The real-life experience (RLE), sometimes called the real-life test (RLT), is a period of time in which transgender individuals live full-time in their preferred gender role. The purpose of the RLE is to confirm that a given transgender person can function successfully as a member of said gender in society, as well as to confirm that they are sure they want to live as said gender for the rest of their life. A documented RLE is a requirement of some physicians before prescribing hormone replacement therapy (HRT), and a requirement of most surgeons before performing genital reassignment surgery (GRS).
The sixth version of the World Professional Association for Transgender Health's (WPATH) Standards of Care (SOC), published in 2001, lists the parameters of the RLE as follows:
The seventh version of the SOC – which was published in 2011 and is the most recent edition of the standards – is more ambiguous, and does not list any specific parameters for the RLE. Instead, they merely state that the individual should be living full-time in their preferred gender role continuously for the duration of the RLE. They also state that documentation of a name and/or gender marker change can be presented as a way of providing proof that the RLE has been completed, but do not state that a name and/or gender marker change is a necessary requirement for completion of the RLE. Taken together, these changes may be signs of WPATH moving away from gatekeeping, which the SOC have been criticized for.
The SOC are followed by most medical professionals who specialize in the care of transgender individuals, and are the most widely followed clinical guidelines for the treatment of transgender persons in use. Hence, the SOC criteria for HRT and GRS, including completion of an RLE when applicable, must usually be met for one who seeks such treatments to receive them.
As of the seventh version of the SOC, a three-month minimum requirement of RLE is no longer part of WPATH's recommended criteria for HRT. A referral letter alone from a qualified mental health professional now suffices. The SOC state: