Informed Consent in the Netherlands
We would very much like to see general practitioners, endocrinologists, and surgeons in the Netherlands start working according to the rules for Informed Consent.
This could look as follows:
- In the first visit on the gender team the transgender person has a conversation of 30 minutes with a nurse. The sole purpose of this conversation is to find out whether the transgender person is capable to make independent decisions about their health and understands the consequences of the medical treatment.
- Immediately after this conversation follows a 10 minute talk between the nurse and the care provider. In this conversation they decide which additional points need to be discussed.
- After that follows a 20 minute conversation between the care provider and the patient. In this conversation the final points of doubt are discussed and the care provider decides whether more consultations are necessary, If not the care provider can initiate the treatment. The latter will apply in most cases. If this applies the patient can take the desired hormone therapy home immediately. If surgery is required, this can be planned immediately.
Callen-Lorde hospital in New York has been using this way of working in the supply of hormones for decades already. With this method they get a percentage of 0.8% of people who have regrets, a relatively low number when compared to the worldwide average of 0.5%-3% (*). In comparison: VUmc has a percentage of people who have regrets of at most 1% (**), so the numbers are comparable. This way of working is accepted in the international Standards of Care. The transgender part of the Callen-Lorde website (including the protocol used) can be found here.
At the moment there are, as far as we know, 0 general practitioners, 0 endocrinologists, 0 surgeons, and 0 gender teams in the Netherlands who have implemented this. If you are a doctor and you are willing and able to implement this way of working, please let us know. You are free to choose whether you want your name to appear on this page, or you just want to weigh in in the statistics (and your name will only be passed on to transgender people who need hormones).
(*) Informierte Zustimmung in der Trans*-Gesundheitsversorgung, Erfahrungen eines US-amerikanischen Community Health Center - Anita Radix und Justus Eisfeld, Z Sexualforsch 2014; 27; 31-43
(**) As Martin den Heijer from VUmc said in this interview by RTL-nieuws.