Sunday, September 14, 2008

The Real Life Test - Is it really necessary?

Stephen Whittle has posted a very interesting article on the Real Life Test or as he more accurately describes it, the Real Life Experience. This is the requirement embedded in medical practice of treating trans patients that we are required to live and work successfully in our intended gender for a period of at least a year - though 2 years in practice, before we an qualify for surgery. Reading Stephens Article, The Real Life Test: to be or not to be, that is the question has challenged my own thinking on this. Should there even be a requirement for "living in role?"

I suppose the difficult questions is whether a trans person should be entitled to surgery even if they are unable to cope with living publicly in their acquired gender. I have come across a small number of trans women who feel they should be entitled to have the right body even if they continue to present a largely male gender. I was recently consulted by a leisure centre faced with a dilemma. A trans woman who presented in their view as male and is preoperative, wanted to use the female open changing facility. They offered her access to a disabled changing facility where she could change in private which she accepted, but she has subsequently returned and asked again to use the female facilities.

Our laws here in the UK permit a trans person to legally change gender without having surgery - and this is often the situation with trans men where surgery is less satisfactory. So if it is OK for a trans man to have a vagina - then surely it is OK for a trans woman to have surgery and still present as a male - especially if it is very difficult to pass. If you are over six foot, with little hair and a very masculine build it is always going to be difficult to pass. But should the reconstruction of our bodies be in anyway linked to the presentation of our gender?

On the other side, of the argument, if it is important for a trans person to be accepted in their correct gender, having surgery is not going to change the way we are treated most of the time. If I do not present a gender expression that other people see as female then I will be treated by many as "different" and will likely be subject to a degree of discrimination even humilliation. We can change all the laws we want - but it will not stop people from treating me inappropriately, just as disability, age, race and other discrimination laws do not stop the issues from happening.

It seems to me that the primary reason for the RLE is to reduce the likelihood of someone suing the medical profession if they change their minds and claim that the doctors were wrong to agree surgery. This has been aggravated by the case of Charles/Samantha Cane. Cane was able to a degree to circumvent the RLE rules because he could afford to. He made a lot of money also from a book and film about his experience then changed his mind, destroyed the career of a leading gender Psychiatrist who was seen to have supported surgery to easily, Fear of litigation is in my view the primary motive for the RLE, although the general social pressure to fix everyone clearly into the gender binary is also a problem.

I have a gender recognition certificate but I am still pre-operative - largely because of the huge waiting lists for surgery but also because I was not in a hurry for surgery - I was more interested in tackling the social challenges and gaining public acceptance as a professional speaker. When I finally got to the gender identity clinic, I was told I wold need to complete two years RLE. When I pointed out that I had already done three years and that my driving license and passport proved that, I was informed that didn't matter I had to do another two years supervised by them. That has now dragged out to three years, mostly because I have not appeared to want it urgently enough which I think they measure by evidence of self harm attempted suicide depression etc.

A friend, who for a variety of good reasons lives in both genders has been refused a referral to the gender identity clinic because she is happy to work as a man (she finds it pointless putting on a wig and make up to do what can be quite mucky manual work work.) Essentially they decided that she would be unable to complete the RLE so refused any treatment.

As I have written this article I have discovered that I really do not have a totally clear view on this myself, but that I am certain that the present policy around the RLE is not right. It is based on a presumption of a sterotypical norm for gender presentation. In order to secure the surgical and hormonal changes that will enable us to reconcile the mismatch between our physical bodies and out gender identity, we are forced to comply with a gender norm, after which we are then free to express ourselves anyway we want. This is exactly what a number of my trans friends have done, settling eventually for a largely androgynous gender presentation, but happy with the sence that they do now have the body they felt they should have been born with.

I think reflecting on this that the real focus should be simply to help trans people to cope with being who they are, not in making them tr to be who society wants them to be. Then perhaps we should be trying to do that for everyone.



Empress Lainie said...

I am one who does not fit a mold either. The day I actually discovered my true mind gender I began living it 24/7. I have been living as a woman now with F on my drivers license and my legal female name since July 2, 2007.

I haven't done any electrolysis, I have only taken phyto (herbal) estrogen, but my body was basically female enough that I have no problem in being accepted as female, even with my natural voice.

Since I was totally bald on top I wear wigs, but I have seen my hair returning on the top of my head.
I will likely have to wear wigs for the remainder of my life tho.

But I wore wigs before my transition since due to my true female nature I hated being bald.

I lost my livelihood and havent been able to replace it becuase 3 people, one of whom had authority, did not like that I was transgendered.

The US EEOC filed a suit on my behalf and I have filed criminal charges against two of the people as they violated specific state laws.

I can never see myself going back to living outwardly as a man again.

I will be 74 next month. My discovery of my true gender answered all the questions I ever had about myself and why I was always different from other boys or men.

'Empress Lainie"

Empress Lainie said...

My story of my journey is posted in Journals section of

Just a note, I was never a male crossdresser myself. The site is for mtf's ftm's as well as any other genderbending people.