A Smoother Transition for Transexuals
Known to many as the last hurdle transsexuals have to face before they can gain access to sex reassignment surgery, the Real life experience (RLE), sometimes called real life test (RLT), is a process where the subject lives in their preferred gender role for a certain amount of time. Despite how many transsexuals see the RLE as an opportunity to match their outer appearance with their inner feelings, they sometimes overlook the challenges they may face before getting what they want. The expenses of buying a whole new lifestyle, the emotional drainage they are likely to face, and the periods of physical pain in hormonal change and cosmetic surgery are main issues that sometimes go unnoticed by those considering the RLE. The time spent as their preferred gender is expected to demonstrate that they can function in the preferred role. 
Since 1979, the RLE has been part of the Standards of Care developed by the Harry Benjamin International Gender Dysphoria Association (HBIGDA). Standards of Care created its sixth version in 1998 to further share the most current thinking of professionals of gender identity disorders . The test is said to have originated from a 1974 pamphlet created by Reed Erickson, a wealthy female-to-male transsexual with the help of his personal doctor, James Lorio. Lorio suggested that Erickson undergo a six month to two year “trial” period as a male, thus developing the idea of the RLE .
The purpose of RLE, as believed by many clinicians, is necessary to prevent regret after surgery. HBIGDA is trying to balance the risks of achieving surgery too early in the transition process and the risks of delaying needed treatment. In the beginning, the HBIGDA Standards of Care used to require a two year RLE before hormones or surgery was given. Currently, this has been updated, after research findings and changes in standard clinical practice, to one year of RLE before genital surgery (but not hormones, breast/chest surgery, or facial surgery). Though it is recommended to have at least three months of RLE or counseling in order to receive hormones, it is not required. However, three months of RLE and/or counseling is required for breast/chest surgery .
Evaluating RLE follows a strict set of guidelines that the mental health clinicians who are doing the person’s psychological assessment will look over in order to allow the person to qualify for hormones or surgery. Mental health assessors check to see how long the person has been living as their preferred gender, what the RLE has been like for them, and how they have dealt with the challenges of RLE . Discussing the difficult areas of the transition process helps to show how stable the person is and whether he or she is strong enough to deal with the inevitable stress that follows. The assessors evaluate the quality of a person’s RLE by reviewing the following abilities:
1. To maintain full or part-time employment;