Netherlands

The Netherlands is one of the more LGBTQIA+ friendly countries in the world (see LGBT Equality Index) offering a high standard of living, robust legal protections, and comprehensive healthcare for transgender individuals. Overall, the Netherlands provides a relatively safe and inclusive environment for trans people. This might be under threat by the rise of fascism though.

Why the Netherlands?

The Netherlands is one of the more progressive countries in the world, famously the first to legalize same-sex marriage in 2001. There are several positive factors to life in the Netherlands:

• Article 1 of the Constitution centers on equality and prohibition of discrimination (see Wikipedia and Dutch constitution text). This explicitly covers discrimination based on religion, belief, political disposition, race, gender, disability and sexual orientation.
• The Netherlands ranks #6 on the World Happiness Report 2024 especially in terms of income and social support. Dutch society generally cares for each other, reflected in decent and affordable (gender-affirming) healthcare as well as education, widely usable and reliable public transportation, societal safety nets like unemployment, overall safe living environments. (The downside: high taxes.)
• Vacation, pregnancy, sick leave: based on employment laws, employees have rights to a minimum number of vacation days (4 times the number of hours worked per week) as well as fully paid pregnancy and sick leave. This can also be used for gender transition, and while not legally required, some companies may even offer special gender transition leave as a separate benefit.
• LGBTQIA+ rights and community: beyond legal rights like gender recognition and same-sex marriage, there are many strong communities with Pride events and dedicated queer spaces in many Dutch cities. Some queer/trans organizations include:
  • COC Nederland as a generic queer aimed organization, with regional associations
  • Transgender Netwerk Nederland as a trans advocacy organization
  • Transvisie as a trans patient advocacy organization, including an English contact group for peer support

Why not the Netherlands?

Recent political developments have seen a rise of the far right - unfortunately the Netherlands is not exempt from the global slide towards fascism. There are also other societal factors to weigh:

• Political climate drifting further right: While the outright fascist party FvD has lost most of its followers, the populist anti-immigrant party PVV has risen in its place and become the largest party in the country in the latest 2023 election. Other government coalition parties include the VVD, the economically conservative liberal party; and the BBB, the conservative climate change denying farmers’ party.
• Dutch tolerance: while the Netherlands is known for its tolerance, this is mostly based on a sense of societal compliance: “just be normal, then you’re weird enough” is an often used Dutch saying.
• Bureaucratic hindrance of trans rights: while gender-affirming healthcare is available, initial evaluation has on average two years long wait lists. Legal gender recognition requires a mandatory “expert statement”: in 2019, a proposal to remove this expert statement met a great deal of societal resistance, thus was dropped.
• Colonialism and racism: with its strong colonial history, Dutch society struggles to come to terms with colonialism and racism. The most obvious is the discourse surrounding “Zwarte Piet” (Black Pete) and the anti-immigrant party PVV’s “fewer Moroccans” speech from 2014, still relevant as they hold governmental power today.

Political situation for trans people

The Netherlands has a law on self determination, meaning you can choose your gender marker and given names, once a year and after a three months waiting period. However the conservative and far right parties are in power and things might change in the future.

More info in this topic here https://www.expatfocus.com/netherlands/articles/living-in-the-netherlands-as-a-transgender-expat-5006

Access to trans health care

In The Netherlands, it is compulsory to take out a private health insurance. Many Dutch insurance providers reimburse a decent amount of gender-affirming care treatments, provided that they have contracts with the institutions performing them.

The official channel to start HRT in the Netherlands is by referral to an endocrinologist, which can be obtained from your GP or your gender clinic, almost always after getting a gender dysphoria diagnosis. You nearly always need an official diagnosis, so if you have paperwork with an ICD-10 diagnosis of F64.0, bring that with you, it will make your life easier.

Undertaking HRT through official channels is not only the safest option, but also the only way to be eligible for at least partial reimbursement by Dutch health insurers. DIY hormone therapy is accessible, sellers exist that ship from within the EU (and thus without any customs interfering).

In the Netherlands, certain gender-affirming surgeries can only be accessed through gender clinics. This means they can only be pursued in consultation with a team of psychologists, endocrinologists, and surgeons.

A lot more information on the topic can be found here https://dutchreview.com/expat/trans-healthcare-in-the-netherlands/

Finding a GP

The first step to accessing Dutch healthcare, including trans healthcare, is to register with a GP (Huisarts). Due to a doctor shortage, it can take some time to find a practice that is accepting patients. Many practices also have postcode restrictions.

The most thorough approach is to use a map search to locate every huisartspraktijk (GP office) in the general area of your registered address, then check with each one individually. Some will have websites that say whether they are accepting patients, and may even let you register online, but most of the time, you have to call on the phone. Most offices have English speaking staff, if you ask.

Once you register, make an appointment (usually on the phone again.) Some Dutch doctors will be surprised that you are making an appointment when you aren't sick, so you can explain that you have a chronic condition that you would like advice about, or that you need to have your usual medication filled for the first time in the Netherlands.

It is important to note that many GP's will schedule 10-15 minute appointments per patient/medical issue. This is also due to a general shortage of medical staff. If you think you will need longer than that you can ask for a double appointment. You can always ask how long the GP's standard appointments are.

Note: most healthcare professionals should be fine treating trans/queer patient. But if you want to be extra sure, Roze In Wit (https://www.rozeinwit.nl/en/) is a registry of Dutch healthcare professionals (GP's, specialists, psychologists) that explicitly state that they are queer supportive. However, this list doesn't mention if the GP's have space to take on new patients; and specialists will need a GP referral to be seen.

Immigration (work in progress)

The most likely routes are:

• Self employment (DAFT): https://inls.nl/daft/ Netherlands-DAFT
  • if you think you will make more than 70.000 euros a year you might want to set up a B.V. (Limited) because that can give you several benefits. If you think you will make less than 60.000 euros a year you will probably want an 'eenmanszaak'. B.V. or eenmanszaak?
  • Some people who moved to Netherlands a couple of years ago via DAFT created a detailed webpage about what they now know: https://v.st/daft#
• Skilled immigration: https://ind.nl/en/residence-permits/work/highly-skilled-migrant
  • you need a job at a company listed here: https://ind.nl/en/public-register-recognised-sponsors/public-register-regular-labour-and-highly-skilled-migrants
  • expat scheme (tax advantage, formerly known as 30% ruling): https://www.belastingdienst.nl/wps/wcm/connect/en/individuals/content/coming-to-work-in-the-netherlands-30-percent-facility https://business.gov.nl/staff/employing-staff/the-expat-scheme-30-percent-ruling-in-the-netherlands/
• Student visa: https://ind.nl/en/residence-permits/study/student-residence-permit-for-university-or-higher-professional-education
  • you will need to study at one of these institutions: https://ind.nl/en/public-register-recognised-sponsors/public-register-educational-institutions
• Asylum options

The netherlands at the moment does not allow asylum processe for americans. While that might changed so far it has not. NL has not accepted American asylum seekers so far, so this may be relevant only as last resort: https://ind.nl/en/residence-permits/asylum/apply-for-asylum-in-the-netherlands#process-and-costs However, asylum from other countries has been granted on grounds of sexual orientation putting you at risk in your Country of origin.

Other routes for working in the Netherlands: https://ind.nl/en/residence-permits/work

Citizenship Pathway

There is one main pathway to get Dutch citizenship as an immigrant.

Naturalization

Standard Residency Requirement: You have lived in the Kingdom of the Netherlands for at least 5 consecutive years with a valid residence permit. You have always extended your residence permit on time. Applicants must demonstrate A2 proficiency in the Dutch language, pass a citizenship test, declare that you are aware that the laws of the Kingdom of the Netherlands also apply to you, prove financial self-sufficiency without state assistance, and have no serious criminal convictions. You must renounce your current nationality. https://ind.nl/en/dutch-citizenship/becoming-a-dutch-national-through-naturalisation#requirements

Accelerated Naturalization: there are some exceptions to the 5 year rule https://ind.nl/en/exceptions-to-the-5-year-term-for-naturalisation-in-the-netherlands

Citizenship by Marriage

Spouses of Dutch Citizens: Spouses and registered same-sex partners of Dutch citizens can apply for naturalization if they have been married to or in a registered partnership with a Dutch national for at least 3 years. You can prove that you have lived with your Dutch partner for at least 3 years. In these cases you would also NOT need to renounce your own nationality as being in a registered partnership with a Dutch citizen or married to a Dutch citizen prior to requesting naturalization is one of the exemptions to the rule.

Community & Social Support

LGBTQ+ Friendly Cities

Although The Netherlands has a worldwide reputation of opennes towards the LGBTQIA+ community, it is not in in the top 10 of most LGBTQ+ friendly countries in Europe, and the situation doesn't seem to change for the better. This is documented by the https://rainbowmap.ilga-europe.org/countries/netherlands/

In the bigger cities (which to American standards are still small) will in general be quite open to trans people but there, too, there will be areas you'd better avoid.

Trans-Friendly Cities (descending in popularity)

• Amsterdam - the obvious choice, it has by far the largest queer community of The Netherlands. Amsterdam also has a high safety index and over 20 queer bars and clubs can be found on Google Maps in the city.
• Utrecht -
• Rotterdam -

Support Groups

Transgendernetwerk (website mostly in Dutch) They have a WhatsApp line for transgender people who have not been in the Netherlands for that long. Here everyone can inquire easily with questions about health care, discrimination, regulatory matters and meeting. You send an app to +31 20-2446558 and on working days you will receive an answer within 24 hours. You can ask your questions in Dutch, English, Spanish or French.

Further resources

This is a list of resources and service providers in The Netherlands https://www.transgendermap.com/guidance/resources/netherlands/

Transgender wijzer https://transgenderwegwijzer.nl/

Ideas for additional topics:

Legal Rights & Protections (work in progress)

Anti-Discrimination Laws

• Legal Protections: Overview of protections for transgender individuals in employment, housing, and public life.
• Reporting Discrimination: How to report instances of discrimination and seek legal recourse.

Legal Gender Recognition

• Process Overview: Detailed guide on changing gender markers and names in official documents.
• Recent Legal Developments: .......................................

Workplace Rights

• Transitioning at Work: Guidance on navigating the workplace during transition.
• Legal Protections: Information on laws protecting transgender employees.

Housing & Cost of Living (work in progress)

Trans-Friendly Housing

• Finding Safe Housing: Tips on locating safe and inclusive living spaces.
• Housing Rights: Information on legal protections against housing discrimination.

Cost of Living

• Expense Comparison: Comparison of living costs between major U.S. cities and Dutch cities.

One question often asked is how expensive it is to live in The Netherlands compared to the US, this is a difficult comparison to make overall because things cost "differently".

• Salaries are generally lower in Europe than in the US, but buying power is higher due to differences in the cost of products and services.
• Healthcare is one of the biggest differences, the average monthly health insurance premiums are €157/month, with a €385/year standard deductible.
• Food is affordable, with access to plenty of fresh fruit and vegetables. A budget of €500/month is reasonable for a 2 person household.
• Mobile and internet is affordable, with an unlimited 5G mobile plan costing ~€25/month, and internet between ~€30 and €60/month (€50 will get you 1gb fiber internet in many locations)
• Public transportation is widely available and (contrary to many local complaints) quite reliable. Intercity train tickets can be expensive though, with a standard 2nd class ticket from Den Haag to Amsterdam costing over €14.
• Eating out has become increasingly expensive since COVID. Dinner at a local restaurant for 2 will easily run you €50.
• Housing is by far the biggest expense, as there is currently a housing shortage in The Netherlands, especially in the Randstad area. The website Funda is the de facto website for renting or buying property in The Netherlands.

• Budgeting Tips: Advice on managing finances in The Netherlands.

Safety Considerations

• Regional Safety: Overview of safety for transgender individuals in different regions.
• Legal Protections: Information on hate crime laws and reporting mechanisms.

Culture & Integration (work in progress)

Cultural Attitudes Toward Trans People

• Societal Acceptance: Discussion on how acceptance varies across The Netherlands.
• Historical Context: Brief history of transgender rights in The Netherlands.

Bureaucracy & Paperwork

• Navigating Dutch Bureaucracy:

The "3 Visit Rule"

A rule of thumb to avoid frustration when dealing with Dutch municipalities (gemeente in Dutch), is to approach any task with the assumption that it will take 3 visits to accomplish. This comes primarily due to lack of knowledge of processes, rules, and requirements by local municipality employees. Employees of the municipality will often request documentation or artifacts that are not listed on the government websites, required a follow up visit. Approaching these interactions with this assumption in mind can reduce frustration and help with planning.

• Common Challenges: Overview of potential hurdles and how to overcome them.

Animal Policies

• For information on how to import your pet to the Netherlands, see: Traveling with pets