Dutch guidelines for transgender care

The Somatic Quality Standard for Transgender Care (published at the end of 2019 and under revision since December 2023) describes care for transgender people in the Netherlands.

More on this site: Revision of the Dutch Quality Standard for Transgender Care.

Quality standard

The Somatic Quality Standard for Transgender Care was published at the end of 2019 and describes care for transgender people in the Netherlands. There is not yet a revised version: the revision began on 1 December 2023, the agreed delivery date of 30 September 2025 was not met, and the register of the National Health Care Institute now lists 30 September 2027 as the final deadline. The development involved, among others, the Dutch Society for Endocrinology, the Royal Dutch Medical Association (KNMG), the Federation of Medical Specialists, Transvisie and other umbrella organisations.

Content

The standard describes the diagnostic process, hormone treatment for adults and young people, surgical options and organisational aspects. For young people, it refers to the Dutch Protocol.

The future

Following the Cass Review and international reassessments, new evaluations are expected in the Netherlands. Amsterdam UMC and UMCG are conducting their own research into long-term outcomes.

Two standards

The Netherlands has two quality standards for transgender care. The 2017 Quality Standard for Psychological Transgender Care describes psychological support and diagnostics. The Somatic Quality Standard for Transgender Care describes physical treatment: hormones, surgery and additional care such as hair removal and speech therapy. A quality standard sets out what healthcare providers, patient organisations and insurers jointly consider to be good care, and therefore also plays a role in reimbursement by health insurance.

Young people

For young people, the somatic standard follows the Dutch treatment model: puberty blockers from the start of puberty, followed by hormones and, from adulthood, possibly surgery. Care for minors is concentrated in a small number of university medical centres. The origins of this model and the research underpinning it are discussed in the Dutch Protocol and the timeline.

Criticism

Critics point out that the standard was drawn up by clinicians and advocacy organisations involved in providing the care themselves, and that it was not preceded by an independent systematic assessment of the evidence, as has happened in Finland, Sweden and England. They also call attention to the changing group of young people seeking care. This is discussed in the article on the development of the Dutch standard.

Political follow-up

In 2024, the House of Representatives called for research into the outcomes of treatment for young people in the Netherlands, after which the ministry asked the Health Council for advice. The Health Council advised in 2026 that care for young people in the Netherlands is carefully organised. The process is outlined in the timeline and under Developments in the Netherlands. The essay The judge as the final arbiter discusses the role a guideline plays when a court must assess whether care was provided with due care.

Frequently asked questions