The VU hospital transgender program

[Plain Jane]

I thought it might be interesting to describe the transgender program I went through at the VU hospital in Amsterdam. This is in the early 1990's, so things may have changed a bit now, I don't know.

You first had to go see a psychologist. He (at the time at least it was a he) would evaluate whether you were a "genuine case". If yes, you would be on the program and allowed to start taking HRT. If not, you were probably out the door. This would take several sessions. From talking to this man quite a bit (of course) I am pretty sure that if you didn't desire SRS you wouldn't have been considered a "genuine case" and wouldn't have been on the program.

After the psychologist gave the go ahead you would start HRT. You had to fully transition after at most three months on HRT. If you didn't, you would be cutoff from HRT.

Around this time you would also start hair removal. Back then there was no laser hair removal yet, so everything was electrolysis (slow and painful). Most people would also get some form of speech therapy/voice training.

SRS would be pretty much exactly 18 months after you started HRT. If you desired BA it was usually done at the same time as SRS. At the time in the Netherlands you could get your gender legally changed only after SRS. I don't know what the rules are these days.

I am not aware of anyone getting FFS or it being discussed as an option.

So how did you pay for all of this? You didn't have to. Everything was covered by health insurance, except hair removal which was capped to a certain limit. With electrolysis requiring many sessions (for me at least) the limit was reached pretty quickly.

So not counting hair removal with a little luck you could be completely done in about two years, and not paying a dime. Hair removal with electrolysis for me took more than two years, and was not entirely covered by health insurance.

[Joandelynn]

Breast augmentation, FFS, voice surgery, adams apple reduction and such are not covered by basic insurance (anymore) and must be paid in full by the patient.

This is not correct, FFS, voice surgery and adam's apple reduction are covered by basic insurance if certain conditions are met. For example, to get your adam's apple reduction covered it has to stick out more than half a centimeter from your neck. FFS being covered is rare (you probably have to look like Boris Karloff before they decide to cover it), but it does happen sometimes.

However, if may take some effort to convince your insurance provider. Point them to this document (pdf, dutch) if necessary.

[Kirsteneklund7]

I thought it might be interesting to describe the transgender program I went through at the VU hospital in Amsterdam. This is in the early 1990's, so things may have changed a bit now, I don't know.

You first had to go see a psychologist. He (at the time at least it was a he) would evaluate whether you were a "genuine case". If yes, you would be on the program and allowed to start taking HRT. If not, you were probably out the door. This would take several sessions. From talking to this man quite a bit (of course) I am pretty sure that if you didn't desire SRS you wouldn't have been considered a "genuine case" and wouldn't have been on the program.

After the psychologist gave the go ahead you would start HRT. You had to fully transition after at most three months on HRT. If you didn't, you would be cutoff from HRT.

Around this time you would also start hair removal. Back then there was no laser hair removal yet, so everything was electrolysis (slow and painful). Most people would also get some form of speech therapy/voice training.

SRS would be pretty much exactly 18 months after you started HRT. If you desired BA it was usually done at the same time as SRS. At the time in the Netherlands you could get your gender legally changed only after SRS. I don't know what the rules are these days.

I am not aware of anyone getting FFS or it being discussed as an option.

So how did you pay for all of this? You didn't have to. Everything was covered by health insurance, except hair removal which was capped to a certain limit. With electrolysis requiring many sessions (for me at least) the limit was reached pretty quickly.

So not counting hair removal with a little luck you could be completely done in about two years, and not paying a dime. Hair removal with electrolysis for me took more than two years, and was not entirely covered by health insurance.

Hi Plain Jane,
                      I know this is an old post but what a useful snippet from the past. Quite a change in approach in treatment philosophy from then until now.

It was quite a black and white scenario by the sounds of it. For most people I guess dysphoria got so bad it was do or die and then leap into the process" boots and all" including surgery. I would imagine not for the faint hearted, probably better than suicide or self harm though.

I wonder how many people crashed and burned on the way? - maybe not that many - but I would imagine loss of friends & family & employment would have been significant.

I'm so glad access to HRT is available via a psychologist these days, HRT is a powerful cure in its self. Real life experience for 12 months and SRS is no doubt beneficial for most, but not essential in all cases.

Statistics from the 70s, 80s, 90s, 2000s, ect would be interesting.

Regards, Kirsten.

[AnneK]

Hi Plain Jane,
                      I know this is an old post but what a useful snippet from the past. Quite a change in approach in treatment philosophy from then until now.

It was quite a black and white scenario by the sounds of it. For most people I guess dysphoria got so bad it was do or die and then leap into the process" boots and all" including surgery. I would imagine not for the faint hearted, probably better than suicide or self harm though.

I wonder how many people crashed and burned on the way? - maybe not that many - but I would imagine loss of friends & family & employment would have been significant.

I'm so glad access to HRT is available via a psychologist these days, HRT is a powerful cure in its self. Real life experience for 12 months and SRS is no doubt beneficial for most, but not essential in all cases.

Statistics from the 70s, 80s, 90s, 2000s, ect would be interesting.

Regards, Kirsten.

It is quite different now.  In Ontario, you used to have to be on RLE for a year before you could get hormones, now it's informed consent.  The rest of the process is also much easier and surgery is covered on our health plan, other than cosmetic surgery.