20 November 2019

Gender healthcare waiting lists – should I switch hospitals?

By Alexa

I am not sure how things are outside The Netherlands when it comes to hospitals specialized in transgender healthcare and their waiting lists, but here it’s pretty bad.

Well, it’s actually not that bad. There are enough specialists at work here and they are all very capable at their work (at least I assume they are 😉). The main problem is the number of University Medical Centers (there are a total of 8 UMCs in The Netherlands), of which 3 have a transgender healthcare polyclinic, resulting in the massive waiting lists we have now.

For teens and young adolescents are two UMCs have a transgender healthcare polyclinic, being the Vrije Universiteit Medisch Centrum in Amsterdam and the Leids Universitair Medisch Centrum (I can’t find their gender healthcare on the site) in Leiden.
The Radboud Universitair Medisch Centrum in Nijmegen will start early next year with their transgender healthcare for this group as well and will expand on a later date for adults as well (point #8 of this information page).
For transgender adults there are only 2 UMCs right now specializing in transgender healthcare. These are the VUmc and the Universitair Medisch Centrum Groningen.

Though for a small country like The Netherlands the amount of UMCs providing transgender healthcare seems pretty big, so is the number of transgenders waiting for healthcare. The VUmc for instance already has over 1400 transgenders adults on it’s waiting list and this waiting list is still growing, resulting in almost 2 years before treatment even starts. There’s no (public) information on the number of transgender people on the UMCG waiting list, but with a 60 week waiting list it might be at least a couple of 100, assuming that the UMCG transgender healthcare team is smaller than that of the VUmc (because of it’s remote location).

What would these waiting lists mean for me? My doctor gave me the referral for transgender healthcare on May 16th this year. Living close to Amsterdam (40 minutes to get to the VUmc using public transport) I choose that hospital for treatment.

Now half a year down the road and having a feeling that I have to wait till hell freezes over before I can get proper treatment I am wondering what to do. I could order hormones from other countries withing the EU (I heard Portugal is pretty cheap), but I think that’s a bit risky. Not to mention that my doctor is already keeping track of me while the soy is stimulating that extreme rare side effect of the valproic acid, but perhaps I could ask him about proscribing the hormones anyway.

An other option might be to change waiting list from the VUmc to UMCG (I’m allowed to be on one waiting list only) and chance that the waiting list of the VUmc won’t get smaller when the Radboud starts their transgender healthcare coming year. I think in general this would speed up the transition by a lot.
Most of the procedures which the VUmc offers have extreme waiting lists and if all procedures (I’m taking 1 year into account for facial plastic surgery) are done without delay (read being in the ‘right’ mental state) it’ll take at least 5 years before the full transition has taken place.
Looking at the same procedures at the UMCG the full transition will take a ‘mere’ 2 1/2 year. The down side of the UMCG is (as I alread said) it’s very remote location in the northern part of The Netherlands.

Aside from UMCG being so remote and taking me roughly 3 hours to get there for only half an hour once a month are the costs to get there. A single trip by train (I don’t have a drivers license and don’t want to be dependent of my neighbors) costs €15,90 now taking my 40% discount into account when travelling outside of peak hours. And while a lot of healthcare is paid for in The Netherlands travelling expenses are not in most cases. And if it is, there’s a minimum threshold (I should ask my health insurance about travelling expenses). There is also the option for a tax deduction, but that’ll only give back around 30% of the expenses 🙁

At times I feel like I’m going crazy and wonder if I can make it through the VUmc waiting lists before killing myself (figuratively). I think that the UMCG is the best solution for me and I should take the travelling costs and time as they are. This’ll mean that I have to make a lot of phone calls today to get things in motion (again).