Vasterman: 1,728 percent growth in transgender healthcare since 2012
Peter Vasterman compared official Dutch healthcare figures and reached a conclusion the Amsterdam gender clinic would rather not hear out loud: demand for care has grown by 1,728 percent in ten years, and that is not a biological phenomenon.
From 289 to 5,280 patients
In 2012, 289 people were receiving treatment at a Dutch gender clinic or mental healthcare institution with this profile. In 2022, exactly ten years later, that number was 5,280. In addition, 5,753 people were on the waiting list. Vasterman does the math: that is an increase of 1,728 percent. No congenital neurological condition shows a curve like this. Not type 1 diabetes, not autism, not schizophrenia. What does show such curves: socially transmitted identity labels in adolescence, trends in mental healthcare, and cultural contagion through peer groups and social media. Research on this social spread can be found at transplek.nl.
The waiting list is growing faster than capacity
Waiting-list figures are only available from 2018 onward. At that time, 1,491 people were waiting. Four years later: 5,753. That is an increase of almost 300 percent in four years. Vasterman points out that healthcare institutions themselves use these figures to argue for expanding capacity. But the logic works the other way around: the more treatment capacity there is, the lower the threshold, and the greater the influx. The waiting list is not a measure of an underlying illness; it is a reflection of a social process that feeds itself.
Three-quarters girls — and that is new
The most concerning figure in Vasterman's analysis is the sex ratio. Between 2012 and 2018, the number of referrals among girls rose by 1,074 percent. Among boys, it rose by 493 percent. In 2018, 75 percent of all adolescent referrals were biologically female. Until around 2010, minors seeking help were still predominantly male. In eight years, that completely reversed. No biological condition changes that way. A social identity can, especially when it spreads through platforms where teenage girls are strongly represented — Tumblr, Instagram, TikTok. The same skewed ratio appears in the figures on young people who identify as trans or gender-diverse.
The international parallel
Vasterman places the Dutch figures alongside those from the United Kingdom and Canada. In England, the number of referrals to the Tavistock clinic rose by more than 4,000 percent between 2009 and 2019 — and there too, the sex ratio shifted from predominantly boys to predominantly girls. The same pattern appeared in Canada. Three highly developed Western countries, the same timeline, the same demographic shift. A congenital disorder does not observe cultural boundaries, but neither does it produce synchronized surges in a specific subgroup. A sociocultural phenomenon does.
What the figures do not tell us
The official Dutch statistics do not tell us how many of the young people treated later detransition. They do not tell us what percentage continues to experience persistent dysphoria and what percentage lets go of the identity. They do not tell us which comorbidities — autism spectrum conditions, eating disorders, depression, trauma — preceded the referral. They do not tell us how many young people receive puberty blockers, or after how many diagnostic sessions. Dutch research is lacking on all of these questions. A later news report states that more than four in five young people referred to Amsterdam UMC began a medical pathway. What is available is the growth curve. And that curve is not a medical picture; it is a sociological one.
Why the figures matter
Vasterman is a media sociologist, not a doctor. He has no stake in treatment outcomes. What he does have is a professional perspective on how figures shape public debate. His point is that Dutch gender healthcare presents figures within a framework that leaves no room for the most obvious interpretation. A 1,728 percent increase in ten years is presented as “people finally daring to seek help,” “destigmatization is working,” and “we need more capacity.” The alternative interpretation — that a diagnostic safeguard has been dismantled, allowing a trend to develop within it — is not seriously examined in Dutch professional literature. Vasterman's contribution is to put that alternative interpretation back on the table, using figures from the Dutch institutions themselves as evidence.