How Dutch TV Appearances Normalized Gender Care, Regardless of Evidence

"We saw a wave of patients who thought, after watching the first television broadcasts: that's me." That was said by Jos Megens, then coordinator of the VU gender clinic in Amsterdam, looking back on the late 1970s. He and endocrinologist Louis Gooren appeared for the first time on Dutch talk shows such as those hosted by Sonja Barend and on Rondom Tien. Megens said that the day after such a broadcast, the hospital's phone lines were "ringing off the hook." This account does not come from critics, but from the documentary Transgender Pioniers by the NPO program Andere Tijden, based on the broadcaster's own archive.

A clinical practice that marketed itself on television

It is an uncomfortable fact that rarely appears in the official history of Dutch gender care: the flow of patients to the VU clinic did not grow primarily because general practitioners referred people based on clinical criteria, but because people recognized themselves in what they saw on television. Megens himself calls it a "wave"—a word more suited to public interest than to a carefully screened patient population. American investigative journalist Mia Hughes describes this mechanism in a recent essay for Genspect as a form of "iatrogenic" growth: the treatment practice itself generated the demand it then proceeded to address. That is Hughes's interpretation, not an established fact—but the underlying events she describes can independently be found in the Dutch public broadcasting archive.

The backstory: Otto de Vaal and the Arnhem case

The roots go back even further. Amsterdam physician Otto de Vaal (1916–1993) had publicly opposed the idea that transsexuality was a mental disorder since the 1950s, following a high-profile treatment case in Arnhem in 1959. According to Amsterdam UMC's own anniversary history, De Vaal founded the Stichting Genderfonds in 1972 together with plastic surgeon Philip Lamaker—the forerunner of the later VU gender clinic, where Gooren and later Peggy Cohen-Kettenis further developed the treatment practice that would culminate in 1998 in the publication that became internationally known as the Dutch Protocol.

What Amsterdam UMC's own retrospective does and does not say is striking. It describes international symposia and knowledge exchange among physicians as the driving forces behind the clinic's growth, but leaves the domestic television appearances—and their effect on the influx of patients—entirely unmentioned. Its medical self-image is one of scientific development; the picture emerging from the broadcaster's own archive is one of public recognition through television. Both sources concern the same period and the same people, but tell a different story.

What was never reassessed

In her essay, Hughes points out that the medical-ethical approval granted by the VU in 1976 for gender reassignment surgery was never fundamentally reconsidered afterward, not even when the clinic grew from a small-scale adult practice into an internationally renowned department for children and adolescents. That is a strong claim that we have not been able to independently verify in an official committee report—the minutes of such decisions are not public—but the pattern is consistent with what our own dossier on the Dutch Protocol shows: a treatment model that expanded as clinical practice for decades before foreign regulators—from the Cass Review to the Swedish SBU—began systematically scrutinizing its underlying evidence base.

That distinction matters to the Dutch public, which has rarely paused to consider exactly how social acceptance of gender care came about here. Not through the gradual accumulation of research evidence followed by public information—but through public information that got ahead of the research evidence, after which the practice itself was interpreted as evidence of social support.

Why this is more than history

This is not a story about malicious intent. Megens and Gooren acted from the conviction that they were helping people who had nowhere else to turn, and for some viewers, seeing themselves represented on television was undoubtedly the first step toward appropriate care. But the distinction between "many people recognize themselves in this" and "this treatment is scientifically supported" is precisely the distinction that still had to be made decades later, during the Cass Review and the Swedish reassessment. Anyone who wants to understand why that happened so late must look not only at the clinical literature, but also at the living room: at what was shown on Dutch television in the 1970s and 1980s, and what was accepted without further scrutiny. How coverage developed thereafter is discussed in the article on the media and public debate. The archive of historical Dutch sources on this site deliberately places those two layers—the medical and the social—side by side.

For anyone who wants to follow the clinical next steps in this history—how the VU practice became more formalized after the 1980s into the protocol that gained worldwide adoption—an extensive reconstruction is available on dutchprotocol.nl, including the roles of Cohen-Kettenis, Delemarre-van de Waal, and Gooren during the 1980–1990 period.

Sources

Andere Tijden (NPO), "Transgender Pioniers", episode 90. anderetijden.nl/aflevering/90/Transgender-Pioniers

Amsterdam UMC, "How pioneers became experts: 50 years of transgender care at Amsterdam UMC", 2026. amsterdamumc.org

Mia Hughes, "How the Dutch Normalized Medical Madness", Genspect, October 1, 2026. genspect.substack.com/p/how-the-dutch-normalized-medical

NTvG, "The first female-to-male gender reassignment operation in the Netherlands", 1959/60. ntvg.nl