by Lilidh Jack
Dutch trans activists took to the streets on the 26th of June, marching past the Amsterdam University Medical Centres, home to the Centre for Expertise on Gender Dysphoria, the gender identity clinic (GIC) where around 80% of Dutch trans people are assessed. “This was definitely symbolic, as participants screamed Fuck het VU! Trans zorg nu! — Fuck the GIC! Trans healthcare now,” writes vreer verkerke, a Dutch trans healthcare activist. The 500-strong protest, organised by the group Trans Zorg Nu, inaugurated the start of their campaign ‘Summer of Trans Rage.’
“This was the biggest trans demonstration in the Netherlands ever. People were at the same time elated and bloody angry. [There was] a good atmosphere — notwithstanding coronavirus restrictions.” Only one of the planned speeches was given outside the centre before police moved the protest along its march to the Stationsplein. The remaining speakers, including one from the Transgender Health Network, which operates in the Netherlands as well as the UK and Ireland, spoke after the march.
Trans Healthcare: Conversion Therapy is Feature, not Bug
Trans healthcare in the Netherlands operates on the GIC system, first seen in North America in the 1950s and ‘60s. GICs, which are most prolific today in the UK, the Netherlands, Ireland, and Sweden, assess whether a person is trans, and whether they meet certain referral criteria for treatment. Before the opening of the Tavistock paediatric gender clinic in 1989, British trans children and young people were seen by the centre in the Netherlands.
Some historical accounts of GICs view “conversion as a step in trans medicine.” Jules Gill-Peterson, trans Historian at Johns Hopkins University continues, “the original requirement by gatekeeping clinicians [was] that any candidate for hormones and surgery have exhaustively proven that no conversion psychotherapy or medical conversion therapy had already stopped them from being trans. Only then would they be allowed to transition.” Some trans activists argue that multi-year wait times, arbitrary criteria, and the excessive deferral or denial of healthcare follow in this tradition.
It is this model of healthcare the activists are seeking to end. Verkerke continues: “The demands all center around autonomy and an end to psychological and psychiatric gatekeeping.” The issue of patient mistreatment went viral in the Netherlands this summer through the Instagram page VUGenderMistreatment. Many of the stories shared on the page discuss doctors denying healthcare for spurious reasons. “Those who want to transition are forced to conform to the outdated image the doctor has of what a transgender [person] is, and must dutifully answer inappropriate questions about sex life and masturbation habits,” writes Principle17 in a statement following the June 26th protest. “Few patients dare to criticise, because of the enormous power of the doctor. Assertive patients [find] that care is delayed or denied.”
A Manifesto for Trans Healthcare
The protest follows the release of Trans Zorg Nu’s four-part manifesto: no waiting lists, no diagnostic criteria— meaning complete self determination, decentralised trans care—fast, safe, and local transition care, and trans healthcare led by trans people. The demands of the newer, younger group echo those of the older Principle17, where verkerke, whose name only capitalises at the start of sentences, has been campaigning for a number of years. “There were very many youngsters with dyed hair [at the protest].
It is important to get the old dogs and the youngsters together and start working on strategies—both for advocacy and for community wellbeing.” Principle17, which petitioned under a similar manifesto in 2017, is named after the Yogyakarta Principles, a 2006 document from human rights groups which affirm that the “highest attainable standard” of healthcare should be available to all, “without discrimination on the basis of sexual orientation or gender identity.”
The protest was attended by some from the progressive left-wing party BIJ1 (“Bey-eyn,” meaning ‘together’), led by Sylvana Simons. Verkerke sounds almost surprised: “[At the] first opportunity after the demonstration, Ms. Simons requested a debate on the state of trans health care.” The debate was sent to the Public Health Committee’s last meeting before the summer recess. Simons presented several resolutions as part of a plenary on specialised healthcare on July 5th. In her speech presenting the resolutions, Simons said the trans healthcare system relies on “pathologising diagnoses” and required “structural change.”
Trans Zorg Nu organised their second protest to coincide with the debate. The resolutions, or moties, similar to day-motions in the House of Commons, bind a government to an idea and state the government’s intention but do not introduce or change laws or governance. “The time when we as cisgender people,” continued Simons, “can pretend to know what transgender people need is long gone. It is high time that we put the control of transition care in the hands of transgender people themselves.”
As part of the ‘two-minute debate’ on specialised healthcare, a resolution to reclassify transgender healthcare from highly specialised ‘third-line’ care, which one might only receive in academic hospitals, to simply secondary care, undertaken by specialised doctors in most hospitals, was accepted with 131 ayes from the 150-member chamber.
A further resolution emphasising the importance of transgender lived-experiences in providing trans healthcare passed with 96 ayes. The house agreed with 114 ayes, a majority of 39, that hormone monitoring and prescription should be undertaken by GPs, but a resolution on the decentralisation of transgender healthcare fell 21 votes short of a majority. Other resolutions, including one calling for an end to psychiatric pre-assessments in trans healthcare, were not accepted for debate. Verkerke expects some movement following summer recess: “We plan to have a plenary debate later this year or beginning next year.” Resolutions which pass plenaries in the lower and upper chambers have the chance to become bills.
The Protests Continue
Activists plan to keep the pressure on politicians until parliament reconvenes. Trans Zorg Nu has two protests planned in Nijmegen and Groningen. “It’s so important for us to be visible,” says Merijn Sommer, who organised a protest in Eindhoven on August 29th. Sommer also sees the protests as an act of mutual care: “those out of the [Amsterdam metropolitan area should] have a chance to join an event like this. We have to support each other and get through this together, that’s the only way to deal with the blatant disrespect from the healthcare providers.”
Trans Zorg Nu are undertaking efforts to increase the presence of those affected by transmisogyny and racism in their steering committee, and so declined to give an official comment at present. The Centre for Expertise in Gender Dysphoria was contacted for comment.
Since this article was written a number of groups hosted a trans dignity march on September 10th, gathering at Admiraal de Ruijterweg 80, Amsterdam, the site of a recent assault against a trans woman, Trans Zorg Nu and Actiegroep Bokkeryers hosted a protest at at the Valkhoffpark in Nijmegen on the 18th of September, and Trans Zorg Nu itself hosted a protest on September 19th at the Grote Markt in Groningen.