RSS Feed

Why the ‘Year Long Test’ to Get “The Surgery” is Kind of BS

testI’m now 9 months into what my gender specialist calls my ‘Year Long Test’, or what I simply call the rest of my life. For those who may be unfamiliar, The Test is the period of time a trans person must live as the gender of their identity in order to qualify for GRS, or as 99% of the population knows it, The Surgery. Ugh, nothing like a slew of capital ‘The’s’ to seriously aggrandize everything. Anyway, I got thinking about this and have a few bits to share.

My first thought on hearing about this requirement was, “How ridiculous. If I know, I know.” My specialist begged to differ and painted it as a huge event upon which the rest of my life would be based, if I even ever got to that point. I humored him to some degree, but took exception to every instance he brought it up. “When you start your Real Life Test…” Hmm? Oh, yeah, you mean when I’ve finally managed to come out to everyone and start living the rest of my existence correctly? I didn’t say I wasn’t a difficult patient, and I suspected he had a well justified voodoo doll of me locked in his desk drawer that he used to make sure I could not find my car upon leaving. I don’t blame him; I’m just saying.

My point of view was very simplistic as I’ve said. The hard part was the long and painstaking effort of telling everyone, but once they knew, I felt weird and uncomfortable around them presenting myself as male as it didn’t exactly jibe with what I revealed. I hated that and knew in my heart of hearts that the real effect was adding to the habit they had of calling me “Mike” and referring to to me as “him”. Once I went full time, it would be pure bliss and I could not imagine ever wanting to go back for even a second.

Well, we live and learn now, don’t we? I will say that I have never considered for a moment going back, but I do see why temptation might present itself. All the big firsts were no-sleepers leading up, like the first day of work, first presenting myself to my family, my child, and old friends. Less stressful, but still on the mind were the first time to the grocery store, taking my son to a birthday party, and my favorite hardware store. Quick note on the last one. The boys at Hector’s never blinked when I came in looking for something and were as friendly and helpful as always in finding the exact right thing to repair a steel cable the dog managed to chew through. Compared to the alternative, however, no contest.

From a different point of view, things might have been different. If I didn’t have the ability to tune out the rest of the world and walk around in a state of blissful dissociation, there is the possibility that the stares would get to me. I don’t actually notice them myself, but my spouse does. If I lost my job and went on 42 interviews where I could tell I was dead in the water just walking through the door, an element of despair may have crept in. If I had no patience for the hour it took to make it out the door after discovering I only had 1 egg left when I needed 2, I may have had second thoughts.

Although I think it may be the exception rather than the rule, I can see where a yearlong test might be useful in seeing if you are ready to live and work as the gender opposite that on your original birth certificate. I consider myself lucky for having the personality I do, not to mention the elements of sheer luck that fell in my favor. Life can grind someone down, even if pursuing something so important and integral to their identity. Now for the big question.

Many aspects of the medical intervention aspect of transition are purely for the comfort of having one’s physical attributes match gender identity. If life becomes so heinous that social transition to the gender of best fit is in no way sustainable, does this change the desire to have one’s body match what is in their head? GRS is not really going to change any aspect of my non-romantic social life. No one is going to be able to see the change and the only marginal benefit is being able to wear slightly tighter pants, which let’s be honest, I probably shouldn’t do anyway. So why the assumption that failing the social Real Life Test means a person is going to be any more comfortable with what lies below the belt?

I believe the assumption is that for those of us who feel so strongly that GRS is an absolute necessity, we will do whatever it takes to grin and bear it through that year. Failure to do so must be indicative that the person is not really transsexual, or at least not sufficiently so to also have a deep personal need to make physical changes. This looks like a big whooping case of flawed logic to me. If the WPATH goal is the alleviation of suffering and the possibility of a fulfilled happy life, taking a rigid stand on this might be hugely counterproductive in certain cases.  Life circumstances can rarely be boiled down to a cold Boolean logic scenario where if A, then B; if not A, then not B, where A is the Real Life Test and B is GRS. In the words of Dennis Miller, “That is my opinion; I could be wrong.” I don’t think so though.

About michellelianna

I'm a transgender woman now in the maintenance stages of transition having all the electrolysis and surgery one can reasonably be expected to undertake. While busy exploring my new world, I took to blogging about it with dubiously popular results. I don't have quite as much to say as I used to, but I'm not quite done yet either.

11 responses »

  1. Justine-Paula Robilliard

    The test is rigged, it is bogus and irrelevant, it serves no useful purpose. It has not been shown to aid in gender decisions, after all there are bigger decisions that have no RLT, real life test, ie children, buying a house, getting “inked”… Many people get inked then years later regret it.. Where was the RLT, to prevent this?

    1 out of countless thousands start transition, have surgery, then regret it, so we all suffer as a result of a percentage of less then 1%????? I know many ciswomen that would not pass RLT, they do not do female work, or dress female per se, they raise children, for them it is not about being female, but about being honest.

    Any headshrinker that requests/demands a RLT is needing to be taking to the nuthouse and locked away. They are abusing you. End of conversation.

  2. I’ve know folk who’ve said they were ready yesterday. Some of these went through the process in the quickest time and got surgery (by any means). But some of those folk were wrong, and afterwards claimed that they’d been “pushed into the decision” by their medical experts and advisers. Others got peer pressured over the surgery and got it before they were ready. It was awkward for them afterwards because it complicated their life at the wrong point. I know at least one person who waited 7 years before she got her surgery, just to make sure she got it for herself and no one else.

    I think the bottom line is that it’s a means of making sure that folk – who might sue the medical advisers and experts later – are less likely to do so (regardless of whatever you’ve signed).

    But in any case I don’t think the surgery is the END of a transition either – it’s the mid point. Adjustment comes afterwards.

  3. Here’s the problem: Insurance and government agencies that would pay for it are gonna generally want there to be some restrictions and conditions; they would not be willing to pay for surgery-on-demand. With the APA finally creating formal guidelines for the treatment of GID/GD and Medicare reviewing its ban on coverage, we may actually get such coverage soon here in the U.S. Of course, you are going to have the RLT to go along with such coverage.

  4. Excuse the pun, Michelle, but if this past year for me was a test, will it be graded on a curve?

  5. I have known MANY transfolks. Through the process of learning about myself I have watched a lot of (mostly) gals transition. For what it’s worth, there are some trans people who do, indeed, have one and only one issue to deal with. They only need to overcome the fear, guilt, pain, anger, frustration and barriers of their Trans Issues. I have also known many more who had other issues to grow through that were significant barriers to their successful transition; PTSD, social anxiety, substance abuse, family and societal baggage, lack of job skills. None of those things will go away by transitioning. I think a lot of them will be amplified by transitioning. Now add to the mix that transitioning seriously changes “where you are in the world” and how you are perceived in the world.

    Oh, and add to it that surgery is not just expensive, it is also a major procedure that will require time and attention and diligence for a good recovery.

    So line that up closely with freaking out family, changes in friendships and relationships, transitioning in a job or searching for a new job, trying to change all the logistical things like name and IDs and navigating a new life while trying to keep your old life from getting all the attention. And while you’re doing it you feel a bit like crap because you are recovering from a gloriously trans-formative but major surgery. Our wee little pea brains can only handle so much…

    Some people truly are ready all at once. Some people truly think they are ready all at once. Most people need a bit of detached dispassionate guidance to help them really be ready. Rules aren’t a solid solution and a gatekeeper’s judgement can be skewed, or just plain wrong. The happiest people I know have taken the time to get their poop together and know themselves. And that is for trans people and cis people. And in both of those populations I have known tons of people who went off half cocked through life and had constant drama and trauma. And oh yeah, I said “half cocked” knowing that a good double entendre is a terrible thing to waste!!!

    Not the only answer, not a new plan, nothing but my interpretations. And I deeply honor and respect everyone’s honest and well thought out path.

  6. I’m torn on this one.

    With the advent of “if you have the cash, we have the surgery” SRS operations in foreign countries it’s too easy to put the cart ahead of the horse and run off and get surgery-without having a real idea of the feminine socialization process by living the magical year…”Me thinks”

    For some, the allure of a store bought vagina making make them a woman is too alluring. In fact, I knew a cross dresser who went through SRS and became the best looking woman in the room but was never able to embrace any inner femininity. And he did his year, then bought a vagina instead of a Corvette.

    On the other hand i have known a few “natural” trans folks who could have gone down the surgical trail at anytime.

    Here’s what REALLY confuses me. I don’t know who should make a call as to when someone is “ready” for SRS. I am not a total believer in the power of therapy and certainly there should not be a rigid time line.

    A great thought provoking question.

    • You have a point. Patience is a virtue, but I don’t think these objectively imposed requirements will work for everyone. I think a trans person in a rush will remain in a rush, despite any potential consequences of doing so. The year-long requirement may just make him or her feel like a year was wasted, and as a result, the transition needs to go even faster to make up for lost time. Of course, I am speaking in the abstract, and not everyone may have this perspective.

      However, I took my transition very slowly, and I think the doctors and the informed-consent counselor were very suspicious when I told them that that was how I wanted to proceed. I’m glad I did, though.

      My doctor explained to me that many transpeople seek breast enhancements very early on in the transition. And then, with the long-term results of the estrogen, these individuals have a “second” breast growing on top of the implant. Not pretty. But it’s not a worry for everyone, and I don’t think waiting a year would prevent that kind of result.

      • Wow, I have never heard of the second breast condition! Not good!!

        As I thought about this question further- ideally when the mental transition has already been completed to the satisfaction of the approving “authority” and if SRS is desired to fully “connect body and mind” it should be so much icing on the cake!

        • Yeah, they’re called bubble boobs. You can see the shape of the implant on top of the formerly small, now much larger, real breasts.

  7. I completely agree with you. The medical barriers really hinder the transpeople’s right to self-determination. I had my own experience with this stuff, even in a place like New York, that will never stop irking me. That’s the thing: these negative experiences will stay with us forever.

    • I enjoyed your site and perspectives! I’m always amazed by how many impressive, thoughtful trans people there are in the world. Now if we can just get the rest of the population to appreciate that…


Leave a Reply

Fill in your details below or click an icon to log in: Logo

You are commenting using your account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s

%d bloggers like this: