Transgender care

(Klik hier voor de versie in het Nederlands)

You’ve been thinking about it for a while, and you suspect you might be transgender or non-binary, or you are already certain about it. What steps can you take?

Where do you start?

You can start with your own research. What gender identity makes you feel most comfortable? Are there pronouns that you feel suit you well? Perhaps you want to be addressed by a different name, or you want to learn more about the transgender community and the various possibilities. To explore this for yourself, we can recommend checking out the following two books and a contact group:

  • The book Am I Trans Enough, How to Overcome Your Doubts and Find Your Authentic Self by Alo Johnston
  • The book The ABC’s of LGBT+ by Ash Hardell.
  • The Transvisie English Contact Group. Transvisie has a contact group for individuals with any connection to transgender life in the Netherlands, who find it more comfortable to express themselves in English than in Dutch.

You can also talk to others who have similar questions as you. You can chat online with experts at Genderpraatjes. The Genderpraatjes website is in Dutch, but the people behind the chat speak English too. You can also ask questions on the T-Nederland forum. There is an English section with a varaiety of topic. Transvisie offers an offline support groups in English that you can join. If you are still in high school, your school might have a GSA network – you can also talk to others there.

If you suspect you are transgender or non-binary and feel you need medical or psychological care, you can register on a waiting list for transgender care. There are various treatment options available. First, inform your general practitioner that you are transgender and in need of care. Express your desire to be on the waiting list of one or more transgender care providers. It’s recommended to register with several locations to ensure you can be helped as soon as possible. You can find all gender teams and other providers on our Transgender Guide – Amsterdam UMC is no longer the only option!

The Transgender Guide is in Dutch only. The Transgender Guide aims to be a roadmap through which transgender individuals can navigate more independently and freely in the sometimes impenetrable forest. The map contains information about, for example, anti-discrimination agencies, medical specialists (for diagnostics, hormones, and surgeries), mental support, and contact and self-help groups. It’s also clear to see that not all support for transgender people is located in the Randstad. There is a good chance that you can find what you need right in your own neighborhood. All mentioned companies and organizations have experience with transgender individuals. Additionally, they are evaluated by Transvisie and Transgender Network based on strict criteria before being included on the map.

When making your choice, consider factors such as waiting time, available treatments, collaborating practitioners, diagnostic procedures, and whether your health insurance has a contract with the provider. Transvisie provides additional information (this page is not available in English) on what to consider.

The waiting time for transgender care is currently long at most providers. This can be a challenging time, especially if you have to wait for a long time, but know that you are not alone. Others have gone through it before, and they have tips for getting through it. Talk to people around you or in the mentioned groups.

“It is a very long time, so it’s important to develop good healthy coping mechanisms. For me, that was support from friends, people you can talk to and vent to. Being allowed to cry and having someone listen for a while.” – Joana, 20 – Read her story

There are various tools you can use to feel more at home in your body. Binders can help flatten the chest, and there is underwear that can compress the penis or add a packer. In the Netherlands, places like UNTAG offer tested and safe products. Always be cautious with your body! Read more about the steps you can take here.

Additionally, you can change your official gender registration and name if you wish and feel ready. Learn how to do this here.

Are you new in The Netherlands and looking for trans healthcare? The Trans United Clinic in Amsterdam provides trans health care to the BPOC trans community, even if you don’t have a residence permit (yet).

Treatments

It’s essential to know the possibilities when considering gender-confirming care for yourself. It’s no longer a fixed transition path; gender-confirming care is tailored to individual needs. Educate yourself so you know what you can and may choose!

Transgender care can be broadly categorized into three branches: psychological, hormonal, and surgical.

Psychological

There are various reasons for seeking psychological care. In the Netherlands, it is currently necessary to undergo a process with a psychologist for a diagnosis of gender dysphoria or gender incongruence before receiving hormonal or surgical care as a transgender person. This process is called the diagnostic trajectory. You go through it with a gender team, a specialized mental health care institution, or an independent gender clinic. You can find a complete list of these care providers on the Transgender Guide.

The duration of the diagnostic phase varies among practitioners, but it generally includes exploring other mental diagnoses through questionnaires, discussions to understand how you experience your transgender identity, conversations about your childhood and sexuality, discussions about resilience and your social support network, and a conversation about your desires in the transition. For some practitioners, the diagnostic process concludes with a second opinion from another therapist – they will review the process once more to ensure everything went well. When this therapist also gives the green light, you can move on to the next step of the transition.

There may be other reasons to seek psychological help. Many trans individuals find it helpful to talk to someone during the waiting period. You can use this psychological support to alleviate mental stress, further explore your gender identity and expression, and process how your life before these changes may have caused pain and difficulties. This way, you get to know yourself better and may have a clearer idea of your desires for the rest of the journey.

Hormonal

After the diagnostic process, you can choose to take hormones or blockers. This is generally done with an endocrinologist, but some general practitioners are also open to providing this care. The endocrinologist (or GP) examines your blood and discusses your specific preferences. There are various options: trans-feminine individuals can block their own testosterone supply and take estrogen, while trans-masculine individuals can do the opposite with testosterone. Administration methods vary, including skin spraying or rubbing, oral ingestion, or injection. If you are still in or before puberty, it is also possible to temporarily halt these changes with puberty blockers, administered by a pediatrician or endocrinologist.

Surgical

In addition to hormones, you can opt for surgical procedures. These may involve changes to external genitalia and/or internal reproductive organs: face, vocal cords, Adam’s apple, chest, reproductive organs (uterus), and/or ovaries and genitals.

Some people choose to go abroad for surgical care due to (excessively) long waiting lists, specific treatment options, or rejection for gender-confirming care in the Netherlands due to significant medical requirements. Keep in mind that postoperative care is still required upon return to the Netherlands, such as if the healing process does not go as hoped. Therefore, ensure you have a Dutch care provider in advance for postoperative care.

There are many different possibilities, and it is always your choice what you want in your transition – nothing is mandatory. Get well-informed so you can make a sound decision. Attend information sessions by care providers or check Transvisie’s website if you need more information.

Aftercare

As great as it is to finally receive the care you need, it doesn’t mean you can’t feel down at times. Gender-confirming care can bring about additional thoughts and feelings that are not always positive, and you need to learn to cope with them. It’s entirely normal for this to be a challenging time. For some, it feels like a second puberty, and the changes to your body and/or appearance can stir up a lot.

Feelings and/or doubts about hormones

When you finally gain access to hormones, it’s a huge relief, but it can also evoke other feelings, such as doubts that weren’t there before. This is entirely normal. Changes in hormones not only alter your appearance but can also change how you feel internally – for example, in how society perceives you or how you see yourself in a new way. Hormones may alleviate some dysphoria, shifting the focus to other aspects of dysphoria. You may not be entirely satisfied with the changes or feel that they are happening too slowly or too quickly. Your doctor is there to discuss these doubts with you and assist you – it’s entirely normal to have these discussions and adjust your care plan according to your wishes.

These concerns also play a role in gender-confirming surgeries. It’s entirely normal to be quite nervous before surgery, even if you’ve been waiting for it for a long time. Doubts may also arise. Talk about it with people around you – many other trans individuals have experienced the same doubts and nervousness. It’s entirely normal not to feel great for a while or to mourn the body you no longer have, even if you’ve been eagerly awaiting these changes. Again, it’s good to talk to other people, and therapy can be helpful. You can find professional support using the Transgender Guide.

After surgery, there’s a long period of recovery. You often have to spend some time at home in bed or on the couch, taking good care of the operated wounds. Therefore, it’s good to prepare in advance with items that help you during this time. Consider, for example, a long charger to charge your phone from bed, a tray to place over your lap, and enough delicious food and drinks. You are also expected to apply postoperative care, such as dilating after gender confirmation surgery or wound and scar care after mastectomy. Seek help from friends, family, or home care (your GP can assist with this) in advance to support you during your recovery period. Make sure you have discussed the necessary aftercare with the surgeon and have everything at home so you don’t have to think about it later.

Complications are always a possibility with surgeries, even years after the operation. Your doctor will discuss all of this with you. If you have doubts and concerns? You can always call them, even if you start experiencing issues long after the surgery. You only have one body, and it’s crucial to handle it with care and attention. Always contact your doctor if something doesn’t feel quite right.

Contactpersonen hierover

Sophie Schers

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