To all transgender people

We are convinced that transgender people are capable of taking the responsibility for their own transition. This site is intended both for transgender people who share this idea and for general practitioners, endocrinologists and surgeons. And of course all psychologists who work with transgender people are welcome to read along.

 
Taking your own responsibility means that you as a transgender person are convinced that you (and: ONLY you) can decide whether or not you need medical treatments or when you need them. You know your own feelings. You know whether you have any doubts - or not. You know whether your transition can/must proceed more quickly or more slowly. Based on this knowledge, you are capable to have an influence on your own transition process. You are not getting ahead of yourself because you are capable to hold back in time and the other way around: you know when it is the right moment to take a new step and you are prepared to take it. Sometimes you may run into an obstacle because you are proceeding too rapidly (or too slowly). These are learning experiences that help you to make better decisions as you go along.
 
You know hormones and operations have disadvantages and you are capable to weigh disadvantages against the advantages. You are aware of the possible adverse effects of hormones and the risks of operation(s) and you know why it is, in your individual case, necessarily to take these risks. You also know that you are strong enough to cope with possible adverse reactions to medication.

You know that 0.5% to 3% of the transgender people who get therapies later have regrets about these treatments and you are aware that this might happen to you.

You accept that, when you read the pages with a red bar at the top of the page on this site, ONLY you are responsible for the decision that you need hormones or operations. You accept that in that situation you cannot hold your psychologist accountable for this, because you have made use of prior knowledge about the tests the psychologist would use on you. This is it moment to make a conscious decision: do you want self-determination (with all the pros and cons involved), or do you prefer to have a gatekeeper (with all the pros and cons of that choice)?

If you choose for self-determination, by all means, make use of our site. This site helps you to understand why psychologists who decide on transgender treatments ask the questions they ask. This site gives you tips and examples that help you to give these people the impression that you are (in their view) a “true transgender person”. We think it is important to pass on these tips, because only if the psychologist gives you room to develop yourself in the direction that is best for you, you will be able to take your own responsibility. We think that is more important than whether the contents of your file match with your true feelings.

If you are convinced that a psychologist is better capable of making judgments about whether or not you should take hormones or undergo operations than you are, don’t worry, you can still read on: most of the pages are just contemplative. There are a few pages you should better avoid: those pages contain advice on how to convince the psychologist that you are a "real transgender person", even if you may feel different in reality. So you might acquire knowledge about the way the psychologist works, while they assume you don’t have that knowledge, which may lead them to erroneous conclusions. To prevent this we have put a big red bar at the top of the pages where this might occur. You can tell your psychologist about this website: it may help them to look more critical at their own methods and techniques and reconsider those. Your psychologist can always contact us about the information on this site.

In principle, this website is written for adult transgender people. We don’t mind if younger transgender people read this, you might notice big differences with the questions or treatments that were given to you.

Finally: we acknowledge that psychologists can be involved in a transition process in various different ways. We are (strongly) opposed to gatekeepers, but we have nothing against psychologists who provide support. We understand that transitions are not easy, and that it can be helpful (or necessary) to have some help in your process. We do have the opinion that in almost all cases the request for help must from the transgender person themself and not from their environment. A psychologist, in our terminology, is only a supportive psychologist if the transgender person is free to stop having sessions at the end of each encounter and that this has no consequence whatsoever for the contents or the speed of the medical process (e.g.: permission to start or continue taking hormones, permission for operations, etc). Whenever refusing sessions has implications for the contents or the speed of the treatment, this means that the psychologist is primarily a gatekeeper.

Only you know what applies in your case. Only you know whether it is wise to read on or to skip some specific pages on this site. We respect your choice: you don’t have to agree with us.

To all general practitioners, endocrinologists and surgeons
We believe in transgender people -and- we believe in you. We think that you, after reading this website, will have a better understanding of where our annoyance about psychologists who decide on treatments stems from. We are asking you to do the diagnostics yourself, based upon the self-determination of your patients. We understand very well that you are not able to decide whether or not we need hormones or operations. We hope you are willing to admit that a psychologist who has to decide on these treatments is also not able to do that...

In our view there are only two criteria to decide whether or not transgender people need treatment with hormones or operations:

1) There is a need for other body parts than somebody currently has -or- there is a need to remove body parts that are now present. The only one who knows this is your patient, we ask you to accept your patient’s conclusions unless you have clear signals that something is wrong.

2)  The patient understands the implications of the treatment. For instance: taking hormones -can- render somebody infertile.
 
The way to examine this doesn’t differ from the way you examine patients with other disorders.

We will further go into this later. For now we want to reassure you: there are organizations in foreign countries with tens of years of experience, they report a low percentage of people who have regrets and high rates of satisfaction from their patients.

To psychologists who are reading along

If you support our goals, we would like to ask you to help enhance our site with your knowledge (we are willing to share information without mentioning the source, you can also send us information anonymously, see the page suggestions and contact).

If you are still working as a gatekeeper, we invite you to stop doing that: in particular, read the chapter about future: the psychologist to understand how peculiar your work is in our view. We are willing to engage in a discussion with you (both personal and through workshops and education).

To people outside the Netherlands who support our points of view

In principle we are a Dutch group. We have only limited capabilities to do this kind of educational sessions in foreign countries. We requested to do a workshop at the EPATH in Belgrade, but our request was rejected. We will be present during the EPATH in Belgrade. We are looking for people in other countries who can tell this story in their country as well. If you are willing and able to do that, please contact us (see suggestions and contact).