In the light of the use of RLT/RLT by numerous so called Gender Clinics, and often for a much longer time that is stipulated in in WPATH:s Standards of Care and somtimes without any aid of hormones or other mecial support, there have been an interesting developemnt in the discussion on the validity of RLT/RLE in the upcomming version of SofC.

During the work to revise the World Professional Association for Standards of Care various apects of the SoC have been revised and scrutinized from a number of angles by various WPATH-members.

Professor Stephen B. Levine reports on the work with a common fixture of transgender care for over forty years, the Real Life Test(RLT) or as it is sometimes call now, the Real Life Experience (RLE).

In his very thorough study he found that although RLE is refered to and mentioned in numerous works on transgender care and health, no scholarly journal article on this subject has even been published that is devoted to the scientific study of RLT or RLE.

Stephen B. Levine concludes “The abscence of a firm scientific foundation to support the utility and validity of the RLE generates unease about setting policies for the management of gender identity disorders. This absence creates at least two ethical objections. First, the principle of Nonmalfeasance reminds us to “above all, do no harm.” The employment of the scientifically unsubstantiated scientific requirement of a Real Life Experiance can be a needless, cruel, and harmful obstacle for patients who are eager to use hormones or undergo genital surgery.

Second the principle of Respect for Patient Autonomy reminds us that the imposition of a scientifically unfounded RLE may be a disrespectful abrogation of allowing for patient self determination.

This article was published electronically on December 10th 2009 in the International Journal of Transgenderism, the official organ of WPATH. Stephen B. Levine is a clinical Professor of Psychiatry at the Case Western Reserve University School of Medicine in Cleveland, Ohio, USA.

I think that it is vital that we trans and gender variant activists really and wholeheartedly take part in the upcomming discussion on the Standards of Care version 7 that is going to be adoped at WPATH Symposion in Atlanta, Ga, USA next fall.

At least two leadning members of WPATH, Professor Sam Winter and Professor Aaron Devor, have proposed that in order to make the upcomming version of SofC more inclusive and in line with the needs of the trans and gender variant people seeking medical and surgical intervention, there should be a broad discussion on the version 7 of the SofC before they are adopted in Atlanta in September 2011.

As a WPATH member and as a member of WPATH Membership Committee I could only urge transgendered proffesionals to join WPATH and to use their influence on the upcoming version of the Standards of Care. Who knows, we might even manage to do away with gatekeeping for good in favour of some form of informed consent.