Amid ongoing discussions about long waiting lists and barriers to transgender healthcare in the Netherlands, a different model is taking root. In Amsterdam and Utrecht, community-led clinics operating in partnership with the local GGD (Public Health Service) are providing direct access to hormone therapy and other essential services, based on the principle of informed consent.
These clinics serve as a crucial alternative for many in the trans community, particularly those who face additional barriers in the mainstream healthcare system. The initiative, championed by advocacy group Trans in Eigen Hand, demonstrates a practical, low-threshold approach to care. However, with both existing clinics operating at full capacity, the project also underscores the significant unmet demand for such services.
What is a GGD Trans Clinic?
The model is straightforward: a dedicated service at a GGD where trans individuals can receive hormone care, sexual health support, and psychosocial guidance without a referral from a specialized gender team. This approach centers the autonomy of the individual, removing the 'gatekeeper' role that can often delay or prevent access to care. It's a system designed with and for the community it serves.
Below is a look at the two clinics currently in operation.
Trans United Clinic, Amsterdam
A collaboration between Trans United Europe and the GGD Amsterdam's Center for Sexual Health, this clinic was established by and for transgender people of color (BPOC). It offers a holistic service that combines medical and community support.
- Services: Hormone care based on informed consent, sexual health services, and psychosocial support.
- Access: Registration is handled via email.
- Current Status: The clinic is currently not accepting new patients due to high demand, a situation that highlights the urgent need for expansion.
Utrecht Trans Clinic
Inspired by the Amsterdam model, this clinic is a community initiative from Colored Qollective, the Utrecht municipality, and GGD Regio Utrecht. It is coordinated by a team of racialized trans individuals and focuses on serving those who are often most marginalized.
- Target Audience: The clinic prioritizes individuals who identify as racialized, are undocumented, or are sex workers, and who have a connection to the Utrecht region (live, work, or visit regularly).
- Services: Access to and guidance on hormones, sexual health services including STI/HIV testing and PrEP, and a social space with community activities.
- Access: Care is available by appointment and can be provided anonymously.
Why the GGD Model Works
The success of these clinics stems from three core principles that directly address shortcomings in the traditional system:
1. Low Threshold: By not requiring a referral from a GP or gender team, the clinics are accessible to people without a regular doctor, health insurance, or a valid residency permit—groups who are often completely excluded from care.
2. Community Trust: Because the clinics are run in close partnership with trans-led community organizations, they build a level of trust that is often missing for individuals who have had negative experiences with the healthcare system.
3. Informed Consent: This is the cornerstone of the model. It respects the patient's autonomy, treating them as the primary decision-maker in their own transition. The role of the healthcare provider is to inform and support, not to approve or deny care based on external criteria.
The campaign by Trans in Eigen Hand argues that the full waiting lists at these two clinics are not a sign of failure, but proof of concept. They show a clear and present need for more such facilities. The organization is actively working with the Transgenderzorg Coalitie to advise other municipalities and GGDs on how to establish similar clinics, offering a blueprint for a more accessible and humane future for trans healthcare in the Netherlands.
