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Are the Criteria for the ‘Real-Life Experience’ (RLE) Stage of Assessment for GID Useful to Patients and Clinicians?

ABSTRACT A clinician's recommendation for progression to gender reassignment surgery is usually supported by a successful RLE. However, the gate-keeping role of clinicians can put them at odds with the supportive position most caring professionals adopt. The RLE criteria used in a regional clinic were reviewed with a cohort of patients undergoing gender role transition. All nineteen patients were male to female trans women, with eighteen living in role all of the time and fourteen being fully aware of the RLE criteria. Eighteen found it useful to live in role full-time, with thirteen finding clinicians' knowledge of their RLE very useful. Five patients experienced problems with living in role, while the majority (n = 14) reported no/not many problems. Despite this, seventeen said they would live in role all of the time, even if their behaviour was not being assessed for progression to surgery. One hundred percent of responders thought that living in role was an important part of the assessment process for gender dysphoria. Although patients found living in role valuable and important, a number of suggestions were made for improvements to the RLE criteria used by the regional clinic. These included the ability to commence hormone therapy as soon as the RLE begins, and incorporating time spent living in role whilst on the waiting list with documented real life experience.