I have 5 different handguns with RDS mounted in different ways.
1. AR9 pistol with a Holosun 510 mounted on the rail co-witnessed to the folding BUIS.
2. An aftermarket optics slide from Swenson for a Gen 3-17 with a Vortex Venom mounted, direct attachment so as low as possible.
3. Gen 4-23 milled by Jagurwerks, optics in front of rear sight with a Holosun 507C-X2, direct attachment so mounted as low as possible.
4. 43X MOS with a C&H adapter plate with a Holosun 507K-X2 mounted, plate is .070 thick.
5. S&W Victory with a Tandemkross mount with a Holosun 507C-X2, between the S&W receiver, bull barrel and TK mount the HS507C is close to or more than .375 high off the bore
If you take the AR9 out of the mix because it isn't fired with a standard two hand hold used with a conventional pistol, I can't say that I can notice any difference when using one or the other.
I did an experiment to see if the red dot height had any impact on getting on target and practical accuracy with the three handguns I have with HS507s. I set up a target with 3 dots at 7 yards and fired a mag from one, set it down and immediately picked up another one and fire a mag, set it down and immediately picked up the third one and fire a mag, all with the same results I get when firing multiple mags with any one of them, didn't matter which one I picked up first, got the results I expected from having fired each handgun in the past.
I took the experiment a set further, I had a friends wife who just got her first pistol a few months ago and had never fired, let alone handled a RDS pistol run the same drill, with a little instruction on finding the red dot as she extended to the target she was making solid hits with each of the handguns.
the only problem was the dirty look I got from my buddy because his wife immediately turned to him saying "I want one".