What does Real Life Test test exactly?

[Guest Hannah]

My number on priority is getting my testestrone levels down to a healthy range. To me, that means castration.

I finally saw a therapist, and she said I would have to wait three months to begin hormones, then a year to get an orchiectomy. So I guess the upcomming fifteen month period is my real life test.

I live as a woman because several months ago I lost the ability to be something I'm not. There is no plan B at this point (although I'll confess that letting my problem get to that point before addressing it was bad planning on my part :/ ).

Anyway, with any test, I suppose there's a possiblity of failing the test. What kinds of things would cause me to fail? I want to have security in that there's a plan to get the testestrone out of my body before really proceeding to do much else in the way of physical transision.

[Guest nomnomnom]

Hi Hannah,

Once you're ready for hormones, your doctor / endocrinologist will prescribe you something that blocks testosterone production. You are unlikely to have to require an orchiectomy to stop T unless there is a reason you cannot take the drug. (health issues, etc).

[Guest Kelly-087]

Is it RLT Prior to hormones?

Because that's kind of really outdated, and most modern psychologists (As in: Educated in the past ten years) don't do that.

And also you don't need a therapists approval for an orchiectomy. Although your insurance might require it. But you could go, and pay a doctor if they're willing to do it and they don't need proof you've seen a therapist.

As far as RLT I thought that term was only really used prior to SRS. It's a period of time, about a year where you're supposed to live full time, or at least as closed to as you can get awhile. It's not really a test, but more like a test for you to make that it is what you want before something truly irreversible is done (many things from hormones are reversible, some are not) and also to give your providers and surgeon assurance that this is what you want.

[Guest Hannah]

It's not really a test, but more like a test for you to make that it is what you want before something truly irreversible is done (many things from hormones are reversible, some are not) and also to give your providers and surgeon assurance that this is what you want.

Ah. So it's not a test in the sense that you will be evaluated on your ability to be a woman by someone else. It's just a test to make sure the desire to continue is persistant. OK. That's what I wanted to hear.

And I'm OK with the time frame as long as I can reasonably expect that nothing will keep me from moving forward. I want the full SRS surgery, but am probably going with the oriectomy first because unless I become rich in the next fifteen months, it will take me awhile to afford the full surgery. I don't know if the three month wait is really a RLT -- it's probably just another attempt to make sure the desire to change the body is not impulsive.

Thanks for your replies.

[Guest KimberlyF]

Is it RLT Prior to hormones?Because that's kind of really outdated, and most modern psychologists (As in: Educated in the past ten years) don't do that.And also you don't need a therapists approval for an orchiectomy. Although your insurance might require it. But you could go, and pay a doctor if they're willing to do it and they don't need proof you've seen a therapist.

The Standards of Care are like a building code. There is the national code, like the SOC, and there are local codes that surpass the national code. They have every right to do that in their home.

Some of the psychs who signed and helped write the SOC have stronger requirements for their own patients.

And according to the same standards, you are required to have at least one letter for an Orchi.

[Sakura]

The idea of RLT seems kinda silly to me. As many who realise transition is not for them usually come to that relaization 3-4 years well after they start . 1 year to explore the gender that you will be for the rest of ones life when one will likely not even beclose to the person they will become in a years time aposed to a life time of growth and or failure that will fallow. a year i feel is no where near long enough to gauge such a thing. after nearly a decade of living as a woman. the socialization i have learned the experiences i have had. i realize now, that one year blip of RLT. has been nothing in the the grander scheme of my life as a woman.most of it was spent piecing a working life back together from the tatters of my old life. looking back now i have grown so far beyond that person that i was at that time, that me and her are barely the same person now.

I have seen others fail this test.so it is not impossible. the problem is most that do fail , fail long after it is to late. though it is not for me to judge ones failure or success . i have just obseved them admitting it to them selves. keeping your head and your arse wired on tight and only you make the right decisions for your self and you will succeed or at the very least know your self more honestly.

good luck in any case though

Sakura

[VickySGV]

Sorry to do this Kelly, but the SOC 7 specifically states on page 60 that two referrals are necessary for an orchiectomy. Even with the referrals there are very few doctors who will remove healthy tissue, so there are a limited number of surgeons who will do it.

The good news is that T blockers do an excellent job of letting the T do its job less and less effectively in a very short time, and will allow the E to take over and help you out. Even genetic women have T working in their bodies every day, and now that my SRS is over, I still have feminine range T, which is all it takes.

Real Life Trial is somewhat of an outdated term and idea, but it means simply conducting you daily life as your preferred gender without vacationing back in male (or female) mode. This means visiting your transphobic Aunt Hattie's as your female self in spite of all the noise it will bring. You are committed to living full time and not playing a who am I going to be today. From what the OP has stated, they are already on their way, and the only way to "fail" the test is to go back to male presentation for any reason other than Halloween or being in a stage cast. You do not need a therapist's OK to do it, and your starting time was whenever you did it. You will decide if you flunked it and not the therapist or doctor. A couple of the surgeons today only pay lip service to it for ths sake of their insurance for people here in good old USA. I did not start my full time living as a woman (and there are those who don't even think I am today) until I was just a little over two years on hormones, but I cross dressed frequently, but I had not come out on my job, and was volunteering with an organizaton that I can no longer be part of. (Their loss!!)

[Guest Hannah]

The idea of RLT seems kinda silly to me. As many who realise transition is not for them usually come to that relaization 3-4 years well after they start .

Hi, Sakura! I guess I look at it like this: making your best guess as to what you need will not always lead to future happiness, true. But not doing what you feel you need will always lead to guilt...

Although I am curious...as you said some fail, what does failure look like?

Sorry to do this Kelly, but the SOC 7 specifically states on page 60 that two referrals are necessary for an orchiectomy. Even with the referrals there are very few doctors who will remove healthy tissue, so there are a limited number of surgeons who will do it.

The good news is that T blockers do an excellent job of letting the T do its job less and less effectively in a very short time, and will allow the E to take over and help you out. Even genetic women have T working in their bodies every day, and now that my SRS is over, I still have feminine range T, which is all it takes.

Real Life Trial is somewhat of an outdated term and idea, but it means simply conducting you daily life as your preferred gender without vacationing back in male (or female) mode. This means visiting your transphobic Aunt Hattie's as your female self in spite of all the noise it will bring. You are committed to living full time and not playing a who am I going to be today. From what the OP has stated, they are already on their way, and the only way to "fail" the test is to go back to male presentation for any reason other than Halloween or being in a stage cast. You do not need a therapist's OK to do it, and your starting time was whenever you did it. You will decide if you flunked it and not the therapist or doctor. A couple of the surgeons today only pay lip service to it for ths sake of their insurance for people here in good old USA. I did not start my full time living as a woman (and there are those who don't even think I am today) until I was just a little over two years on hormones, but I cross dressed frequently, but I had not come out on my job, and was volunteering with an organizaton that I can no longer be part of. (Their loss!!)

My thought was to find a doctor who did SRS, too, so that it could be done in a way that wouldn't disqualify future SRS. But I guess I have time to search...

As far as RLT, I think someone who is able to present in guy mode for the comfort of others once she stops repressing her gender is a stronger person than I am.

I'm sorry it didn't go so well for the volunteer organization...

[Sakura]

Trust me.... you will know it when you see it.

[Guest Hannah]

Trust me.... you will know it when you see it.

Hmm...a friend of yours, perhaps? If so, I'm sorry this caused problems for your friend, Sakura.

[Guest Kelly-087]

Sorry to do this Kelly, but the SOC 7 specifically states on page 60 that two referrals are necessary for an orchiectomy. Even with the referrals there are very few doctors who will remove healthy tissue, so there are a limited number of surgeons who will do it.

Not a problem!

It's just that I've read stories from people who didn't have any refferals and were able to obtain one.

[Guest Sarah Faith]

Trust me.... you will know it when you see it.

Hmm...a friend of yours, perhaps? If so, I'm sorry this caused problems for your friend, Sakura.

Honestly, I think if you go to a support group you have a pretty good chance of seeing at least one person like Sakura mentioned. I've only gone to one at the suggestion of my therapist and a friend who is 8 years post op, and it seemed like a pretty decent cross section of trans people. I also won't do it again though, the entire experience was mildly depressing.

I think everyone who is thinking of transitioning, or thinking of surgery should seriously examine their reasoning and them selves. Hormones, surgery, and transitioning are all very serious and it may not be for everyone. I've dealt with severe gender dysphoria for as long as I can remember and I simply couldn't even function in everyday life as male it pretty much destroyed every aspect of my life. Even then when I finally had my first appointment with my doctor for HRT I was questioning and examining my motives, reasons and feelings to make sure I was making the right choice. I don't have kids, and I knew that because I never banked my sperm that when HRT made me sterile that door would be closed. Not to mention the potential health risks that HRT posed.

The RLT is primarily to satisfy the doctors and psychologists, but the fact is that they aren't the ones you need to do it for or need to satisfy. They don't have to live with your decision to start HRT or have SRS, you do so its important that as you move forward you examine what is important to your life, and your motives to be sure that you are making the right choices for your self. These are choices you may never get to take back.

I'm certainly not trying to discourage you or anyone from transitioning but the gravity of these choices are such that they need to be approached with the right attitude.

[Sakura]

good post sarah. Right on in many key areas and a foot ball fan yaaaaay !

nope hanna no one i really know on a personal level, just in my time with this "community" i have seen alot of things. and the saddest thing i have seen is a post transitional regretter. those who have more money than they have patience , those who thought being a woman would fix everything that was going wrong in thier life, those who do it for a sexual thrill. and those who just genrally nothing will fix them and transition was thier last ditch effort. things typcally seem fine at first, they are out and on top of the world, but thier transition tend to be topical. as sides from dressing like a woman they do not really grow as a woman. but many rush head long into things like srs and hrt. it is only after that " newly transitioning buzz " wears off that they really evaluate if this was the right move for them. and a few realize at best they were prolly a crossdresser that lead them selves astray. not saying that is you. just giving a example of ones i have seen fail and the various reasons i have seen and read about. This choice is ours and ours alone , cutting threw the fluff and the cheer leading is difficult , and it takes awhile for the new to wear off. but once it has and you are at the core with all the BS stripped off, that is when you will make the honest assesment of if this is right or wrong for you.

Sakura

[Guest Hannah]

Hmm...I guess when I talk to people I make the assumption that only the person I'm talking too is able to occupty their mind, and only that person knows what they need to be happy, assuming they can reasonably evaluate the options. In the case of transgender behavior, I further assume because the person is encroaching on the biggest societal taboo, one for which there is great adverse pressure, they do so only after exploring every other option they could. And I think gender is fixed (cis sexual people don't worry that their gender will suddenly change mid life...).

He...I'd be guilty of being a cheerleader when I sense the person is sure of their decision.

But I guess the fact that some regret changing their body means my assumptions are not always correct. Self knowledge is a very hard thing, I'll grant.

My decision to move forward comes from the relazation that as much as I'd like to be able to live as a woman with a male body, I find that it's not practical. I want to at least know my body will not become more masculine and make matters worse, and I'd like to get rid of the offending organs.

The desire to be a woman has been gradually growing for my whole life, although most notably in the last few years. It has grown stronger than my motivation to survive. Before, I never understood why transsexuals would go through the trouble. Now I do -- the feelings are always with you -- they never take a vacation. I suppose I do risk regret, but I'll take that risk...

However, because I sometimes find myself talking to people who might be questioning their gender, I also think I have to learn as much as I can about those who do regret their decisions...

[Guest]

Really good stuff here. Also, I would like to build on it a little. I like to say that the Real Life Test is just the prelude to the real life test! It does not get easier, but it does get better. DIY horomones can ge a huge mistake. Yes, it's your body, yes, it's your choice, yes, it is also your responsability and honey you can't press re-wind if things do go deadly or paralysingly wrong. You are all on your own and shooting craps in the dark. The things in place in the system, are to keep you alive and increase your chances of a successful transition. It is not a cake walk! Stormy seas ahead, take a cruise ship, not a row boat! One needs to be mentaly and physically prepared as best they can. No one can predict your outcome. I state all this for those readers that "Just can't wait!" Transitioning is not instant coffee. Puberty is three to five years and no one escapes it, or speeds it up. Mistakes in a rush early, can mess with the results my friend.

I am of a peculiar few maybe, I learned late in life I an intersexed. It may be only a small part of the reasons I was headed in this direction anyway. For me, may I repeat, for me, the estrogen hitting my body caused me a huge paridigm shift in my thinking, that does not happen so quickly for most transitioners. It was like all the circuit breakers on the girl side of my brain were off and then were suddenly turned on. If I had to cop to even knowing what Gender Dysphoria was, I would say mine was very mild. I had been a lifelong closet dresser with all the purge cycles. Also, not knowing why really, that I would always start again. It was really only sexual when I was young, but then everything was sexual, with raging hormones naturally. All this became pieces to my puzzle. I was dressing incognito female/androgyne long before hormones, but only part time. I enjoyed slipping back and forth between genders. Hey I'm both male and female, why not? Little did I know? Giggle.

Hormones made my life much more satifying and really worth living with a good working girl brain. Unfortunately, or fortunately depending on one's outlook, my female side is way, way more dominate then my male side. More pieces to my puzzle. Now dressng full time and living full time as female, my Gender Dysphoria kicked in with a vengence. Some call it male fail. Giggle. I can't do icky boy clothes for more than a few hours and I certainly can't keep up a male presentation for any reason, for anybody. I get physically sick and way depressed, like instantly.

60% of my friends are genetic female, they are my support group and teachers of what I did not get growning up. They are my safety net and where I feel most comfortable. 25% are trans female and male, some are here and I love them all. The last 15% are genetic males that I am not so warmed up too. Old male friends are very dear to me, but I make few new ones.

OK Jody, what's your point? The point is, that I had to get behind the mask and take down my life completely as I knew it. Find the authentic me and let her out for the world to see. I think I pass my real life test, but now having won the prize, I have to carry it with me forever. Sorry, no U-turns. Now that's the real, real life test. LOL! Transition is not to be taken lightly, ever!

Hug. JodyAnn

[Guest Hannah]

Hi, JodyAnn. Thanks for your post and sharing some of your experiences.

For me -- perhaps this is odd, but I already feel like I'm already taking hormones. I consider it mostly that I've stopped repressing and fearing feminine things, but I almost feel it's more than that. Like my brain is changing -- feminine things are growing more exciting, I'm becoming more emotional, and all that. I can't say I was ever masculine but I'm loosing the ability to even fake it anymore. I know testosterone levels drop as one ages (I'm 29), and I guess I assume it has something to do with that -- it's probably a small sample of what hormones will do in full force.

And as I change I have to approach myself differently. For example, if I go to a sad movie, I will cry. It used to be I could shut that off in public... Now I just have to accept it will probably happen.

So even without additional hormones, I'm finding I have to change my self-management strategies just because of naturally dropping testosterone levels. I've read about the changes people report from taking hormones. What I will have to discover myself is their intensity and how they will effect me personally. It's exciting on one hand -- another step in this adventure. But as always, change is hard. Though I can already tell, life is becoming less gray and more worth living...

[Charlize]

Hannah, I have to say that i don't think your T is getting lower at 29. I both hate and am glad to say your still a child. No offense meant. I would guess the feelings you have are due to being honest about who you are. Your no longer in the denial we have all tried. The freedom to be yourself can suddenly take you from grey fields to the technicolor of OZ. I found those colors and live with them now in a world of at least attempting to be honest at all times.

I get confused sometimes. i think that is to be expected.

I was on and now am off of HRT. It is painful but i'm still me and still happy to be all the woman i can be. Things may change in what i can do in furthering my transition but some serenity has come just through honesty and being myself.

Hugs,

Charlie

[Guest KimberlyF]

Hmm...I guess when I talk to people I make the assumption that only the person I'm talking too is able to occupty their mind, and only that person knows what they need to be happy, assuming they can reasonably evaluate the options. In the case of transgender behavior, I further assume because the person is encroaching on the biggest societal taboo, one for which there is great adverse pressure, they do so only after exploring every other option they could. And I think gender is fixed (cis sexual people don't worry that their gender will suddenly change mid life...).

He...I'd be guilty of being a cheerleader when I sense the person is sure of their decision.

But I guess the fact that some regret changing their body means my assumptions are not always correct. Self knowledge is a very hard thing, I'll grant.

Before starting HRT where I go, I had to have a psych eval. I have recently seen notes from that, and I was marked as 'No Axis 1'. I got along so well with this woman right out of the gate, and I had decided to answer any questions and be honest and open.

Since that time I'd been treated for many months for social anxiety disorder and depression.

One session, which is all that is required by many Informed Consent programs, is not enough to correctly ID many disorders.

Yes, only the person you talk to can occupy their minds, and GID is a self-IDed issue. But that doesn't mean the person is always correct.

In the case of pre-adolesent children, they are wrong more than right. In the case of adults there are numerous conditions that can cause one to think they have GID when they don't. An obvious one for a self-described MtF is to actually be a fem gay man.

This doesn't even begin to tap into the fact that among actual Trans, there are so many healthy end points along the road. And what works for me will most certainly not work for others.

This site does not allow the discussion of dosages, because it is harmful to self-medicate.

IMO, 'pushing' or 'cheer leading' without knowing if the person you are talking to is in a deep depression and will believe your answers will fix everything or is psychotic or suffering from some other axis I disorder that could prevent a smooth transition, has just as much potential for harm. It is best left to the pros.

[Guest Hannah]

Hi, Kimberly.

I guess I probably misused the word cheerleading. I suppose cheerleaders sometimes push for an action. To push someone to do something without them initiating would be something that's best left to a professional since they have the power to know what is best. I'm sorry for being unclear.

But anyway, I'm seeing a professional, so it's all good.

[Guest Sarah Faith]

Hi, Kimberly.

I guess I probably misused the word cheerleading. I suppose cheerleaders sometimes push for an action. To push someone to do something without them initiating would be something that's best left to a professional since they have the power to know what is best. I'm sorry for being unclear.

But anyway, I'm seeing a professional, so it's all good.

It's hard to not cheerlead sometimes, I mean this is a support forum and we all want to try to help others through things we've had to go through. Often times when I type a encouraging response I spend a few moments thinking how the person might take it or respond to it. It can be easy to forget that just because something is working for me doesn't mean it will work for every single other person. A lot of people think that "Oh if I just get on hormones I'll be happy." but the fact is it only opens up possibilities. My life is a bit of a train wreck because of my dysphoria and hormones aren't going to fix that over night I still have to pick up the pieces and start over. For me that wasn't possible before, I tried many times and every time I emotionally imploded. Transitioning has opened many doors for me that had long been barred but I still have to walk through them.

I certainly wasn't trying to discourage you from transitioning, or starting hormones in my previous post. I just think its important that we don't rush into these medical decisions with out a great deal of self reflection and a good deal of realistic expectations. In the few months since I've returned to the forums I have seen a few people become very very upset over the standard "Talk to your GT" or "See your doctor" answers, they seem to want to rush head first into this with out very little regard for the risks. Hormones, Surgery, Social Transition all of these things are major and life changing, you can make your life worse, you can lose everything and everyone.. Even if all three are right for someone, if they aren't just a little scared going into it then I'd be seriously concerned about their state of mind going into it. Cheerleading the wrong person could push them into choices that they regret for the rest of their lives, I for one don't want to be responsible for making someone elses life worse.

In regards to your own transition Hannah, just keep an open mind and and an open heart every step of the way. I think that would be the best way to "pass" the RLT.

[Guest Hannah]

>My life is a bit of a train wreck because of my dysphoria and hormones aren't going to fix that over night I still have to pick up the pieces and start over. For me that wasn't possible before, I tried many times and every time I emotionally imploded. Transitioning has opened many doors for me that had long been barred but I still have to walk through them.

What do you mean by emotionally imploded, Sarah?

>Cheerleading the wrong person could push them into choices that they regret for the rest of their lives, I for one don't want to be responsible for making someone elses life worse.

I have to think about that a bit. You have to have power over someone else to be able to push them in a direction they were not naturally inclined to go. I generally assume I don't hold that kind of power, especially not as a stranger on the internet. I assume people are too stubborn to let me tell them what to do, even if I were to try. All I can do is provide emotional support and provide information and options to the best of my ability.

(Adults are responsible for their own decisions, in my opinion...)

Perhaps my model for other people is based too much on my own stubbornness. I don't know...

>In regards to your own transition Hannah, just keep an open mind and and an open heart every step of the way. I think that would be the best way to "pass" the RLT.

Oh, thank you, Sarah.

[Carolyn Marie]

I just want to applaud everyone on this thread for some really insightful, meaningful and honest thoughts and opinions. This is great stuff, and I'm very impressed. Please carry on.

HUGS

Carolyn Marie

[Guest Sarah Faith]

>My life is a bit of a train wreck because of my dysphoria and hormones aren't going to fix that over night I still have to pick up the pieces and start over. For me that wasn't possible before, I tried many times and every time I emotionally imploded. Transitioning has opened many doors for me that had long been barred but I still have to walk through them.

What do you mean by emotionally imploded, Sarah?

>Cheerleading the wrong person could push them into choices that they regret for the rest of their lives, I for one don't want to be responsible for making someone elses life worse.

I have to think about that a bit. You have to have power over someone else to be able to push them in a direction they were not naturally inclined to go. I generally assume I don't hold that kind of power, especially not as a stranger on the internet. I assume people are too stubborn to let me tell them what to do, even if I were to try. All I can do is provide emotional support and provide information and options to the best of my ability.

(Adults are responsible for their own decisions, in my opinion...)

Perhaps my model for other people is based too much on my own stubbornness. I don't know...

>In regards to your own transition Hannah, just keep an open mind and and an open heart every step of the way. I think that would be the best way to "pass" the RLT.

Oh, thank you, Sarah.

I developed anxiety issues due to my dysphoria. I tried college at least 3 different times and I barely made it through a single semester, between the panic attacks and the fact that I would see girls my age living normal lives.. I'd break down I'd feel suicidal and then I'd withdraw, eventually I just never tried again. For me transitioning, and hrt has caused the majority of my anxiety issues to ease.

In the case of Adults being responsible for their own decisions, not always. If someone doesn't actually have dysphoria but believes they do because of a midlife crisis or some other psychological issue.. Cheerleading, and telling them what they want to hear could very well be the tipping point into pushing them into making a decision they really shouldn't be making, at least not with out some type of professional help. I'm not saying don't encourage people with the choices they make, I'm just saying if someone is unsure of what they should do then pushing them with encouragement could be bad. On the other hand if someone has made up their mind, and they are doing it safely then great! Who am I to question at that point?

I'm pretty stubborn too Hannah, and there have been times where I didn't think that solutions for me may not be solutions for others. I absolutely have been guilty for cheerleading with out thinking and I try to avoid that now!

You're welcome Hannah, I'm just happy that you are doing it the right way.

[Guest JazzySmurf]

The HRT, RLE, SRS (possible FFS) sequence works almost like dating... like, if a person is believes they are a woman/man/more and wishes to try to live as such, then HRT and RLE is quite sufficient to do so. So, it's almost like a trial as with dating; at this point, SRS (the equivalent of marriage) is an unnecessary risk and attempting the reversal is not an easy undertaking.

I think that part of the RLE is that, it is also possible for many transpeople to have their dysphoria be completely relieved by HRT itself, and hence something as dramatic/intrusive/painful as SRS is not necessary. If people still felt persistent dysphoria during RLE (especially with regards to their genitalia), then SRS becomes a viable option, though certainly not intended to be a cure-all. At this point, the decision is then made as to whether or not to commit to the SRS/dive in, for better or for worse, in sickness and in health. (Something similar also applies for facial feminization surgery (FFS).)

Best of luck, Hannah! :-) hugggsssss

ps: I use RLE (real life experience) in place of RLT mostly because, well, many people now view this stage more as a progressive self-discovery stage, and less as a kowtow-for-the-letters stage.

pps: @ Sarah: good for you for breaking out of that anxiety well!!

[Guest KimberlyF]

It's hard to not cheerlead sometimes, I mean this is a support forum and we all want to try to help others through things we've had to go through.

I totally get this. I think the issue for me is how one goes about the cheerleading.

Saying things like the following when someone has felt alone and never part of a group, then comes to a community that seems welcoming can have a major effect:

"I am so glad that you have started HRT! When I started, it was life changing! It's great to start living a true authentic life and running your body on the fuel it was meant to run."

Some who may have felt a part of something, then not feel any different or maybe even have doubts on HRT are often told it's normal.

Do they now question, or do they go with it? How do you risk isolating yourself from a community when maybe for the first time you feel like you belong?

How about making everyone feel welcome. You may transition or you may not. You may have HRT or you may not. You may have SRS or you may not. This is the ultimate choose your own ending. Instead of "HRT was the best thing since sliced bread!", which can make one want those feeling too, how about "I have found HRT to be a necessary step for me, but many never start it."

Questions and doubts ARE normal, but that doesn't mean they don't need answers.

ps: I use RLE (real life experience) in place of RLT mostly because, well, many people now view this stage more as a progressive self-discovery stage, and less as a kowtow-for-the-letters stage.

I mostly say FT unless its talking of the required period to get letters.

Every day one starts this journey should be filled with a bit of self-discovery/self-evaluation.

And the surgery requirements are for the safety of the patient.

There are people denied SRS or HRT because of health reasons every so often and I don't hear people screaming something like gatekeeper. But the idea that one needs to prove they are mentally healthy is considered backwards and repressive in some corners.

We all know what this mind/body conflict can feel like. This surgery given to the wrong people can create this conflict that didnt really exist in someone to begin with. What could be more backwards than that?