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Real life experience

Real life experience (RLE), sometimes called real life test (RLT), is a process where transsexual and Transgender people live in their preferred gender role for a while, in order to demonstrate that they can do so; and historically to gain 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 state: “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.”

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, whereas in Thailand the WPATH SOC is not usually followed and RLE may not be required.

Real life experience is usually considered to start after transitioning full-time. However, some individuals may choose partial RLE, for example, living full time with the temporary exception of work or school.

The intention of requiring RLE is to reduce the incidence of post-treatment regret, by giving people more time to realise the full and sometimes unexpected consequences of transitioning. It also provides a time when people can learn to function in work, school, and gender appropriate social roles. During this time, people can begin documentation changes – especially legally changing one’s name to a gender appropriate one.

The RLE period can be dangerous for Trans people, since the person must live in their target gender with less than complete identity documentation, running the risk of discovery. Many Transgender people have suffered assault, murder, fatal denial of care, or other human rights abuses after the mismatch between their gender presentation and their genitals and documentation have become apparent.

While not guaranteed to prevent negative consequences, people who do not yet have completely congruent identity documents may wish to carry a letter from their therapist or physician. This letter should state that the person is under the care of the clinician and is undergoing a RLE as part of ‘prescribed therapy.’ While Transphobic individuals committing hate-related violence will not be affected by such letters, the treatment by police, health care providers, and other officials who control gender segregated facilities may be influenced by such documentation.