1,728 percent growth: what Vasterman's figures really say
Peter Vasterman put the official Dutch care figures side by side and reached a conclusion the Amsterdam gender clinic would rather not hear out loud: care demand 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 in treatment at a Dutch gender clinic or mental health institution with this profile. In 2022, exactly ten years later, there were 5,280. On top of that, 5,753 people are on the waiting list. Vasterman calculates: that is an increase of 1,728 percent. No innate neurological condition shows such a curve. Type 1 diabetes does not, autism does not, schizophrenia does not. What does show such curves: socially spread identity labels in adolescence, hypes in mental health care, and cultural contagion via peer groups and social media.
The waiting list grows faster than capacity
Waiting list figures are only available from 2018. At the time, 1,491 people were waiting. Four years later: 5,753. An increase of almost 300 percent in four years. Vasterman points out that the care institutions themselves use these figures to plead for capacity expansion. But the logic runs the other way: the more treatment capacity, the lower the threshold, the bigger the inflow. The waiting list is not a measuring instrument of an underlying illness, it is a mirror of a social process that feeds itself.
Three-quarters girls — and that is new
The most worrying 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 by 493 percent. In 2018, 75 percent of all adolescent referrals were biologically female. Until around 2010, minor referrals were still predominantly male. In eight years that tipped over completely. No biological condition tips like that. But a social identity does, especially when it spreads via platforms where teenage girls are dominant — Tumblr, Instagram, TikTok.
The international parallel
Vasterman places the Dutch figures next to those of the United Kingdom and Canada. In England, the number of referrals to the Tavistock clinic rose between 2009 and 2019 by more than 4,000 percent — and there too the sex ratio tipped from predominantly boys to predominantly girls. In Canada the same pattern. Three highly developed Western countries, the same timeline, the same demographic shift. An innate disorder does not respect cultural borders, but does not produce synchronous explosions in a specific subgroup either. A social-cultural phenomenon does.
What the figures do not tell us
Official Dutch statistics do not tell us how many of the treated young people later detransition. They do not tell us what percentage retains persistent dysphoria and what percentage drops the identity. They do not tell us which comorbidities — autism spectrum, eating disorders, depression, trauma — preceded referral. They do not tell us how many young people receive puberty blockers after how many diagnostic sessions. For all these questions Dutch research is lacking. What is available is the growth curve. And that curve is not a medical picture, it is a sociological picture.
Why the figures matter
Vasterman is a media sociologist, not a doctor. He has no stake in treatment outcomes. What he has: a professional eye for how figures steer public debate. His point is that Dutch gender care presents figures in a frame that leaves no room for the most obvious interpretation. A growth of 1,728 percent in ten years is presented as "people are finally daring to come forward", "destigmatisation works", "we need more capacity". The alternative interpretation — a diagnostic gate has been knocked over and within it a hype could develop — is not seriously investigated in Dutch professional literature. Vasterman's merit is that he puts that alternative interpretation back on the table, with the figures of the Dutch institutions themselves as evidence.