About The "Real Life Experience" and Detransitioning

by: Autumn Sandeen

Thu Feb 26, 2009 at 00:15:00 AM EST

A week ago last Tuesday (February 17th, 2009), Jossip apparently just caught wind of this story, and then mainstream publication USA Today did their own story on Penner's detransition story. Now, Querty, OutSports, Joe.My.God, and Towleroad (among others) posted their own pieces which highlighted the Mike Penner-to-Christine Daniels-to-Mike Penner story.

So, with the reheating of this detransition story in the mainstream media and LGBT blogosphere in the past week, I thought it best to repost this story to help explain why people transition.

In this piece I use the term unsuccessful to describe a Real Life Experience (RLE) -- a transsexual transition -- that concludes in a detransition. Successful and unsuccessful are the terms used by World Professional Association for Transgender Health (WPATH) professionals to describe how a patient concludes an RLE. A successful RLE is one where a transitioning person essentially continues living in their target sex after a year; an unsuccessful RLE is one where a transitioning person detransitions to their natal sex. I'm not using the terms successful and unsuccessful as value judgments for what the best outcome is for any particular RLE.

This is very a personal story to me. The USA Today story includes a picture of Mike when he was presenting as Christine  -- it was a photo taken at the National Lesbian & Gay Journalist Association (NLGJA) convention in 2007. That is the event where I met Mike. I spent that weekend hanging out with a group of trans journalists who included Ina Fried, Mike Penner, and me. The loss of the personal and professional friendship I shared with Mike still weighs pretty heavily on me.
~~Autumn~~

Some days I hate my job at Pam's House Blend, and this is definitely one of those days. I really need to explain what the Real Life Experience [(RLE) -- also referred to as the Real Life Test (RLT)] is and why some transsexuals detransition...And, this is because the person I met as Christine Daniels is apparently detransitioning (also called retransitioning) to Mike Penner.

Basically, I need to separate the personal from the professional when discussing how detransitioning fits into transsexual experience -- a sometime component of transitioning sexes -- and yet on the very personal level I wish it weren't at the impetus of someone I've known and care deeply about that's leading me to discuss the subject.

But life is what it is.

So, the first thing that needs to be explained is exactly what a real life experience is, and where detransitioning fits into the real life experience.

[Below the fold: excerpts from the Harry Benjamin Standards Of Care on the "Real Life Experience"; comments by a gender therapist on detransitioning; and some reasons why transitioners sometimes detransition.]

The act of fully adopting a new or evolving gender role or gender presentation in everyday life is known as the real-life experience. The real-life experience is essential to the transition to the gender role that is congruent with the patient's gender identity. Since changing one's gender presentation has immediate profound personal and social consequences, the decision to do so should be preceded by an awareness of what the familial, vocational, interpersonal, educational, economic, and legal consequences are likely to be. Professionals have a responsibility to discuss these predictable consequences with their patients. Change of gender role and presentation can be an important factor in employment discrimination, divorce, marital problems, and the restriction or loss of visitation rights with children. These represent external reality issues that must be confronted for success in the new gender presentation. These consequences may be quite different from what the patient imagined prior to undertaking the real-life experiences. However, not all changes are negative.

Parameters of the Real-Life Experience. When clinicians assess the quality of a person's real life experience in the desired gender, the following abilities are reviewed:

1. To maintain full or part-time employment;
2. To function as a student;
3. To function in community-based volunteer activity;
4. To undertake some combination of items 1-3;
5. To acquire a (legal) gender-identity-appropriate first name;
6. To provide documentation that persons other than the therapist know that the patient
functions in the desired gender role.

Real-Life Experience versus Real-Life Test. Although professionals may recommend living in the desired gender, the decision as to when and how to begin the real-life experience remains the person's responsibility. Some begin the real-life experience and decide that this often imagined life direction is not in their best interest. Professionals sometimes construe the real-life experience as the real-life test of the ultimate diagnosis. If patients prosper in the preferred gender, they are confirmed as "transsexual," but if they decided against continuing, they "must not have been." This reasoning is a confusion of the forces that enable successful adaptation with the presence of a gender identity disorder. The real-life experience tests the person's resolve, the capacity to function in the preferred gender, and the adequacy of social, economic, and psychological supports. It assists both the patient and the mental health professional in their judgments about how to proceed.  Diagnosis, although always open for reconsideration, precedes a recommendation for patients to embark on the real-life experience. When the patient is successful in the real-life experience, both the mental health professional and the patient gain confidence about undertaking further steps.

So, what's supposed to happen when a transitioner has a unsuccessful RLE is that the transitioner detransitions.

I had an appointment with my own therapist, Patricia Wojdowski, L.C.S.W., on Wednesday. While at the appointment, I asked her some questions regarding detransitioning, and asked if I could post her responses at Pam's House Blend.

I actually was kind of surprised at Patricia's answers. Basically, in her long practice with trans clients (she's been involved with studying and treating transsexuals and other gender variant people since the mid-seventies), the single commonality for all of her detransitioning clients has been that external pressures were the impetus. All of her clients who have detransitioned still considered themselves as having a gender identity that didn't match their natal sex, but external pressures -- issues such as inability to find employment, biases and discrimination in the workplace, an inability to find appropriate housing, conflict with friends and/or family, etc. -- are why the RLE is evaluated by the client as unsuccessful, and the client decides to detransition.

I know there are other reasons than the ones my therapist cites. Sometimes the reason is relating to faith, where one becomes an "ex-transsexual" or "ex-transgender" (the trans equivalents to "ex-gay"). Sometimes it's because the person really isn't a transsexual, and an unsuccessful RLE catches them before they experience transsexual regret. Since my therapist doesn't practice conversion (or reparative) therapy, she wouldn't see those who are detransitioning for reasons of faith. But, it is interesting that in all the years of her practice, she's never seen a transsexual who has detransitioned due to because the detransitioner has figured out that he or she really wasn't transsexual -- all of her detransitioners have detransitioned due to external pressures.

So, back to our impetus -- is Mike Penner detransitioning from Christine Daniels because he's under external pressures, or is it because he figured out during his RLE that his gender identity really wasn't female? Honestly, I have a guess, but I have no real idea.

The bottom line is that when a person begins a transsexual transition -- especially a very public transition -- one trades one set of problems related to having a hidden, real or perceived gender identity that's in conflict with one's natal sex for a completely new and different set of problems. That new set of problems often include difficulties related to housing, employment, and public accommodation --basically just dealing with others' biases and discrimination -- family issues related to one's spouse/ex-spouse and children, as well as having one's peers, friends and family still seeing you as either still a member of your natal sex instead of your target sex, or as a member of some "third gender" rather than as your target sex.

Detransitioning may relieve most of the transitioning stress, but at least in the case of male-to-female transitioners who detransition, one can't go fully back to one's previous life. Prior to transitioning, most are fairly closeted about having cross-gender identity and expression issues. When detransitioning, one's peers, friends, and family -- and in Mike's case, the sports community audience he writes at the Los Angeles Times for -- know there are at a minimum gender expression issues. In other words, since in broad society most can't tell the difference between a male-to-female transsexual, a drag queen, a crossdresser, and an effeminate gay man, a detransitioner going back to a male expression of public gender is going to be perceived as if he were gay because of the time spent living as female; basically the detransitioner won't fully regain his heterosexual privilege.

Transitioning is hard; detransitioning is hard. My warmest thoughts are with Mike -- I wish him the absolute best.

~~~~~

[Note: LenaD has a related diary entitled The road not taken on the same subject as this diary, but with a somewhat different take. ~~Autumn~~]

~~~~~
Further reading:
* Transsexual regret
* A Warning For Those Considering MtF SRS
* Can One Be A Transgender Christian?

~~~~~
Related:
* Christine Daniels Retransitioning Back To Mike Penner
* LA Times' Penner: "I am a transsexual sportswriter."
* Check out LA Times sportwriter Christine Daniels' transition blog (Autumn note: The blog is gone.)

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