Gender Care: What Is het and How Do I Get Started?

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!