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This is an information resource mainly written for trans US citizens considering emigrating to another country, although we hope it is useful beyond that.

Please treat this wiki as a starting point for your own research, not as an authoritative source of truth or as legal advice.

Many of the authors have gone through the process themselves and want to share what they have learned.

Netherlands/Healthcare

From Trans World Express

Overall, the Dutch healthcare system has an excellent reputation. The 2023 Legatum Prosperity Index ranked the Netherlands as the 11th best in the world. According to the EC 2023 country health profile, the country boasts an incredible 0.2% of the population reporting unmet medical needs. Expatica also has a general article available here.

But the medical system in the Netherlands works very differently from the US. This page is meant to give US immigrants an overall reference frame for what to expect when seeking healthcare in the Netherlands.

Coverage

In the Netherlands, healthcare is generally seen as a right, not a paid commodity. Access to care for all is prioritized with solidarity through mandatory medical insurance. This reflects the overall societal support seen in other fallbacks like legal minimums for paid time off and paid sick leave. Along with affordable health insurance, you do not have to worry about high medical debts like in the US - which makes you generally less financially vulnerable due to illness.

Health insurance has an average premium cost of €153/month in 2025 and deductible ("eigen risico"/own risk) of €385 per year, unless you choose a higher deductible yourself. Anything above €385 (or your self-chosen deductible) is covered without paying more than your premium. The basic health insurance package is mandatory for every Dutch resident. The minimum coverage in the basic package is determined by the government and is quite broad, including the bulk of essential medical care, medications and medical aids.

Health insurance does not come with your employer! You choose your own health insurance with an insurance company of your liking, where you can also opt for their additional insurance packages for extra coverage. Note that dental care beyond age 18 is always an additional package.

Expatica covers more specific information about Dutch health insurance here.

Trans In Eigen Hand has a guide for choosing a health insurance in specific consideration of trans care coverage (currently in Dutch only, English translation to follow). This includes a table of which gender clinics are contracted with which health insurance companies. There are also many general sites for comparing health insurance companies such as Independer.nl, Zorgverzekering Informatie Centrum, Geld.nl, and Zorgwijzer.nl which can help you find the right plan for your needs. Be aware that after your initial choice of health insurance, you can only change out every December.

Government information can be found here.

Practices

Dutch doctors are likely to follow professional guidelines that have a more conservative nature than those in the US, which may require some adjustments for new arrivals. For example, Dutch doctors are extremely cautious about antibiotics resistance, so will be less likely to prescribe antibiotics - especially when suspecting a viral infection, where antibiotics don't help. This is a good thing to reduce the chances of antibiotics resistance, but also leads to the stereotype that they will tell patients to "just take paracetamol" and that getting "actual" medicine/treatment is difficult. (Dutch article about immigrant experiences)

This image is further exacerbated by the fact that several medications that are available over-the-counter in the US are prescription-only in the Netherlands, such as corticosteroid creams or stronger allergy medications. While OTC medication is available at drug stores ("drogist"), prescription medication is only available at formal pharmacies ("apotheek"). Note that cold/flu combination medications common in the US, like Dayquil, Nyquil, and Sudafed, are not available in the Netherlands in general. Instead you'll be advised to use a mix of separate OTC meds, such as paracetamol tablets and a decongestant nasal spray.

Additionally, general annual check-ups (without having a medical condition) are not considered medically necessary and are thus not offered. Public healthcare screenings generally start at a later age than their equivalent screenings in the US. For example, people with a cervix are recommended cervical cancer screening (PAP smears) starting at age 21 in the US versus age 30 in the Netherlands. Requests for annual check-ups or earlier screenings are not likely to be honored by Dutch doctors, unless there are additional medical reasons.

Organization

The Dutch medical system is organized in different tiers of access meant to fit the severity of the health issue at hand:

  1. First line: this is self-accessible primary care, where the GP acts as a central coordinator as well as gatekeeper for the other tiers of more specialized care. The GP stays in the loop of all the patient's healthcare needs and determines when care beyond their own practice and other first-line practices (e.g. psychologists, physiotherapists) is needed via referral to a specialist in one of the next tiers.
  2. Second line: these are general hospitals and clinics that are able to cover most specialties, and covers all the common patient cases within each specialty. These require GP referral. This might include teaching hospitals where medical interns and residents are trained, as well as some research activities.
  3. Third line: these are university medical centers (UMC's) which are directly associated with universities for academic education and research. These also require GP or 2nd line specialist referral. They are able to deal with more complex and/or rare patient cases as doctors tend to be more specific experts within their specialties.

Generally speaking, finding a GP is central, contrary to seeking out a medical specialist directly as is more common in the US. Note that a GP in the Netherlands is more akin to a family physician in the US, with several years of specific primary care training after general medical school. They will be responsible for overall continuance of care and can be relied upon to make the right call when specialized care is needed with the right level of urgency, e.g. triaging for emergency care.

There is also a division between the type of care needed, with different legal backgrounds for who is responsible and how it's financed:

  • Somatic healthcare: aimed at ailments and treatments of a primarily physical nature, although this may also include psychological/social support. Mainly performed by hospitals.
  • Mental healthcare ("geestelijke gezondheidszorg/ggz"): aimed at ailments and treatments of a primarily mental (psychological and/or psychiatric) nature. Mainly performed by separate mental health practices or clinics. See further down this page for more information.
  • Long term care: aimed at chronic ailments and treatments requiring professional care in the patient's home, or in a professional care facility.
  • Youth care: aimed at supporting youth growing up safely. Mainly performed by municipalities.

Again, the GP will be the place to start for referral to the right type of care.

Trans/queer friendly health professionals and services

There are several registries available from different organizations aimed at improving queer/trans healthcare. However, not all health professionals are aware of the existence of these registries to add themselves: this is still a work in progress. There are likely more trans-inclusive health professionals out there, so please do not hesitate to contact health professionals not listed on one of these registries.

Note that above lists do not mention if the GP's have space to take on new patients (see "Finding a GP" below) and as mentioned, specialists will need a GP referral to be seen.

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 new patients. Many practices also have postal code restrictions.

As mentioned on the main page, providing gender-affirming care is considered specialized (2nd/3rd line) care, not directly provided by the GP. Therefore for an initial diagnosis or more specialized treatments e.g. gender-affirming surgeries, you will need a GP to refer you to specialized gender clinics. However, if you are already diagnosed and only need existing HRT to be continued, some GP's are able and willing to do so, but not all are familiar. Below information will take you step-by-step how to find a new GP and approach the topic of gender-affirming care with them.

1: Find a GP office to get registered

The most thorough initial approach is to use a map to locate every huisartspraktijk (GP office) in the general area (neighborhood up to municipality due to postal code restrictions) of your registered address, then check with each one individually. You can also start by looking at Trans in Eigen Hand's list of transfriendly GP's for any that cover your postal code area. Some GP offices will have websites that say whether they are accepting patients, and may even let you register online, though you may have to call on the phone. Most offices have English speaking staff, if you ask.

Note that the online registration form should only cover administrative information, no medical information yet, including that you are trans. That's better suited for the in person introductory appointment to meet your doctor, which you can make or will be made for you after registration.

If you can't find a GP on your own, then you can contact your health insurance provider to help with mediation ("bemiddeling"): they are obligated to find you a suitable GP who can provide you with care, as not having a GP is a direct barrier to regular healthcare in the Netherlands as described above.

Valid refusal vs medical discrimination

Be aware that according to guidelines by the LHV (national GP organization), GP's may refuse to take on new patients only based on:

  1. the practice is full: there is no space for new patients - unfortunately common due to doctor shortages, all Dutch residents have to deal with this;
  2. the practice is too far away: during emergencies, GP's are obligated to try and be with a patient within 15 minutes - usually the reason for postal code restrictions, although GP's are allowed to register patients at further distances if they both agree that is acceptable;
  3. there is too large a difference in "vision of care": this refers to principled differences such as alternative medicine or euthanasia, where a GP may not support these treatments.

However, a GP is not allowed to refuse a new patient based only on them being trans, as that is medical discrimination in direct violation of Article 1 of the Constitution as well as professional medical doctor oaths (Artseneed) and behavioral guidelines (KNMG Gedragscode voor artsen). Should you run into this, it is possible to report this to Transgender Netwerk Nederland as discrimination.

2: After registration

Once you're registered at a GP, it's important to schedule an introductory appointment with your new GP. That way, you can get to know them and evaluate whether they're a good fit for you. This face-to-face meeting is also the right time to explain further medical context e.g. that you're trans, or that you have a chronic condition, or that you need to have your usual medication filled for the first time in the Netherlands.

Be aware that some GP's may be hesitant about taking on trans patients, not because of purposeful discrimination but due to the ignorant assumption that all care must be related to being trans, so they cannot fulfill that need without specialized knowledge. Obviously this is not the case: a trans patient can break a leg requiring care just like any cis patient. It can be helpful to approach the GP with your need for basic GP care of first line family medicine and referrals to more specialized care as necessary, and that you do not expect them to handle all trans-specific care on their own.

Note that many GP's will schedule 10-15 minute appointments per patient/medical issue. If you think you will need more time, you can ask for a double appointment. You can always ask how long the GP's standard appointments are.

How to approach continuation of HRT

Make sure you have all your medical paperwork from the US with you, including formal diagnosis (usually ICD-10 code F64.0) and details about any existing hormone or other treatments, like type and dosages. Continuing existing HRT is not considered part of standard GP care in the Netherlands, but there are several professional GP organizations providing professional information and guidelines for HRT in first line family medicine to facilitate more GP's into becoming comfortable doing this. Your GP may be one of them already, which will make this easy.

However, if your GP is generally open to it, but lacks knowledge to do so, you can refer them to the following professional resources - it's possible they are willing to educate themselves and continue HRT for you when prompted with the right information:

If your GP is not willing to continue HRT themself despite these resources, ask for referral to a gender clinic: providing referrals to specialized care is undisputably part of standard GP care. Trans In Eigen Hand has an overview of gender clinic wait times: it helps to check if there is a gender clinic within acceptable travel distance for you providing HRT ("Endocrinologie" under the column "Zorg in-house") with better waiting times than the university-associated gender clinics, so you can point your GP to them. Most GP's are only familiar with the multi-year waitlists at university-associated gender clinics and will by default refer you there, when other gender clinics with shorter waiting times may be suitable for your care. NB: Be sure to check if that gender clinic is contracted with your health insurance company for proper coverage!

Even if they want to refer you elsewhere for HRT, you can ask your GP to continue your existing HRT prescription only to bridge the waiting time. Given proper medical paperwork, your GP may be comfortable enough doing so, knowing a specialized endocrinologist is just around the corner.

If your GP remains unwilling to work with you after registration and you do not want to or cannot switch to another GP, get in touch via Main Page#Contact Us and ask to be connected with the TWE-NL group for more personalized guidance.

Mental healthcare (ggz)

This is organized by the same tiers described above preceeded by the GP's having practice assistants specialized in mental healthcare ("praktijkondersteuner huisarts ggz/POH-GGZ") prior to referrals to 1st line mental healthcare (basic GGZ; outpatient), 2nd line (specialized GGZ) and 3rd line (highly specialized GGZ).

The POH-GGZ is actually very important as a fallback due to long waitlists for referrals to any of these GGZ tiers of care. Although there are so-called "Treeknormen" (Treek norms) for the 1st and 2nd lines of mental healthcare, setting a maximum of 4 weeks for application and 10 weeks for treatment (so 14 weeks in total), the majority of clinics far exceed these waittimes due to being understaffed. 1st line can take several months, while 2nd line can take a year.

These waitlists can be a main motivator to choose a practice not covered by insurance, instead paying out of pocket. Be aware that a sliding scale for this is not commonly offered.

You can find an overview of English speaking therapists here.

Emergency care

Emergencies during a workday are handled by your GP. They can handle most small problems (stitches, for example), and can triage worse problems. When calling your GP, there will always be a way to indicate an emergency and jump the phone line to speak to someone directly.

Outside of working hours, you can contact the nearest "huisartsenpost" or after-hours GP station, similar to an urgent care clinic. This is usually staffed by GPs from the surrounding area and situated in or near a hospital.

If the emergency is outside of their scope, the GP or their assistants will send you to the emergency room. (The after-hours "huisartsenpost" is usually next to an ER just in case.) This is for serious cases where hospital staff are needed. Usually you will need to go through a GP to access this care.

If there is a medical emergency that requires EMTs or an ambulance, call 112. This is the 911 equivalent in the Netherlands. Police, fire, and medical emergencies can be reported through this number.

Covid practices

Covid vaccinations are offered by GGD, the public health organization, on an annual basis in autumn. Officially the vaccination is aimed at high risk groups based on age and medical conditions - however, other people can also get vaccinated based on having loved ones at risk. In practice, this does not get checked: just make an appointment to go and you should be fine. For 2025, the next rounds will start on 15 September 2025: you can make an appointment online from August 26th.

In terms of covid precautions, covid self-tests and medical masks (EU equivalent of KN95 masks are FFP2) are available over-the-counter at drug stores ("drogist") at own cost. Be aware that masking is unusual and may be frowned upon as Dutch societal pressure for post-pandemic return to "normalcy" was and remains very high. A few people may wear masks in public transport. Most people do not wear masks in hospitals or other healthcare settings, but you should be fine wearing one if you want. Note that despite the 2019 anti-immigrant "burka ban" for face coverings in public spaces, medical masking is not illegal: the same law includes specific exemptions such as personal protection so no reason for concern there.

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