Gender healthcare: what exactly does het mean? And where do you start when you’re looking for information? Navigating the gender healthcare system can be complicated. Long waiting lists, different healthcare providers, and a maze of options don’t always make it easy to figure out which care is right for you. 

In this blog, we’ve laid everything out for you. Whether you’re just starting your journey, are already in the middle of a care process, or as an ally want to learn more about gender-affirming care: we’ll guide you step by step along the way!

Within gender-related care, there are two branches: psychological care and medical care. 

Psychological care:

People seek psychological gender care for various reasons. Some people want to talk to a psychologist about questions they have regarding their identity, while others seek this as a way to bridge the waiting period until they can receive medical gender care. In principle, any psychologist can provide this counseling. However, we recommend seeking out a psychologist with knowledge and experience in this area, so that they can provide you with care and support that meets your specific needs.

You can also receive psychological gender care as part of a diagnostic process. In the Netherlands, you cannot simply start medical gender care. To do so, you need a diagnosis of gender dysphoria. The diagnosis can only be made by a gender team, a specialized mental health institution, or an independent gender clinic. Not every psychologist is qualified to conduct this process.

You can also request an expert statement either as part of or separate from a psychological treatment program. You do not necessarily need to be receiving psychological gender-related care to do so. However, you must request the statement from a professional who is authorized to issue it. A copayment is often required for this, which varies by professional. Through the Transgenderwegwijzer You can find an expert in your area. You’ll need the expert statement if you want to change your gender designation (F, M) and/or your name on your ID card. Do you want to change your gender designation on your ID card to an X? In that case, you do not need an expert statement, but you can include it in the process if you wish. Would you like to know more about this? Then visit Transgender Network Netherlands For more information.

Medical Healthcare:

If you choose to receive gender-affirming care, a diagnosis of gender dysphoria is usually required first. As part of this process, you’ll work with a gender psychologist to assess a number of factors, such as determining whether you have a social support network that can help you through medical procedures, what coping strategies you use to deal with difficult moments, and whether you have all the necessary information about the medical transition. Once you’ve received a diagnosis from a specialist, you may be referred to one or more providers of medical gender care. This care can be broadly divided into two categories: hormonal care and surgical care.

Hormonal 

You can choose to take hormones or to ‘block’ hormones. There are ‘feminizing’ (estrogen) and ‘masculinizing’ (testosterone) hormones are available. With estrogen, the supply of testosterone is also often ‘blocked.’ Both hormones will cause your body to change. For example, your fat and muscle distribution may change. Testosterone can deepen your voice, and estrogen can cause breast growth. When you take a hormone, the changes you experience, the extent to which they occur, and when they occur vary from person to person. For example, a certain change might occur in one person after just 2 months, while in another it might not happen until 6 months later. Hormones are administered in various ways, such as by applying gel, taking pills, or receiving injections.

Hormones are generally prescribed by endocrinologists. In June 2026, Transvisie published the guide Guidance on Gender-Affirming Hormone Therapy in Primary Care Published. This guide is a practical tool for primary care physicians to support transgender, non-binary, and gender-diverse people in their decision-making process regarding hormone therapy. The goal is to hopefully reduce your wait time. You can show the guide to your general practitioner. Please note, however, that the guide does not guarantee that your general practitioner will prescribe hormones for you. A general practitioner must feel ‘competent enough’ to guide you through this process. In any case, this guide will help you discuss the matter with your primary care physician!

Surgical

In addition to hormones, you can also opt for surgical procedures (surgeries). You can undergo surgery on areas such as your face, vocal cords, Adam’s apple, breasts, uterus, and/or ovaries and genitals. So there are many possibilities, and every surgery is different. Be sure to take the time to thoroughly research the options and how the procedure works.

Maybe you want to start with hormones and then have surgery, or the other way around? Or maybe you only want hormones or only surgery? You can decide for yourself what your process will look like and what order you want to follow. Do you want hormone therapy and surgery? In the Netherlands, you’re often required to wait 6 months between these two steps. 

It’s up to you to decide which steps to take—or not to take—nothing is mandatory! Be sure to read the information carefully so you can make an informed decision and know what to expect.

Who is gender-affirming care for? 

By "gender-affirming care," we mean care that is aimed at people who are trans and/or non-binary, and/or people who experience gender dysphoria. Often, the goal of this care is to affirm a person’s gender identity. Many trans and non-binary people need gender-affirming care, but not everyone does. You don’t have to want or receive gender-affirming care to be transgender or non-binary. You can also experience gender dysphoria without needing gender-affirming care. Everyone has different needs, and that’s totally okay. 

Gender-related care can also be a part of the lives of intersex people. Intersex refers to people born with a body that does not conform to society’s norms for male or female. In the Netherlands, approximately 1 in 200 people are intersex. Some intersex people choose to receive gender-affirming care, but many intersex people still face medicalization: medically unnecessary interventions, such as surgeries or hormone treatments, that are intended to make their body conform more closely to societal ideas about a ’typical’ boy’s/man’s or girl’s/woman’s body. These interventions are often performed without full or informed consent. As you can imagine, this can have major consequences for a person’s mental health and well-being. Intersex people do not need to—and cannot—be ‘cured.’ Intersex people are part of the diversity of different bodies, and that diversity does not need to be altered or ‘fixed.’.

When people think of gender-affirming procedures, they often immediately think of trans and non-binary people. Yet gender-affirming care is much broader than that. Cisgender people also regularly undergo procedures to align their bodies with their gender identity. Examples include a heart transplant, breast augmentation, breast reduction for cis women, or a mastectomy (a mastectomy) in cis men with breast development. All of these treatments can contribute to how a person feels in their body. The main difference is that these forms of gender-affirming care for cisgender individuals are often seen as self-evident, while comparable care for trans and non-binary people is still regularly the subject of debate. 

Step-by-Step Guide: How Do I Get Started with Gender-Affirming Care?

1. Before you go to your primary care physician, it’s a good idea to do some research on the various gender care providers. Family doctors are often far from aware of all the options available in gender-affirming care, which means you might sometimes end up, unintentionally, in a situation that doesn’t quite match what you’re looking for. When choosing your healthcare provider, keep the following in mind: What is the wait time? What treatments do they offer, and which healthcare providers do they work with? How are you diagnosed? And does your health insurance plan have a contract with this healthcare provider?
2. Have you made the decision? After that, go see your primary care physician; they can refer you to the gender care provider of your choice. Our most important tip: register with multiple providers at the same time. Wait times for gender care can be very long, and by registering with multiple practices or clinics, you’ll increase your chances of getting help as quickly as possible.
3. Once you’ve been referred, the waiting begins. It can feel frustratingly long, but fortunately, there are ways to pass the time and experiment with what feels right for you. Consider things like: expressing yourself through clothing, thinking about whether you want to change your name and/or pronouns, telling those around you about your journey, as well as experimenting with possible binders, taping, packers, tucking, or prostheses. In addition, be sure to reach out to peers and like-minded people. Building a community around you helps immensely, so you always have someone to turn to BOHAUS Events!
4. Once your turn (finally) comes after the waiting period, you can begin your gender care journey! Whether you want hormones, surgery, or psychological support, one thing is certain: you’ll have to share a lot about yourself with a professional. You’ll often be asked (sometimes somewhat uncomfortable) questions about, for example, your childhood, how you’re really doing right now, your sex life, how you experience gender dysphoria, your social support network, and much more. There’s also room during these conversations to discuss your wishes and needs, and what kind of gender-affirming care you’d like to receive. During this phase, you’ll speak with various specialists—from psychologists and psychiatrists to endocrinologists and doctors—to determine together which steps are right for you. 

Where can you receive gender-related care?

Throughout the Netherlands, you can find various providers of gender care, but please note: not every place offers the same services. One organization may offer only psychological counseling or a diagnosis, while another may focus on hormone therapy or provide a combination of both. Fortunately, you don’t have to figure it all out on your own. Transgender Network Netherlands and Transvisie have created a handy overview where you can find almost all providers via transgenderwegwijzer.nl. Our tip: Don’t just look for gender-affirming care providers in your area. Some organizations also offer remote (online) care. This means you can sometimes receive care from someone in Groningen while you’re in Maastricht! 

Good to know if you’re young: Are you 16 or older? Then your parent(s) or guardian(s) no longer have a say in your care; you get to decide all of that on your own. In addition, healthcare providers are not allowed to share medical information with anyone else. This means that starting at age 16, you can receive gender-affirming care completely on your own terms.

Did we miss something? Is there information in this blog that is incorrect (or no longer correct)? Or do you have a question? Please contact us!

2025 is starting to come to an end, which means that everyone die 18 or older should be looking at zijn/haar/diens/hun health care ze benefits! Already heall if you get or want/are going to get gender care in 2026.

This is the moment!
So why is this so important? A health care verzekeraar contracts with health care providers, and each health care verzekeraar determines zelf which health care providers ze contracts with. 

What if you don't do this? Then you may het so zijn that you have to start paying money out of your own pocket unnecessarily. If a health care provider does not he have a contract with the health care provider from whom you receive care, you often have to zelf pay part of it out of your own pocket. Identifying your care needs and finding an appropriate health care provider can therefore save you a lot of money. 

Good to know: Gender care (transgender care) is largely reimbursed from the basic Verze benefit.

What can you think about and pay attention to?

• Find out what gender care you want/will receive in 2026 and from which health care provider(s) theze care will come.
• Check on the website of the health care provider(s) with which health care providers zeker ze have a contract hebben for 2026.
• Is the health care provider die you want to use not yet contracted? Contact your health care providerzekeraar for information and check also with the provider zelf for clearheid.
• Compare several health care verze benefits with independent comparison site such as Zorgwijzer.nl.
• Using the previous steps, determine which healthcare providerzekeraar het best suits your healthcare needs.

Important dates

• December 31: This is the last day to zeggen your current verzekering.
• Jan. 31: This is the last day to close your health careze benefit for 2026.

Onze tips

We generally recommend about het a combination policy with free/own cueze. This usually allows you to zelf determine which healthcare provider you use, even if your healthcare providerzekeraar does not have a contract with hen heeft. This is especially useful if you don't yet know which health care provider you will get care from, or if you are enrolled with multiple health care providers. Without your own/free cueze you het run the risk that you will not be reimbursed for care at a specific healthcare provider, or that you will have to pay zelf more. Depending on your healthcare providerzekeraar, contracts and het type of care (e.g., GGZ or MSZ*), some of the cost may come out of pocket. Non-contracted GGZ is often partially reimbursed; exactly how much depends on the verzekeraar and het gekozen package.

Set your deductible to €385 and zet het pay in installments on, spreading your deductible. Will you still not meet it? Then you get it back at het end of het year. This way you avoid paying a large sum all at once.

Do you have a low income? You may be eligible for care allowance. You can checken and apply for this through the Taxdienst. 

You can also look at how ethisch responsible and sustainable your health care verzekeraar is. In fact, health care providers sometimes invest hun money in arms trading or fossil energy, which is bad for the world. You can research this through fair-moneyzer.co.uk..

*GGZ = mental healthheid care: because het reimbursement difference in mental health care is small, you can zelf weigh whether a verze benefit with own/free cueze is relevant. Theze care includes expert opinion, diagnostics and psychische help.

MSZ: medical specialistische care: want/get surgicalische- or hormone care, but don't know where yet? Choose a policy with own/free cueze, reimbursement is high and you often don't have to pay anything zelf. Theze care includes surgicalhe or hormone care.

Before taking out a health care ze benefit, do some zelf research on this! Choose a healthcarezekeraar die het best suits your healthcare needs.

What can I kiezen?
We hebrought you the most commonly used gender health care providers and health carezekers, including hun contracts. 

We hebben taken some of the largest health care verzekerers and gender care providers, so not all of them. Under each named verzekeringsconcern, there are several verzekerers, see zorgwijzer.nl for more info on this.

There is undercheid in the table between the GGZ (mental healthheid care) and the MSZ (medical specialistische care). In gender care, het obtaining expert opinion, diagnostics and psychische help falls under mental health care. MSZ includes surgery (gender-affirming surgery) and endocrinology (hormone care).

Do you still have questions after theze blog, or zijn things still unclear? Please send Roan an app or email, hij maybe you can helpen! +31 6 12 29 13 63, roan@bo-diversity.com

Disclaimer: theze table was created with information die available on 15-12-2025, there may be other information known zijn in the meantime. So please zelf still do research on this. 

To explain transgender identities, it helps to first understand the term ‘cisgender’. If you are cisgender, your gender identity matches the sex assigned to you at birth. For transgender people, this is different. There are two main types of transgender identities:

Transgender binary people
The term “binary” means two-part, and in this context, it refers to the traditional male/female categories. You are a transgender binary person if your gender identity doesn’t align with the sex assigned at birth, but you identify with the opposite binary gender instead. In other words, a trans binary person may identify as a trans man or trans woman, fitting within the male/female categories.

Transgender non-binary people
Trans non-binary people, however, don’t identify strictly within the male/female binary. Instead, their gender identity or expression exists outside of these two categories. Examples include identities such as gender-fluid, genderqueer, polygender, bigender, demigender, and agender. Each of these identities are unique. A gender-fluid person’s identity may shift between genders over time. A demigender person partially identifies with a certain gender, but not fully. Lastly, an agender person does not experience any gender. This identity is separate from the sex assigned to them at birth, although they can always influence each other.

Social transition
When you identifyzelf as a transgender person, people often assume that there is both a social and physical transition. However, some people do not wish to undergo a physical transition. In addition, a physical transition is not accessible to everyone, for example because of financial barriers, long waiting lists, medische reasons or other personal circumstancesheden. This is where social transition plays an important role.

A social transition involves changes in daily life that don’t require any medical or physical adjustments. It’s about aligning how others perceive someone as their true gender identity. Social transition can include changing one’s name, adopting new pronouns, changing clothing style or appearance, and adjusting behaviours or roles in social contexts. Each person’s social transition is unique and can be flexible, allowing them to add or change elements as they grow more comfortable with their gender expression.

Physical transition
A physical transition, also called a medical or bodily transition, involves medical steps to change someone’s physical characteristics to better align with their gender identity. This can include hormone therapy, surgeries, or other medical procedures such as laser hair removal or voice training. Not everyone chooses or needs a physical transition—some people feel their gender identity is best reflected through social changes without physical adjustments, while others find physical changes necessary.

For some transgender and non-binary people, both social and physical transitions are important; for others, just one type of transition may feel right. The decision to pursue a social or physical transition is highly personal. Many people experience a sense of gender euphoria—positive feelings when their gender identity is affirmed—through social or physical changes. Respect and understanding of others, including the use of correct pronouns and recognizing someone’s chosen name, can make a meaningful difference, even without physical transition.

When we talk about transgender and non-binary people, terms like ‘gender dysphoria’ and ‘gender euphoria’ are often used. But what do these terms actually mean? 

Gender dysphoria as a medical term
Gender dysphoria is the term used in the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders) to describe the psychological distress that occurs when someone’s gender identity does not match the sex they were assigned at birth. Although gender dysphoria is not classified as a mental disorder, it is recognized as a diagnosis to help people access medical care if they need it. The term is used in the medical field to identify transgender and non-binary people who are eligible for gender-affirming care.

To access this care, gender dysphoria must be officially diagnosed by a psychologist or psychiatrist, who must follow the criteria in the DSM-5. This system often places gender psychologists and psychiatrists in the role of gatekeepers, meaning transgender and non-binary individuals often have to prove they are “trans enough” to receive the support needed. Many transgender and non-binary people, as well as some gender psychologists and psychiatrists, find the DSM system stigmatising and view the diagnosis requirement as an obstacle to receiving care.

In this blog, however, we want to focus on the individual experiences of gender dysphoria and gender euphoria. While we can criticise the system, we aim to make it better understandable to those who experience either discomfort or joy related to their gender identity.

The definition of gender dysphoria and gender euphoria
Gender dysphoria refers to the discomfort or psychological distress that someone feels when their gender identity doesn’t align with their assigned gender at birth. This can be both physical and social: gender dysphoria might come from feeling dissatisfied with one’s body or from social situations where a person’s gender is not recognized or affirmed.

Gender euphoria refers to the positive feelings, inner joy, and peace someone experiences when their gender identity is fully expressed. This can also be both physical and social: gender euphoria can come from physical changes that align better with one’s identity or from social recognition and validation of who someone truly is.

Examples of body dysphoria and euphoria 
Body dysphoria occurs when a person feels discomfort because their body doesn’t match their gender identity. This could include feeling unhappy with one’s breasts, genitalia, or bodily characteristics like body hair or muscle mass that don’t align with how they see themselves. A person’s voice can also be a source of dysphoria, as well as body shapes that don’t match the desired gender identity. 

Body dysphoria is generally a personal experience, but it can also occur during interactions. For example, someone might feel uncomfortable if they are touched on their shoulders or hips. In many cases, this leads to the desire for medical interventions, like surgeries or hormone treatments, to make the body align more with one’s gender experience. These physical changes can lead to body euphoria, which is the joy or satisfaction someone feels when their body or expression matches their gender identity. Examples of body euphoria include the happiness someone feels when their body changes through hormone treatment or when they feel proud and comfortable in clothing that reflects their gender identity.

Examples of social dysphoria and euphoria
Social dysphoria can occur when someone is not treated as the gender they identify with. This type of dysphoria might happen when someone is misgendered with the wrong pronouns or forced to choose between gendered spaces, such as public restrooms or changing rooms. Social euphoria happens when someone feels seen and heard by others or in certain spaces. By addressing someone with their correct name and pronouns, you contribute to the social gender euphoria of transgender and non-binary people. 

Do you have to experience dysphoria to feel euphoria?
No, you don’t have to experience dysphoria to experience euphoria, or vice versa. Not everyone feels bodily or social dysphoria. For example, some demigirls and demiboys may identify with being female or male physically but not with the social gender norms, roles, and expectations attached to those identities. Cisgender people might experience gender euphoria but usually don’t experience gender dysphoria, as they typically don’t encounter situations where their gender is misinterpreted. 

Not every gender identity will experience the same types of dysphoria or euphoria, as these experiences vary from person to person. For example, not all transgender men experience body dysphoria related to their primary sex characteristics. Some people think that with a certain gender identity, there should come certain expectations—for example, transgender women should have a higher voice, breasts, no facial hair, and a vulva, or non-binary people should appear androgynous and not “too masculine” or “too feminine.” These are stereotypical norms that come from the binary gender system that dominates society, and it’s important to let go of these assumptions. 

Gender dysphoria and gender euphoria are personal experiences, so don’t make assumptions. What you can do is ask someone what can make them feel dysphoric and how you can contribute to their gender euphoria.

Many people assume that sex and gender mean the same thing, but nothing could be further from the truth! Why is it important to understand that there is a difference? Because one is about your biological sex – hormones, glands, genitalia – and the other is about the cultural and societal expectations based on their sex. 

Sex
When we talk about sex, we’re not just referring to what’s between your legs. We’re talking about everything in and on your body that relates to it. This includes things like sex chromosomes, sex glands, hormones, and both internal and external genitalia. These elements together make up what we call ‘sex.’ It’s called ‘sex assigned at birth’ because it refers to what was observed on the day you were born. It has nothing to do with how you feel inside.

In our society, we often see sex as a binary concept: male and female. However, this isn’t true for everyone. Around 1 in 100 people have an intersex variation, which is not exclusively ‘male’ or ‘female.’ For intersex people, there’s a variation in one or more of the aspects that determine sex during childhood development.

Gender
Gender is about society's expectations based onze sex. Onze society is built on gender roles and sex norms that you must adhere to as a person. Theze roles and norms zijn often not spoken out loud, but we all feel ze them. For example, only women wear skirts, dresses or nail polish, men wear pants. Men don't scheren hun legs, women should. Women zijn bescheides, men assertively. Women don't poop, men do - and send pictures to hun friends. There zijn ontzettenty of gender expectations die we still maintain together anno 2026. How stifling! Now, do you want to know more about how to break theze norms? Or do you want to know how het about your gender identity, expression and the perception die people have about you hebben? Then also read the blog ‘“What is the difference between gender identity, gender expression, and gender perception?”

Gender refers to the cultural and societal expectations placed on us based on our sex. Our world is built around traditional gender roles, which are expectations about how you should behave based on your sex. However, many people want to step outside these expectations. They may not identify with or may even strongly reject the expectations society places on them based on their sex. These people often identify as transgender and/or non-binary.

What is your gender identity?
Your gender identity describes your internal experience of being a man, a woman, a non-binary person, or something else. Everyone experiences gender differently, and it isn’t something you can always understand just by looking at someone.

There are three main types of gender identities:
- Cisgender:You are cisgender if your gender identity matches the sex you were assigned at birth.
- Transgender (binary):You are transgender (binary) if your gender identity is the opposite of the sex you were assigned at birth. This includes trans men and trans women. 
- (Transgender) non-binary:This is an umbrella term for people with a gender identity and/or expression outside the male/female binary. Examples of gender identities under this umbrella include genderfluid, genderqueer, polygender, bigender, demigender, and agender.
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What is gender expression?
Gender expression refers to how you present or express your gender, including your appearance, clothing, hairstyle, and behaviour. You have some control over your gender expression, depending on your resources and environment. However, this doesn’t mean that your gender expression has to fit into the traditional binary gender expectations. 

What is gender perception?
Gender perception is how people perceive and evaluate each other’s gender and bodies. Unlike gender expression, we can’t control how others perceive us. We see gender based on a variety of visual and social cues. In addition to your gender expression, physical characteristics and the social roles you take on also influence how people perceive your gender. 

The stereotypical binary view of how a man or woman should be can sometimes take over our minds. This often leads to assumptions being made, which frequently results in misgendering trans and non-binary people.

How do you let go of your gender perception?
To let go of your gender perception, it’s important to train yourself to avoid making assumptions about people’s gender. You can’t always tell someone’s gender just by looking at them, just like we don’t know someone’s name when we first meet them. So you can simply ask for their pronouns. It’s important to remember and use people’s pronouns correctly. Struggling to do this? Check out our blog ‘What to do if you misgender someone?’

The big LGBTQIA+ alphabet
You may sometimes feel overwhelmed by all the letters in the rainbow acronym — why do we have so many labels? And why does one person use them, while another doesn’t? The simple answer is this: the words we use shape the world we live in. If we can use words to describe who we are, we can better understand ourselves, and others can too. To help create awareness, understanding, and acceptance around gender, these labels are important. They give us a tool to educate and communicate. Without these words, we wouldn’t be able to explain who we are as clearly.