Real Life Test

The Real Life Test, also called the Real Life Experience, was a requirement in older transgender medical protocols that a person live full-time in their affirmed gender for a set period, often one to two years, before being approved for hormones or gender-affirming surgery. It came out of gatekeeping-based standards of care used through much of the late 20th century. Critics argued it forced people to live openly without the physical changes that would make doing so safer and more comfortable, and that it placed arbitrary burdens on access to needed care. Contemporary standards, including recent WPATH Standards of Care and widely used informed-consent models, have largely moved away from a formal, mandatory Real Life Test.