replace it at all?

You see, my concern is that the RLE gives people a chance to think, to re-evaluate themselves and test out the waters to see if the really can live in their preferred gender. 

Is it possible that a few bad decisions are avoided that way?

All this just for the chance to re-evaluate yourself and test out the waters.

But at what cost?

Does anyone really need to test out the waters?

If an individual can analyse themselves enough to identify as transsexual surely they can guage how they will be received.   

 

Amy has to be a case in point.

The outcome of embarking on the RLE for Amy, or at least her current situation, has been less than optimum.  

I'm not saying in all cases, but in her case she was ill-advised to 'come out' as transgender. 

You know, before I get flamed for being insensitive, or whatever, there are at least two perspectives on this issue.

One of them is it could have been done differently.

 

There is absolutely nothing wrong with continuing with transition while gradually 'morphing' into a female.

In fact, over looking the exceptions to going full-time that are prescribed for RLE is simply an anachronistic and distorted reading of the Standards of Care.

 

A progression through stages of anti-masculine, metro-sexual, effeminate and finally feminine is a workable model keeping in mind of course that there are an infinite number of ways a person could identify, in the final stage, as female. This proposal has the advantage of arresting the progression at any stage, re-evaluating and redesigning the approach or even reversing the decision. And without putting everything at risk. 

 

It was pointed out by a SRS surgeon here in Melbourne that several individuals have had SRS and still continue to live in the male role. 

This post was edited by Former Member at December 27, 2014 8:15 AM GMT

Firstly, if you are Chalice, why not sign in that way.

 

Main points though.  What IS the cost to an indicidual of the RLE?

 

People do need to test the waters.  Seems silly to jump in then find you cannot swim.

 

There are very very few people who can 'analyse' themselves- successfuly.  Simply because they usually have baggage which is quite invisible to them.  I am NOT saying it is rare.  You may be one of the few individuals who can, in which case fine for you.

 

I cannot see where RLE is incompatible with your model - they both have the same end goal - to evaluate and stop or slow down as needs dicate.  RLE has the advantage in that it is probably beneficial to those who have not reached the capability for exacting self analysis that you have.