Transgender care for adolescents in the Netherlands is characterised by a carefully designed pathway. The Health Council states this in an advisory report drawn up at the request of the Ministry of Health, Welfare and Sport.
Questions about gender identity can be part of natural identity development. For a small proportion of young people, these questions relate to gender dysphoria: a deep feeling of discomfort because the perceived gender identity does not correspond to the sex assigned at birth. Part of this group desires treatment with so-called puberty blockers and/or gender-affirming hormones. In the Netherlands, this treatment is only available after extensive diagnostic assessment and subsequent treatment indication.
Research shows that hormone treatments are physically effective and that they seem to improve mental health. The treatments may also have negative effects, but the Health Council sees no reason, based on the limited data that are available on this subject, not to offer the treatments, especially because denying treatment can also have harmful consequences for mental health. The council is unable to comment on the number of people who regret undergoing hormone treatments in the Netherlands. There is too little data on this.
The council concludes that transgender care for adolescents fits within the health law framework for, among other things, patients’ rights and the organisation of care. During the elaborate exploratory phase that characterises Dutch transgender care, but also during the rest of the care trajectory, there is sufficient room for the provision of information to the adolescent and their parents and for the reflection that is necessary for voluntary informed consent for potential hormone treatments.