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About The "Real Life Experience" and Detransitioning

by: Autumn Sandeen

Fri Oct 24, 2008 at 17:00:00 PM EDT



[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~~]

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.]

Autumn Sandeen :: About The "Real Life Experience" and Detransitioning
Page 17 of the Harry Benjamin Standards Of Care For Gender Identity Disorders says this about the RLE (emphasis added):

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.

~~~~~
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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I wish him well.
  Thank you for some more clarification on terms.  As a dear friend of mine has said.  Transition is like taking a train. you leave the station and can stop at any place along the way. But just remember, there is a point when you cannot return and after a certain amount of time on the train it will never return from where it started.

If I make sense? it was quite by accident.

It's hard either way
Thanks for the mention Autumn and thanks for sharing your thoughts on this.

I agree with much of what you've said, and you raise a good point about how Penner really can never go back to being a "standard issue hetero guy."

But I did want to challenge you on one thing: framing things as "detransition = unsuccessful" presumes that transitioning is the "right" outcome. When really the point of RLE is to figure whether it's an outcome that will give you the sort of life you want.

I've too have seen too many cases where people detransitioned due to constraints, such as the ones you mentioned. That's to say, had those external pressures not been there, these are people who would be happier transitioning.

But... as I mentioned in my diary, I've also seen people detransition because they genuinely believed other things in their life -- such as preserving a relationship with a spouse -- were more important. (FWIW, I've heard of crossdressers who gave up crossdressing but since these sorts of folks rarely end up in a gender therapist's office to begin with, and they're also not the folks who make grand pronouncements about quitting, rather they just quietly fade from the scene. So they tend to be off the radar.)

Unfortunately, because a small number of certain types of narratives -- such as "transition or suicide" -- are so dominant, these people's decisions are routinely second-guessed. For some reason people feel they can presume they know better than the person themself what sort of life they ought to have. (BTW, I'm not suggesting you're saying this about Penner.)

It goes back to the issue that there's such a limited set of narratives -- especially those that are "societally acceptable" and able to be used to argue in favor of getting rights (and getting necessary medical treatments for transitioners). So seemingly some people can get really threatened when someone else's life doesn't validate their own story. (Similar to how many LGB people get so defensive about the idea that sexual orientation may be partly chosen by some people.) Even those who aren't overtly defensive can often act in ways that presume other paths don't exist -- ironically much in the same way that cisgender people can act like they're the "normal" ones rather than just statistical norms.

Ultimately I think it's much healthier -- and much more defensible, in terms of rights etc.* -- to acknowledge that there are many different paths people take.

* For example, we don't insist that a person be protect against discrimination based religious beliefs because they are "born that way," rather we recognize that while religious orientation is a choice, it's so fundamental to who we are that it deserves protection.


I used the word my therapist used...

...And I presume that she meant successful or unsuccessful in whether or not the initial goal of beginning to liv permanently as one's target sex was met with the RLE -- verses whether or not detransitioning at the end of an RLE period is a good or bad result.

I don't like the phrase "successful RLE" either, specifically because it can imply what you're hearing when I used that word. There are people who begin an RLE, as we know, who shouldn't follow through with transitioning -- why saddle them with the thought they were "unsuccessful"?

My problem was that I personally couldn't find a better word than the "successful" word my therapist used to communicate that the transition "didn't take" like it was expected to.

Again -- you make a good point though.

-----
~~Autumn~~

As if there were safety in stupidity alone.
--Henry David Thoreau


[ Parent ]
Thanks for clarifying
I agree, we don't necessary have good language to talk about the issue.

[ Parent ]
Single commonality
Thanks for this post Autumn! I am a person who did RLE for over a year and then retransitioned. I really wish anyone had bothered to tell me what you just said; "the single commonality for all of her detransitioning clients has been that external pressures were the impetus."

This really makes me angry, I want a world where we can be whoever we are and wherever on the gender continuum we feel right. Safely. Employed. Etc.


hmmm..
a bunch of psychobabble.

I began transition in 1988 (mtf) and moved away from a redneck town full of hate mongers to complete the process in 1989.  By 1991 I was living FT (I don't care for the RLE/RLT terms) when I met another woman.  We got married and I adopted her two small children as my own.

We lived as a lesbian couple for a few years until I lost my job and we had to return to the redneck town I had left, I had a house there we could return to.

I began the de-trans process.  For two reasons.  My kids.  I could not put my kids through what I knew would happen to them at school in this town full of hateful and ignorant people.  I began to assume a male role and became a father figure and presented as a somewhat traditional male figure.  I was miserable but I put my kids needs before mine.  My kids grew up and they are now adults and have their own kids.

And now, I am once again living my life for ME...  I lived my life for them, now it's my turn.  I resumed transition about 2 years ago and I'm well past the point of no return.  I can't pass for a guy even if I try.  I still have a long way to go but I've come a long way.  I won't be going back though.  This is "do or die".  
I'm living FT again though I still need to take care of the legal things like name and GM changes which I intend to do in 2009.  I'm not wealthy so it's difficult.

Transition is not a "One size fits all" process.  It's different for everyone.  Some people take longer than others, some people take the steps in a different order.  Just know this, transition is NOT easy nor is it fun.  It's hellish.  It's NOT fun.  But, it's life or death for me.  Nothing will stop me.  Many things may slow me down but nothing will stop me.


Another Thought or Two
Something I have seen has been a start to transition, undo and go back to life before and then sometime later transition again.  Sometimes the time is not right.

Another is that I have a good friend who did untransition.  She has her reasons which do make sense for her life.  Although, the exterior has gone back the inner spirit is still transitioned.

The commonality is that only we can know ourselves and if a total physical transition is necessary to achieve true life.  AND, it is only our inner self that knows.

We no longer need to fulfill the Barbie roll to "prove" to anyone who we really are.  We do not need to create a persona that is as false as our previous actor lives.  AS for Mike-Christine, I am waiting to talk to her again, only to offer my support in living a very public life.  Sometimes it is hard to explain when everything about you becomes public consumption exactly what the pressures are like.  

Pam,
J'aime ma Peau



thank you
for the education.  As one who identifies as "queer by proxy," there is a lot for me to learn about the GLBT community, especially the T.  This has been enormously helpful for me personally and spiritually.  My thoughts and prayers go out to Christine/Mike, and to all who face these issues.

queer by proxy - there's another few initials - LGBTQQIAQBP?
That just might win the world Scrabble record.

[ Parent ]
For Scrabble
we will need a few more usable letters, such as a U or E or R, maybe a C or D...

Pam,
J'aime ma Peau



[ Parent ]
nah, I really only have
voice without vote in the community, so I don't think I get any initials.  But thanks!  And I guess I only get a toaster oven?  I haven't figured that out yet.

[ Parent ]
Autumn, thank you for writing this post
I stopped transition some years ago, moved out of state, cut off contact with my friends.  It was hard and continues to be hard.  It was a matter of survival, and I am surviving, but I am not happy.

I was never as visible as Mike/Christine, and this surely has made things easier for me. But my abrupt, unexplained disappearance must have been hard on my friends whom I deserted. I regret how I treated them, and yet I can't bring myself to re-establish contact... it is too painful.

I am sorry for your loss of contact with your friend. I know that, intellectually, Mike's decision is understandable, but that doesn't make your loss hurt any less.

Thank you for helping everyone here to understand what is going on.  And thank you (and also the persons who have commented) for making me realize that I am not alone in my situation. This thread is a tremendous balm for me.

If you want allies, you have to be an ally.


It's such a personal experience
I've worked with and for the transgender community off and on for the past decade.  Several friends  or acquaintances have charged ahead through the Benjamin Standards, others have reached the stage of living full-time in their desired gender and stopped there or stepped back.    

The challenging aspect of Christine/Mike's experience is that it's taken place in such a public forum. It was so exciting to hear about the acceptance of Christine's friends, colleagues and teammates when she came out.  Now that she's transitioning back to Mike, it's likely that there are some people asking, WTF?  

For me, it comes back to "What's best for Mike?  Is he comfortable with himself and where he's at with his life?  This could be what my mom calls 'a teachable moment' to have a further discussion about the fluidity of gender, sexuality, self-perception and public perception.

Christine was incredibly brave to talk publicly about her experience.  I think it's just as brave for Mike to acknowledge that moving forward isn't something he's prepared to do at this point in his life.  I wish him well.


Good luck, Mike, and know You have friends.
Good luck, Mike.

I'm of the mind we do what we must when we must.

There will be a thousand and one people second guessing you, and it will sting, for that's its nature, but not one of them is anything more than a second guess.  

Many more did it before, and people do that.

Live your life, as you need to, for your reasons, on your terms, in your way.

Or not.

Either way, none of us walks in your shoes.  But all of us wish you the best, and know that no matter what, some of us will be here.

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

I gave thought to transitioning back.

Not a lot, and never in moments where I was at my best.

I will always say that transitioning costs you everything you value.  There is a reason that we are afforded "a name everlasting".  This is a path least traveled, one where we always find the way we need to be.

the best transition is the one that takes you to contentment.  It may take 6 months, it may take 20 years.  You may go far, and stop, you might go a little way, you may need to back down and approach it from a different direction.

The only way to go wrong in being yourself is to not be so.

http://www.dyssonance.com  Breaking all the rules...


I'd rather be happy for Mike than sorry for Christine.

My first reaction was, how humiliating it must be for him to have this be so public.  On the other hand, it can just as easily be seen as a story with a happy ending.  Mike tried to be Christine, found out he wasn't, and is now back to being Mike - all the while keeping his job with an apparently supportive employer.  Of course, rarely are things so black and white.

I wish him well whatever his decision, but since he's being talked about, not doing the talking himself, it's mostly speculation on all our parts, isn't it?



I Agree With Your Therapist 100%!
People on the outside have NO idea of all the stresses people born transsexual go through.  The only way I can translate it is for gay/lesbian folks.  I tell them take any discrimination and intolerance you face and raise it by a factor of 10.

People don't fail transition.  They are beat down by an unaccepting society in a myriad of ways:

First, there are family issues.  My divorce was final 3.5 months after I came out to my ex.  I'm not allowed to see or contact my children in any way, shape or form.  Then there are your parents, siblings and other relatives to deal with.  The parent-child relationship can be exceptionally difficult to redefine.  I got somewhat lucky in that department because my parents were quietly supportive.

Second, is the employment issue.  It's virtually impossible to transition without money.  One has to carefully plan everything out and be ready for the worst (being fired when you come out).  People have to be part secret agent as they contact human resources anonymously to feel out their companies policy is, if they have one, in regards to transition.  Once again I got lucky, my position is hard to fill and my record was spotless.  As a result they didn't want to lose me.  Unfortunately the majority of folks still get summarily fired when they disclose their status and intention to transition.

Third, religion is a very thorny issue for many.  They struggle to reconcile who they are with what their church teaches.  Many churches openly discriminate against LGBT folks.  It's no secret that the suicide rate for transsexual people is high and this is one of the reasons.  The key realization for most folks is that you can be Christian and transsexual; that the church can and is wrong about a lot of things.  I struggled with this myself at the beginning of my transition, but I found resources that gave me the answers I needed.

Fourth, healthcare discrimination.  Many doctors refuse to treat us:

http://en.wikipedia.org/wiki/S...

The truth is most doctors and therapists haven't a clue about transsexual people.  Don't believe that medical people are somehow more enlightened.  I know I'm a healthcare professional and I've seen what happens when a gender variant person comes through our ER.  The good new is things are changing.  Last years the AMA voted to include us in all of their anti-discrimination policies.  And this June they went a BIG step farther by calling on the insurance industry to start covering our care.... including surgery.  Change takes time though, the insurance industry in the US is by and large unrelegated.

Fifth, the DSM.  Related to healthcare is our continued inclusion in the DSM.  Despite the support of the AMA, the APA seems to be resistant to removing us from the DSM.  Despite all the research done in the last 20 years that indicates transsexualism is a birth condition, certain pseudo scientists inside the APA seem intent on keeping us captive and denying our civil rights.  My hope is that with the support of the AMA the DSM will lose it's relevance.  Although I detest the DSM, I do support the Standards of Care put out by WPATH.  It brings some structure to the process of transition.  WPATH has openly expressed it's displeasure with the APA.

Good God this is becoming a book,  I'll try to wrap it up.  There is also:

Housing discrimination

What will the neighbors think?

Anti-trans violence during transition when one appears gender variant.

Legal discrimination.  Some states refuse to allow birth certificate changes. Some refuse to offer proper identity if you're pre-op.  Lawyers may refuse to help you.  Not to mention to being treated extremely unfairly by divorce courts and more.  And our right to marry is also still in question in many states.

Unscrupulous therapists that treat you as an ATM.

Lack of qualified therapists in many parts of the country.

Social Security outing pre-op folks with "no match" letters.

And the list goes on.  Transition is hard, but it's not because of self-acceptance issues or self-doubt.  It's because our society continues to make it so.  Positive change is happening, but it is still painfully slow; I often use the word "glacial" to describe it.  I hope that someday people will be free to be themselves and we will all recognize as a nation that it's our diversity that's makes us great.  Until then the struggle continues.


Why RLE Can Be Good
I will preface by saying that I am not yet in RLE, though I hope to get that rolling next year.

There's an old saying - "If you can't take the heat, get out of the kitchen." If you can't stand up to society and live the life you say you want, then you really don't want it. (At least, not at this moment. As others have said, it can be started again later.) Isn't it better to find out that transition isn't for you before you get to the point of no return?


I wish you well now and in the coming years
RLE can be stressful and I hope you encounter the best of outcomes.

I agree that RLE is vital.  And I agree with the hot kitchen statement, too.  But I think it is going too far to say that if someone "can't stand up to society" "then you really don't want it."  An attitude of damn the torpedoes, full speed ahead may move a person forward, but it also may get them into a life-threatening situation.

Just because someone drops out of transition or re-transitions doesn't mean they didn't really want the change. Nor does it mean their desire for change has gone away.  The important issue here is overall happiness.  The costs of the change may just be, or have been, unbearable.

What Mike is doing is very hard.  And to do it in the public eye must be unimaginably stressful.  I hope he is able to find the support he needs, and pray that he is not overwhelmed.  

If you want allies, you have to be an ally.


[ Parent ]
Right on
There would be no point in transition at all unless we actually put it into practice and make it work.

Since I transitioned last year, I've been hit full force with the external pressures spoken of here, namely total rejection by my family and loss of my job followed by discrimination in seeking employment. I keep getting calls from recruiters who like my resume, but the next thing I know, the job mysteriously vanishes. Every time. I am getting nailed on the background investigations. Also, I think I may be getting blacklisted in my career, it's a tightly knit community around here and word gets around easily. I never had debt before, had an excellent credit rating, but now I am spiraling down deeper into debt all the time and about to lose my house to foreclosure.

And yet not for one second have I ever regretted transitioning or considered undoing it. It's absolutely essential to my continued survival, which puts everything else in perspective. I'm getting some hard knocks, but if I hang on things will get better and I can rebuild up from here. Thanks to transition, I now enjoy such profound inner peace and happiness that I could never have imagined before. I will not trade this for anything. I have faith in divine providence which has always gotten me through the tough times before, and I will get through this. I also see positive signs of hope for progress toward our equal rights, so hang in there.

Here's what I find about compromise--
don't do it if it hurts inside,
'cause either way you're screwed,
eventually you'll find
you may as well feel good;
you may as well have some pride

--Indigo Girls


[ Parent ]
Come to think of it
The sportswriter formerly known as Christine never suffered unemployment or financial problems. Some other force must be at work in their decision to reverse transition, something we don't know and can only speculate about.

My economic woes are harsh and frightening, the loss of my family has been a series of painful heartbreaks, but none of this has made me reconsider my transition. Something else is going on within the individual that is known only to them. I have to question the conclusion of Autumn's therapist, because explaining this by external pressures alone just doesn't add up. To me it looks like these decisions arise from within.

That does not excuse the unjust external treatment by society, which must change and change soon.

Here's what I find about compromise--
don't do it if it hurts inside,
'cause either way you're screwed,
eventually you'll find
you may as well feel good;
you may as well have some pride

--Indigo Girls


[ Parent ]
Is it a detransition or a new transition?
Hey guys... It's me, Josef Kirchner, perhaps hailed (by some) as the most famous detransitioner of all time.  lol  One of my producers alerted me to this article that I read with interest, thanks Autumn, and thanks again for your help this Spring when I was filming my latest documentary, A Change of Heart found at MSNBC.com in it's entirity. (shameless plug) Just a quickie on that one... The documentary was rated #1 network show the night it aired and people all over the world in my travels have come up to me on the street recognizing me and telling me how inspiring my story is to them.  It makes them feel like they can accomplish anything they want to in life seeing what all I have been through and accomplished.  

For my own life this has been a wonderful experience.  I really don't regret a moment of any of it!  There is something wonderful to be learned from all of life's experiences, mine being similar to getting to reincarnate three times in one lifetime!  To say I regret ever having transitioned from male to female is hard for me to say, but if we must be technical about it you can put me down on a new type of list...Could we call it the Transsexaul Regretter Successes?  This one life we know of that we get to live is for LIVING, and living to the fullest!  You are responsible for you own happiness everyday and YOU are the only measure of your own greatness!

I hope Mr. Penner joyfully finds his way back to living as male for whatever reasons he may have for doing it.  I think my 20 years as Judy was fulfilled and now life as Josef is another bright and shining new lease on life.  I want to encourage all gay, lesbian and trans people to be all you can dream to be!  Just do it from the heart with all the right reasons in mind, enjoy and then if one day the unthinkable is thought and you wish to make another change....well, it is not the end of the world!  It very well could be the beginning of a whole new wonderful world for you and for others.  Everyday, life is made more beautiful for me receiving letters from those who's lives I have positively inspired or given hope.  Sometimes when trans people regret their change or wish they could just wave a magic wand and go back to how things used to be they get very depressed because they think there is nothing that can be done.  I say, do what you want!  Be happy and bless others with your happy life.

Life if beautiful!
Josef


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