Real Life Experience Prior To Surgery...

[Guest Nelly]

On another note though I feel a RLT is pointless when the person doing it can't pass at least a good % of the time I know us FTM have a slight advantage with our HRT to some MTF I wish there was alot more offerd to those that needed it so if the RLT is a must then those doing it can do so with dignity and gain confidence.

This point and the fact that there is no scale for measuring the RLT. In other threads we found out that girls can wear male clothing without any problem. So do I make a RLT test when I go out as a girl wearing male clothing? Who is coming and check my RLT? Must I wear a pink flower test to show that I do RLT?

The test is to see if we can handle life in our wished gender roll. If I can not pass I do not live the life of the gender I want, I have to live the life a strange person I do not want to be. So thinks to make it easy has to be done first. I do not know if HRT effects of some month make big different visible to other people. I think it is more a thing in our brain that we can handle some situations more better.

Greetings

Nelly

[Guest RainBird]

I have been living full-time for almost two years and have been on HRT for almost 10 months.

In Australia we have to experience the 'RTL' and prolonged HRT for a minimum of two years before being granted as an 'approved' candidate to undergo gender reassignment surgery (GRS, SRS), not including orchiectomy, trachia shaving and the like.. We do have some great services available such as the Monash Gender Centre and various support groups but the big issue here we have in this country is that there is no government funding for transgender related medical procedures which I believe is due to a great lack of understanding and/or interest. This really needs to be addressed considering that it relates to non cosmetic grounds, a physical medical conditions which advesrely affects our well being for many left untreated. It is unfortunate that this is the way it is at the moment but I do hold on to my optomism and hope that things will change or I somehow find a miraculous opportunity to do better financially.

Hugs,

The persuit of freedom - Jacci

[Guest Zabrak]

I think it should be two years. It'll make sure the person thought it through and are really sure they want it.

[Guest Naomi Stardust]

i am starting to think that it should varry with the individual

but i still think two years is too long

[Guest Lizzie McTrucker]

I did my time and so should you! j/k j/k admins put down the Ban gun.

In all seriousness I think one year is a decent time frame for RLE. That gives you plenty of experience in being the gender of your choosing and ideally gives you a chance to experience a multitude of social settings to experience and learn how to handle yourself as the opposite gender. Plus every day isn't going to go smoothly and there will be days when you feel like just stopping the whole thing. It's better to have these experiences before you make a permanent change to your body and you have options. Once you get that surgery and are living as the gender of your choosing, you're pretty much dedicated now to that gender no matter what happens. While just living as the opposite gender if something doesn't feel right it's easy to change. Not so much once you wake up in a hospital room, notice parts you had before are no longer there and think "uh oh...what'd I do?"

[Sally]

I did my time and so should you! j/k j/k admins put down the Ban gun.

In all seriousness I think one year is a decent time frame for RLE. That gives you plenty of experience in being the gender of your choosing and ideally gives you a chance to experience a multitude of social settings to experience and learn how to handle yourself as the opposite gender. Plus every day isn't going to go smoothly and there will be days when you feel like just stopping the whole thing. It's better to have these experiences before you make a permanent change to your body and you have options. Once you get that surgery and are living as the gender of your choosing, you're pretty much dedicated now to that gender no matter what happens. While just living as the opposite gender if something doesn't feel right it's easy to change. Not so much once you wake up in a hospital room, notice parts you had before are no longer there and think "uh oh...what'd I do?"

That was a a great comment, I don't think that there could be a better explaination for the need for RLT.

Love ya,

Sally

[Guest Little Sara]

Personally "none" is my verdict. I've been full-time 3 years, but that's cause I don't even have 1000$ saved up now. I might need 5~20 more years to save up for it, unless I get a sugar daddy or something.

Still I don't believe in enforced RLT for anyone, by authorities who can withhold treatment on their say so (they don't like you: that's reason enough).

Requirement for those who travel to Thailand for GAS is on average 6 months RLE -most highly sort Thai Surgeons when dealing with Western clients tend to follow the standard of care recommendation regarding psyche assessment reports but are somewhat relax with the RLE period of their trans patient…

Its true they require 6 months RLE, but they mainly require 6 months with name changed. They do NOT require shrink letters. They waive that requirement. They'll accept shrink letters if you have them, but they won't refuse you if you don't have them. They always do personal interviews pre-op.

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In Quebec and Ontario and Saskatchewan. If you want SRS funded by the government, you need to go into the "approved program" (Ontario + Saskatchewan = CAMH, Quebec = Montreal General Hospital).

This "approved program" refuses over 90% of people outright from even entering the program, with a 45 minutes assessment. Prostitution disqualifies, being considered a gay man by them disqualifies, believing in things they don't believe in disqualifies (If you're Buddhist, its just too bad).

Now, if you even manage to enter this program and be accepted, you need to go see their private shrink with your own money out of your pocket (even if public shrinks are 100% covered, for all, private shrinks are not - ergo: they force you to spend extra money, 75$+ extra a week to go see a shrink, just to follow you up, wether you need it or not).

If after 12 months RLT they like you enough, they might approve HRT. If you get unemployed during RLT, tough luck, your counter restarts to 0. Once you're on HRT, you need 24 months, and then, they just might approve surgery, if they like you. You need to keep going visiting that shrink during that whole 3+ years, not going is probably subject to being dropped from the program. Not enough cash? Too bad for you, transition is for middle-class people, didn't you know that?

So yeah, I won't support those regressive policies.

Even those who require 3 months RLT for HRT I find regressive, because they're not flexible at all. They want 3 months to have 3 months, not AT ALL for other reasons. They usually don't care one iota about your mental health.

Who wants to go see a shrink because they're forced to and not because they need to see a shrink for the therapy?

I got my hormones from a generalist who did not require a diagnosis or anything before prescribing hormones. I got a diagnosis 2 years later, after 2 years full-time and 2 years HRT.

I went full-time at the same time I went on hormones. If I had worked at the time, there is NO way, I would have gone full-time right then. Because I didn't work, I could take it at my own pace, and judge for myself when I attained enough passability not to be subjected to problems.

--------------------

Docs do not get this to protect themselves from malpractice lawsuits from patients. They get this to protect themselves from malpractice lawsuits from other doctors! That UK doctor who gave hormones before 3 months? He got crap for it too. By whom? Other doctors from the NHS, who love their own regressive policies and want it imposed on all.

How do you protect yourself from suits? Make your patient sign a waiver "I hereby recognize that I start hormones with full knowledge of consequences and possible side-effects and hereby acknowledge that I will not hold it against [doctor name] if I decide this wasn't for me." There you go, suit-proof.

Surgery is the same. You sign a waiver, and unless there are *physical complications* (which are very much the fault of the surgeon), you have no right to sue for having the surgery done on you.

I'm pretty sure its standard practice to make patients sign waivers like that before any surgery. And that people going for other surgeries don't need 2 years assessment to determine if operating them is "the right thing". It's just BS because doctors and shrinks like to test your determination and endurance, not at all a desire to protect people. It's a desire to "prevent the spread of transness", the way a mandatory sex-offender registration for gay people would "prevent the spread of gayness" (at least openly).

By doing this they keep power and control over us, because we have no voice. They do not want us to have a voice, and to participate in our own treatment. Patient-centered? Doesn't exist to them.

[Guest Zenda]

Personally "none" is my verdict. I've been full-time 3 years, but that's cause I don't even have 1000$ saved up now. I might need 5~20 more years to save up for it, unless I get a sugar daddy or something.

Still I don't believe in enforced RLT for anyone, by authorities who can withhold treatment on their say so (they don't like you: that's reason enough).

Its true they require 6 months RLE, but they mainly require 6 months with name changed. They do NOT require shrink letters. They waive that requirement. They'll accept shrink letters if you have them, but they won't refuse you if you don't have them. They always do personal interviews pre-op.

------------

In Quebec and Ontario and Saskatchewan. If you want SRS funded by the government, you need to go into the "approved program" (Ontario + Saskatchewan = CAMH, Quebec = Montreal General Hospital).

This "approved program" refuses over 90% of people outright from even entering the program, with a 45 minutes assessment. Prostitution disqualifies, being considered a gay man by them disqualifies, believing in things they don't believe in disqualifies (If you're Buddhist, its just too bad).

Now, if you even manage to enter this program and be accepted, you need to go see their private shrink with your own money out of your pocket (even if public shrinks are 100% covered, for all, private shrinks are not - ergo: they force you to spend extra money, 75$+ extra a week to go see a shrink, just to follow you up, wether you need it or not).

If after 12 months RLT they like you enough, they might approve HRT. If you get unemployed during RLT, tough luck, your counter restarts to 0. Once you're on HRT, you need 24 months, and then, they just might approve surgery, if they like you. You need to keep going visiting that shrink during that whole 3+ years, not going is probably subject to being dropped from the program. Not enough cash? Too bad for you, transition is for middle-class people, didn't you know that?

So yeah, I won't support those regressive policies.

Even those who require 3 months RLT for HRT I find regressive, because they're not flexible at all. They want 3 months to have 3 months, not AT ALL for other reasons. They usually don't care one iota about your mental health.

Who wants to go see a shrink because they're forced to and not because they need to see a shrink for the therapy?

I got my hormones from a generalist who did not require a diagnosis or anything before prescribing hormones. I got a diagnosis 2 years later, after 2 years full-time and 2 years HRT.

I went full-time at the same time I went on hormones. If I had worked at the time, there is NO way, I would have gone full-time right then. Because I didn't work, I could take it at my own pace, and judge for myself when I attained enough passability not to be subjected to problems.

--------------------

Docs do not get this to protect themselves from malpractice lawsuits from patients. They get this to protect themselves from malpractice lawsuits from other doctors! That UK doctor who gave hormones before 3 months? He got crap for it too. By whom? Other doctors from the NHS, who love their own regressive policies and want it imposed on all.

How do you protect yourself from suits? Make your patient sign a waiver "I hereby recognize that I start hormones with full knowledge of consequences and possible side-effects and hereby acknowledge that I will not hold it against [doctor name] if I decide this wasn't for me." There you go, suit-proof.

Surgery is the same. You sign a waiver, and unless there are *physical complications* (which are very much the fault of the surgeon), you have no right to sue for having the surgery done on you.

I'm pretty sure its standard practice to make patients sign waivers like that before any surgery. And that people going for other surgeries don't need 2 years assessment to determine if operating them is "the right thing". It's just BS because doctors and shrinks like to test your determination and endurance, not at all a desire to protect people. It's a desire to "prevent the spread of transness", the way a mandatory sex-offender registration for gay people would "prevent the spread of gayness" (at least openly).

By doing this they keep power and control over us, because we have no voice. They do not want us to have a voice, and to participate in our own treatment. Patient-centered? Doesn't exist to them.

Kia Ora Sara,

Judging by your comments, I take it you're not very happy with the Canadian system...

Here in Aotearoa [NZ] I guess it's also the luck of the draw...I didn't have any problems whatsoever going through the system here, both for starting HRT, transitioning and for government funded surgery[a system quite similar to that in Canada]...My doctor prescribed HRT and also referred me to a psychiatrist for diagnoses who in turn referred me to the endocrinologist-plus my doctor organised 6 sessions with a gender counselor After my endo applied for government funding, I had to pay for an independant psychiatrist's assessment[to see if I was suitable for surgery]Plus I also had to pay for the consultations with the three surgeons and the clinic's psychiatrist and clinical psychologist-come social worker[which cost around $600 all up]

The psycho-surgical team at the gender dysphoria clinic treated me with respect throughout my dealings with them as did all the government departments I had to deal with...Some local trans-people have had a real hard time when dealing with government departments and the health department here...

I guess if one has no problems when going through the system, to them it will seems there are no problems with it...I'm sure those in Canada who have suscessfully passed through the system would not paint as a dire picture has yourself...

However I'm sorry to hear that you had been given such a hard time during your transition...

BTW they all knew that I follow the teachings of the Buddha-which was no problem with them whatsoever[it's possible they to had a understanding of his teachings]...However if I said I believe in fairies, pixies or unicorns, then that would be a different story-possibly a straight jacket job...

Metta Jendar

[Guest Zenda]

Kia Ora,

Some surgeons in Thailand DO require a psyche report, some are not so laidback as some Westerners believe...

Metta Jendar

[Guest Zabrak]

Judging by your comments, I take it you're not very happy with the Canadian system...

In B.C our system is not like that - it seems to only be those places with those "systems".

[Guest Nelly]

Hi,

do you find out in a RLT that you can live without the thing down there? I mean in all situation of a RLT you are living with the thing stil attached to you. So within the test it is not proven that you can live without it. On the other hand, if you let removed it to early, that you later find out that you do not want to be a woman, that the man role in society is that what you want, than a lot of FTM shows that living as a men without a thing down there is possible.

So the big problem is, how can you find out that you do not miss the thing when you can not remove it for a test? For this a therapist is a good thing. You can talk about it and maybe you can find out if you can or can not live without it. I read that a real man is scared by the idea to lose the thing by accident.

Then there is the question about HRT before RLT. HRT make it easier but it make also a permanent change of your body. SO why is HRT possible but not SRS?

Greetings

Nelly

[Guest Zabrak]

Hi,

do you find out in a RLT that you can live without the thing down there? I mean in all situation of a RLT you are living with the thing stil attached to you. So within the test it is not proven that you can live without it. On the other hand, if you let removed it to early, that you later find out that you do not want to be a woman, that the man role in society is that what you want, than a lot of FTM shows that living as a men without a thing down there is possible.

So the big problem is, how can you find out that you do not miss the thing when you can not remove it for a test? For this a therapist is a good thing. You can talk about it and maybe you can find out if you can or can not live without it. I read that a real man is scared by the idea to lose the thing by accident.

Then there is the question about HRT before RLT. HRT make it easier but it make also a permanent change of your body. SO why is HRT possible but not SRS?

Greetings

Nelly

That line confused me slightly( the one I bolded). I'm not sure I understand it.

However, I get what you're saying about RLT "proving you can live without SRS as the other gender". The thing is, some only live without SRS because they HAVE too. They may not like living without srs, they may find it harder to find someone to be with without srs. SRS may complete some people. Thus why even if you can prove you can live without it - doesn't mean you want to live without it.

"Real men" are scared to loose it because if they do they have nothing left behind. FTMs still have something - same goes for MTFs.

SO why is HRT possible but not SRS?

Some of the effects of HRT are perma and others are not. It's not as a extreme change as 'down there'. HRT is also a lot less money then SRS.

[Guest Little Sara]

Kia Ora,

Some surgeons in Thailand DO require a psyche report, some are not so laidback as some Westerners believe...

Metta Jendar

I know one of them requires a letter from any specialized doctor (not meaning therapist necessarily), as in, I could get a letter from my endocrinologist.

[Guest Little Sara]

I guess if one has no problems when going through the system, to them it will seems there are no problems with it...I'm sure those in Canada who have suscessfully passed through the system would not paint as a dire picture has yourself...

I was refused in the program.

Reason for refusal: Believing in reincarnation, they also said I believed in magic (I said I believed in physical causes for being trans, not magic), which meant together that I was schizoid and unfit for transition (although I already was full-time and on hormones for a while, at the time).

I got the information from other people who've been in the program, or who had friends in it. I eventually got it straight from someone who went 3+ years in the program without having her surgery paid for. Heck she was 3 years in it pre-HRT, but full-time. She also had needed to sell drugs, just to pay the shrink visits.

That's the sign of doctors who care about their patients?

[Guest Nelly]

Hi,

what I mean was, that the RLT can not prove that you can live without your thing down there.

the FTM prove that you are able to be a man without the thing down there. All together mean that one person can live with or without that thing in all types of gender. So what give us the information of RLT? Nothing. Also there are a lot of bio girls or bio boys who look not like the typical girl or boy. If take a close look to people you can not find a straight border from male to female.

For me it is more important that a therapist find out the real reason for SRS or transition. If man do it only for sexual reason, to be turned on, than it is wrong to do it.

Greetings

Nelly

[Guest Leigh]

None. I mean, for most of us don't we spend forever thinking about it on our own? I guess it's different for every person, but I've spent so much time thinking and researching on my own, I don't know why I have to get therapy, etc.. plus for people like me who don't have insurance to pay for all the therapy, it just puts it off even further. As soon as I get insurance I'm getting my Gosh darned surgeries...

Maybe that's just my own experience though, lol...

[Guest amie]

It depends on the person, plain and simple.

Keep in mind that it’s not in that therapist best interest to push you through in a speedy fashion.

He or she is in fact getting paid by the session.

Now, allowing one to move through quickly on occasion does promote his or her name throughout the TS Community.

But I'm certain many reserve this approach for those cases in which it's abundantly obvious a mistake was made.

That whole specific time frame thing has never sat well with me anyway. It wrongfully clusters everyone together in terms of their ability to function and not everyone needs to do it for that long. On the other hand, some may need to do it a bit longer.

[Guest Lizzie McTrucker]

I used to live with another pre-op M2F and she did her RLT in 9 months, which I thought wasn't long enough because all she really did was work and then come home.

[Guest julia_d]

I return to this subject to look at it from a completely different direction. This time I want to look at it from the perspective of the person who is no longer able to get any kind of legal employment whatsoever due to some stupid changes in the law over the last few years.

Scenario:: You have been living full time for 8+ years. Names on all the documents which can be changed have been.. years ago. So long ago that anything with your old name on it looks like it isn't yours. Passed the RLT 6 years ago then whatever.. was on the short path surgical waiting list only requiring that one pscyh second opinion to be completed and off into the world free from a lot of the other problems which go with being trans.. not sure to this day where everything went astray, but it did.

Eventually get fed up of being in nowhere world and start chasing.. uncover a trail of neglect and carelessness.. another matter that I'm not going to dwell on.. but my GP seems the most likely candidate. A post-op friend and mental health worker was forced to "re-educate" that doctors practice in the correct use of pronouns and being non-judgemental.. that's not the doctors, who are just blatantly uncaring and not interested.. seemingly at the instigation of the PCT to avoid handing out money for any "cosmetic" procedures.. It was the reception staff who took great pleasure to out you and put you in a position of real physical danger. Who likes to have their name and address shouted across a room which is full of people who are already nudging each other and staring and pointing and whispering... Not good enough in a system which makes such a fuss about "confidentiality"

Anyway.. I digress from my point which is this.

The RLT is supposed to show how hou cope in your new role.. 100% in your new role. It fails.. and here is why.

Under the UK immigration laws to get any legal employment you now have to prove you are a UK citizen, or have rights to live and work here.

Fine eh?.. NO .. the only forms of ID they will accept are a birth certificate with either a driving licence or passport... OR if you have no passport then a birth certificate along with some other state issued documents... medical card, p45, p60 (tax documents) No problem?.. read on...

You can get what is called a "gender confirmation certificate".. issued by a part of government on submission of 2 reports.. one from any doctor and one from a "specialist" on a very restricted list of "approved" practitioners.Once you have this document in your possession you can have your birth certificate, driving licence gender marker and passport changed.. so far so good??.. NO .. They will only issue one after SRS.. or in exceptional circumstances without it but only if there is a very.. and I mean very.. valid medical reason for not performing surgery. Anybody who is healthy enough for surgery is excluded from having their vital information changed..

Great.. so there you are.. sitting there with no way to prove who you are or that you are entitled to work. None of the "acceptable" documents match who your current ID says you are. Puts you in the lovely position of either deliberately outing yourself and making a big fuss with change of name deeds and then appeals to the immigration department.. who DO usually reject you.. because your tax records are flagged F while your ID flags M .. so one or the other isn't you eh? .. Leaves you with two realistic options.. you drop into the twilight world of illegal and casual employment or attempt to survive by playing the depression card in the state benefits system.... Real depression and loss of esteem follows.. and you really do start to lose the social skills you need when you barely have enough money each week to keep the roof over your head and live on a minimal diet. I have to think very carefully about how to afford the fares to go to see a specialist.. To afford the fares for the trains means about 7 days living on beans and bread. How to find £80 to go and see a consultant at the other end of the counrty??.. you tell me.. My excess income from benefits over direct housing expenses is £17 A MONTH!!

How does that help anybody?.. The very system fails 100% of transpeople before they even start.. A lovely catch 22 . The RLT is about managing to live, work and survive in your new role, but in one action they have scuppered it completely and utterly... Minimum 2 years living and working in your new role.. how??.. If you can't gain any legal employment.....

Why is the suicide rate so high?.. I think I just answered that one.

[Guest Zenda]

They will only issue one after SRS.. or in exceptional circumstances without it but only if there is a very.. and I mean very.. valid medical reason for not performing surgery. Anybody who is healthy enough for surgery is excluded from having their vital information changed..

Kia Ora Julia,

I was under the impression that with this new bill that was passed back in 2004/5[the gender recognition bill] one could obtain a new birth certificate and other legal documents without the need for surgery, well that was the information I was given when I contacted them...However in my case they said it would be best to wait till I had my surgery-they didn't mention anything about 'only under special circumstances' would they allow you to be legally recognised without surgery-the only thing that they stipulated was one must have been diagnosed by a mental health professional and have been living as ones perfered gender on HRT for at least two years...Mind you this was back in 2005 when the act had just been implemented-things were quite new and some government officials involved with the 'gender recognition panel' were just coming to grips with it, things could have changed I guess...

Are you saying that even with all the necessary documentations 'psych assessments proof of HRT and living as ones perfered gender for two years or more' they still won't issue you with a new birth certificate?

Metta Jendar

[Guest Little Sara]

I used to live with another pre-op M2F and she did her RLT in 9 months, which I thought wasn't long enough because all she really did was work and then come home.

Some cissexual people do this all their lives. Some minus the "come home", living in their vehicle so much they are workaholic.

I don't go out much either.

3 years of full-time and hormones here. 8 months of work in that. I work and come home as well. I'm very well adapted still. That doesn't mean anything if I don't go to the mall or bars to socialize after work, it might be that my income is best spent elsewhere.

[Guest Little Sara]

Kia Ora Julia,

I was under the impression that with this new bill that was passed back in 2004/5[the gender recognition bill] one could obtain a new birth certificate and other legal documents without the need for surgery, well that was the information I was given when I contacted them...However in my case they said it would be best to wait till I had my surgery-they didn't mention anything about 'only under special circumstances' would they allow you to be legally recognised without surgery-the only thing that they stipulated was one must have been diagnosed by a mental health professional and have been living as ones perfered gender on HRT for at least two years...Mind you this was back in 2005 when the act had just been implemented-things were quite new and some government officials involved with the 'gender recognition panel' were just coming to grips with it, things could have changed I guess...

Are you saying that even with all the necessary documentations 'psych assessments proof of HRT and living as ones perfered gender for two years or more' they still won't issue you with a new birth certificate?

Metta Jendar

Wether it works as you say it does, or not. In the US, Canada, France, Germany etc, it doesn't (surgery is absolutely needed). A couple US states (2 or 4?) will not change it at all, even after surgery. Ireland also will not change it after surgery. Japan does it in special cases only.

So in any of those cases, employment-wise, you better find anti-discrimination businesses, or people who really like your job skills.

[Guest StrandedOutThere]

Wether it works as you say it does, or not. In the US, Canada, France, Germany etc, it doesn't (surgery is absolutely needed). A couple US states (2 or 4?) will not change it at all, even after surgery. Ireland also will not change it after surgery. Japan does it in special cases only.

So in any of those cases, employment-wise, you better find anti-discrimination businesses, or people who really like your job skills.

My home state (South Carolina) won't change birth certificates. All you can get is a card attached to the original that says mentions the change. The old record stays freely available. Thankfully there aren't a lot of occasions where you need to present a birth certificate.

I've heard that Massachusetts lets you change your license without surgery, just a therapist letter.

Check it:

Massachusetts Transgender Political Coalition

At least progress is being made! I really feel like the driver's license change is important as a safety issue. It's scary when you get pulled over and your license doesn't match your gender presentation.

[Guest Little Sara]

A card attached to the original sounds like it being amended with mention of the past. Some states don't even go that far (or Ireland and Thailand for that matter).

[Guest StrandedOutThere]

A card attached to the original sounds like it being amended with mention of the past. Some states don't even go that far (or Ireland and Thailand for that matter).

That's true. I really shouldn't complain.

I haven't actually interacted with the vital records department in my home state yet, so we'll see what my experience is like. I've heard that, although we are allowed to get the amendment, the employees do everything to possible to hinder that process. I'll definitely post about my experience.