The largest gender clinic in the Netherlands, in the Amsterdam UMC, is not accepting new adults for the time being. The decision is the result of an overload of gender care. There will be “many more people […] referred to us than we can handle,” Amsterdam UMC writes in an email document for people who want information about waiting times at the outpatient clinic. Children and adolescents who are registered on the waiting list will still be called for an intake interview.
People come to the gender clinic of the Gender Dysphoria Knowledge and Care Center (KZcG) in Amsterdam UMC who feel that their birth gender does not suit them. After a referral from a general practitioner or another healthcare provider, patients are placed on the waiting list for a first appointment with a psychologist, after which a diagnostic process may begin. In this process, psychologists (and sometimes psychiatrists) investigate whether someone suffers from gender dysphoria. And whether people can be treated with hormones and possibly undergo surgery.
The hospital was forced to take steps because waiting times within the treatment process are also increasing. After an intake, patients have to wait longer and longer for a second appointment: for children and adolescents this takes about two months, for adults more than a year. While the number of registrations has been steadily increasing for years, the clinic “like the whole of the Netherlands is faced with a shortage of psychologists.”
‘Inflow’
Currently, more than 4,500 adults and 1,000 children and adolescents are on the waiting list in Amsterdam. One hundred new registrations are added every month. Every year the hospital sees an average of 450 adults and 250 children and adolescents.
The hospital is not talking about a patient stop, adults can still be referred to Amsterdam UMC, the spokesperson for the clinic emphasizes. But they will then be put on the waiting list – so little will happen with them for the time being. “As soon as the psychological staff is in order again,” adults can “enter” again.
What we do know is that this increase is also seen in other places around the world
The hospital does not know exactly why more and more people are registering for care. “What we do know is that this increase is also being seen in other places around the world.” It is possible that people could find their way to the outpatient clinic more easily due to growing attention, acceptance and awareness in society, according to Amsterdam UMC. The number of people referred to the gender clinic is also growing because there is more room in healthcare not only for people who identify as men or women, but also for people who are non-binary, for example.
Waiting list
Just like Amsterdam UMC, other gender clinics also have limited capacity and people have to wait there for years. According to the Amsterdam outpatient clinic, the solution does not lie in expanding one center, but in collaboration with hospitals, mental health institutions and general practitioners. “In consultation with the Ministry of Health, Welfare and Sport, health insurers and patient organizations, Amsterdam UMC has been indicating for years that it is unable to handle the strong increase in referrals alone,” Amsterdam UMC writes.
Amsterdam UMC cannot predict how long adults and children will have to wait. Currently, adults who were referred by a GP or healthcare provider in November 2020 are scheduled for an initial consultation with a psychologist in the spring. So they have been on the waiting list for about 4.5 years. Children and adolescents who are then called up have been on the waiting list for approximately 2.5 years.
The hospital writes in the document that people can also speak to their health insurer. “You are ultimately insured for care and cannot receive it at the moment.”
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