As you have seen in the practical examples, we believe in transgender people and in their abilities. These abilities are comparable with those of all other people in the Netherlands. There are clever transgender people and stupid ones and many, many in between. There are people who are capable of doing everything by themselves and people who always need help from others to make progress and many, many variants in between. There are people who overestimate themselves and people who can do much more than they think they can and many variants between them.
But if people have to be subjected to compulsory mental care, there must be something very wrong with them. In the Netherlands compulsory mental care is a last resort, which is used very sparingly. Except... for transgender people.
What we would like, is that if a transgender person requests hormones, this request has to be judged by his general practitioner or (only in more complicated cases) by a specialized endocrinologist. And if a transgender person requests an operation we think a surgeon should make the decision whether to perform the surgery. Neither for hormone treatments nor for operations should one or more referral letters from a psychologist be needed.
The criteria for such treatment should be no different from those for other kinds of medication or operations. Over the past decades, the psychologists who decide on treatments for transgender people have grown into a role we do not agree with. Unfortunately the doctors who provide care still fear people would think they are careless if not 100% of the treatments for transgender people are backed by a screening by one or more psychologists.
This way of working has already existed for decades in the US, and the Standards of Care also support this way of thinking. This can be found in the Dutch language version on page 36 and in the English language version on page 41 (Informed Consent).
We hope that Dutch general practitioners will also stick their necks out soon. There are general practitioners like Helen Webberley MD (https://www.GenderGP.co.uk) who already provide hormones. She does her consultations by video link, by mail and also v