House of Representatives — Parliamentary Questions on the Dutch Approach (2023)
On 27 March 2023, Members of Parliament Pouw-Verweij (JA21) and Van der Plas (BBB) submitted written questions to the Minister of Health, Welfare and Sport about the growing criticism of the Dutch Approach to transgender care for minors. The questions were prompted by an article in de Volkskrant. Minister Kuipers answered the questions on 9 May 2023.
What it says
The questioners refer to the Swedish health authority's conclusion that the risks of hormone treatment for minors currently outweigh the potential benefits, and to the British NICE reviews, which rate the evidence as being of very low certainty. They ask whether the Dutch approach still meets current standards of scientific knowledge and clinical practice, and whether an independent systematic review would be possible.
The response
The minister responds that it is up to the professional organisations to define good care in standards and guidelines, and that he does not determine the medical content. He refers to the ongoing evaluation of the Quality Standard for Somatic Transgender Care. According to the Health and Youth Care Inspectorate, there were no indications of unsafe transgender care. The questions form part of the debate on the Dutch Protocol and the developments in the Netherlands.
More from the questions and answers
The document contains nineteen questions. The article in de Volkskrant was published on 24 February 2023 and described how the once highly praised Dutch treatment of transgender young people was facing increasing criticism. In addition to Sweden and England, the questions and answers also address Finland, the revision of the German guideline, a new guideline in New Zealand, and version 8 of WPATH's Standards of Care. The minister states that the evaluation of the quality standard is being carried out by the Knowledge Institute of the Federation of Medical Specialists and funded through ZonMw. According to him, an independent systematic review by the National Health Care Institute is not under consideration. He points to ongoing research by Amsterdam UMC and Radboudumc into the broader group of young people with gender dysphoria. Regarding regret, he cites a 2018 study by Wiepjes and colleagues: 0.6 percent of trans women and 0.3 percent of trans men regretted the removal of their gonads. The answers were published on 11 May 2023.
What happened next
A year later, the subject returned to Parliament following the final report of the Cass Review. The government's response is set out in the June 2024 parliamentary letter. The foreign assessments cited by the questioners can be found in this archive in the SBU report from Sweden and the NICE review from the United Kingdom.