What is transgender?

Transgender means that someone does not, or does not fully, identify with the sex registered at birth. For example, a transgender person may have been born male and feel that they are a woman, or have been born female and feel that they are a man. The word is an umbrella term and says nothing about whether someone has undergone medical treatment.

What does transgender mean?

The word is made up of the Latin trans, meaning 'on the other side of', and gender. Here, gender refers to gender identity: the inner sense of being a man, a woman, neither, or something in between. For a transgender person, this sense does not correspond to the sex recorded on their birth certificate. The opposite is cisgender. More background information can be found on what is gender.

Transgender is an adjective. It is therefore generally preferable to say transgender person rather than 'a transgender'. The term is broad. It includes people who want hormone treatment or surgery, as well as people who only change their name, clothing, or form of address. People who identify as non-binary are also often included in this group.

What is a trans woman?

A trans woman, also called a transgender woman, is someone who was registered male at birth and feels that they are a woman. An older term for this direction of transition is male-to-female, abbreviated as MTF. The broader term is transfeminine. A trans woman may use hormones or have undergone surgery, but this is not required.

What is a trans man?

A trans man, also written as transman or transgender man, is someone who was registered female at birth and feels that they are a man. The older term is female-to-male, abbreviated as FTM. The broader term is transmasculine. Here too, the word says nothing about medical treatment.

Difference between transgender and transsexual

Transsexual is an older medical term. It was used for people who wanted to adjust their bodies to the other sex through hormones and surgery. The international ICD-10 classification still referred to transsexualism. In its successor, ICD-11, which has been in effect since January 1, 2022, this was replaced by gender incongruence. Transgender is the broader term: it also includes people without a desire for medical treatment. In everyday language, transgender has largely replaced transsexual. The story of how transgender developed from a narrow label into an umbrella term can be found on letterbrij.nl. The best-known symbol of people who identify as transgender is the transgender flag from 1999.

Difference between transgender and transvestite

A transvestite wears clothing associated with the other sex, occasionally or regularly, without wanting to live permanently as the other sex. Transvestism concerns clothing and presentation, not identity. Transgender is also different from intersex. Intersex concerns congenital physical variations in sex characteristics, while transgender concerns a person's experience of their own sex.

How many transgender people are there in the Netherlands?

The answer depends on the definition. In 2024, Statistics Netherlands (CBS) published an estimate based on the 2023 Safety Monitor. According to this estimate, approximately 1 percent of the population aged 15 and over identified as transgender, non-binary, or genderqueer. That amounts to approximately 151,000 people: 60,000 transgender men, 45,000 transgender women, and 45,000 non-binary or genderqueer people.

A narrower definition produces a lower figure. A 2012 study by Kuyper examined people with a gender identity that differed from their sex who were also dissatisfied with their bodies and wanted treatment. This applied to 0.6 percent of men and 0.2 percent of women aged 15 to 65, which translates to 22,052 to 44,104 men and 5,474 to 16,422 women (source).

Transgender and gender dysphoria

Transgender is not a diagnosis. There is no medical test that can establish whether someone is transgender. The diagnosis of gender dysphoria describes the persistent distress experienced by some transgender people. Not everyone who identifies as transgender has this diagnosis. Anyone who is questioning their identity can complete the Transcheck and discuss it with their family doctor. Personal stories about waiting lists, hormones, and uncertainty can be found on ikbentrans.nl.

Medical transition

A medical transition usually consists of hormone therapy and, for some people, surgical procedures. The treatment is significant and partly irreversible. It concerns fertility, sexual functioning, and often lifelong medication use. Making an informed decision requires complete information about these consequences. Some people later reconsider their transition. See detransition.

Legal position in the Netherlands

In the Netherlands, a person can have the sex on their birth certificate changed. Since July 1, 2014, surgery has no longer been required. However, an expert's statement is required, and the applicant must be at least 16 years old (source). A bill to abolish this statement was withdrawn by letter of 13 January 2026 (source). Read more about the Transgender Act and about changing sex registration.

Critical considerations

Gender identity is a concept that cannot be measured objectively. It is based on what someone says about themselves. Because the term transgender is also used by people without dysphoria, the distinction between a medical condition and an identity becomes blurred.

At the British gender clinic GIDS, the number of referrals rose exponentially from 2014, mainly among young people registered female at birth (source). In the Netherlands, the number of referrals for transgender care among young people rose from 1,179 to 2,772 between 2020 and 2022 (source). In 2018, Littman introduced the controversial term rapid-onset gender dysphoria in this context. Social media and peer influence have been cited as possible explanations.

Medical care is also the subject of debate. The Dutch Dutch Protocol was long considered an international standard. The British Cass Review (2024) described this as an area of 'remarkably weak evidence' and wrote that there is no good evidence on the long-term outcomes of treatments for gender-related distress. In December 2022, Socialstyrelsen in Sweden gave a weak negative recommendation for puberty blockers and cross-sex hormones in minors (source), and according to the Cass Review, the Swedish and Finnish guidelines differ from other guidelines in recommending medical treatment only within a research framework given the lack of evidence (source). On June 30, 2026, the Health Council advised that care for young people in the Netherlands is carefully structured (source). See the Cass Review.

The Swedish register study by Dhejne and colleagues (2011) of 324 adults who underwent sex reassignment surgery between 1973 and 2003 found a higher risk of mortality, suicide, suicide attempts and psychiatric hospitalisation after surgery than among controls. The authors conclude that the surgery may alleviate dysphoria but may not suffice as treatment. Are you thinking about suicide or worried about someone? Call 113 Suicide Prevention at 0800-0113 or chat via 113.nl.