- Do you feel different from the gender you were assigned at birth? You might be transgender
- It is your choice whether you do something with that. Maybe you feel fine just the way you are. Maybe you would like to make some changes
- Do you want your body to reflect how you feel? You can get help
- Do you have questions about your gender? Or are you having mental health issues? You can get help
- There are places where you can meet other transgender people. Also especially for sex workers
Questions about gender
It is possible you feel different from the gender you were assigned at birth. Maybe you were raised as a girl, but feel like a man now. Or you were raised as a boy and now feel like a woman. Or you feel neither like a man nor like a woman. If this is the case, you might be transgender.
You decide if you want to do something with those feelings. That is your choice. You do not have to have surgery or take hormones in order to be transgender.
Would you like to share your feelings or doubts? Or would you like advice about what is possible? You can talk to someone who specializes in transgender health care (Dutch only). You can do that of you are not sure about your gender. Or if you are sure, and are running into problems. Negative responses from people close to you for example.
You can also decide to change your body so that it better reflects how you feel. That means taking hormones or having surgery.
Change your body
Do you want your body to reflect how you feel? You can get medical help in that case. You do have to go to the doctor first. The doctor can refer you to the hospital.
There is a large team of doctors at the VUMC in Amsterdam who know a lot about gender. But there are also other places where you can get help (Dutch only)
There is a clinic in Amsterdam operated by and for transgender people. A lot of sex workers go there. You can get help and advice there. The doctor there can also write a prescription for hormones.
You don’t have to have an operation or take hormones to be transgender. That is your choice. Do you want to change the gender on your passport (Dutch only)? You can also do that without transitioning medically.
Hormones
Hormones can change your body. Do you want to take hormones? You need a prescription from a doctor.
You don’t have to take hormones to be transgender. That is your choice.
Would you like to have children? Talk to your doctor about it. Hormones can make it more difficult to have children. You can have sperm or eggs frozen before you start taking hormones. That way, you can still have children later.
You don’t want children now or at all? If you do, use a condom when fucking. Hormone treatment is not a sure protection against pregnancy.
Trans women often use estrogen and testosterone blockers. These change all sorts of things in your body:
- Your breasts grow. How fast they grow and how big they will become is different for everyone
- You will lose muscle mass
- You might not be as interested in sex
- It will be less easy for you to get an erection or you won’t be able to at all anymore
- After a while, no sperm will come out of your penis when you come. It is possible that a little bit of fluid will come out
Precisely how hormones will change your body is different for everyone. It may be a while before you notice the changes. Are you worried or do you have any questions? If so, go to your doctor.
Trans men often use testosterone. These change all sorts of things in your body:
- You voice will become lower (your voice changes)
- You will start to get a beard and mustache
- You will get more hair on your arms, legs and stomach
- Your clitoris will grow. How fast it grows and how big the clitoris will become is different for everyone
- You will stop getting your period after a few months
- You might be more interested in sex
Precisely how hormones will change your body is different for everyone. It may be a while before you notice the changes. Are you worried or do you have any questions? If so, go to your doctor.
Do you feel like you are neither a man or woman? Or a bit of both? You might be non-binary. In that case, hormones can also help your body adjust to how you feel. Talk to your doctor about which hormones are best for you. Read more about non-binary genders here (Dutch only).
Operations
You can also have operations to have your body be more in line with how you feel. For example:
- Your breasts will be removed (mastectomy)
- Breast implants: your breasts will be made bigger. Do you take hormones? If you do, wait to have this operation until you can see what the hormones are changing about your breasts
- Your womb will be removed (hysterectomy). You will no longer have your period. Sometimes, the ovaries are also removed
You can also have operations on your vagina or penis.
- You will get a vagina (vagioplasty). That is sometimes called a neo-vagina.
- You will get a neo-penis. It is made from your clitoris and is very sensitive when you have sex (metoidioplasty)
- You will get an average penis. It’s made of a piece of skin from your arm or leg (phalloplasty). That is sometimes called a neo-penis
A neo-vagina or neo-penis looks roughly the same as the penis or vagina of people who are not transgender. Your future penis or vagina also feels and works roughly the same. There are also differences:
- You can come if you have a neo-penis. But no sperm comes out of your penis
- A neo-vagina does not produce any moisture or hardly any. That means you will need lube when you have sex
You don’t have to have an operation to be transgender. That is your choice.
Waiting lists
Unfortunately, there are long waiting lists for transgender health care. At the VUMC in Amsterdam, it takes up to two years before you can be seen for an initial consultation about your transition.
Read more about hospitals and waiting times here (Dutch only)
STI test
It is important for you get tested for STIs on a regular basis. That way, you can get the right health care if you have an STI and you can’t pass it on.
Not all doctors know quite what to look for when they do an STI test on a transgender person. This is important:
- Are you a trans man with a vagina? Tell your doctor or nurse. They will give you an STI test (a vaginal swab)
- Are you a trans woman with a penis? Tell your doctor or nurse. You will get a urine test to find out whether you have STIs in your bladder
- Are you a trans man and do you have a new penis (neo-penis)? You will get a urine test to find out whether you have STIs in your bladder
- Are you a trans woman and do you have a new vagina (neo-vagina)? In that case, you can also get an STI and pass it on through your vagina
Read more about STI tests for transgender people (Dutch only)
Take an STI test
Are you a sex worker? Then get an STI test twice a year. You can do this at your doctor’s officer or for free at the municipal health service (GGD). Then you will know for sure whether you have an STI. And you will get medicine for it right away.
Contact
Contact with other transgender people can feel very nice. They are going through some of the same things you are. That means you don’t have to explain everything.
The T-huis is in Amsterdam. They have a lot of projects operated by and for transgender people. Like encounter groups, for example. And self-defense courses. A lot of sex workers go to the T-huis.
Check out local contact groups (Dutch only)
Check out contact groups at various places in the Netherland (Dutch only)
Get three free Hepatitis B vaccinations
You can also catch Hepatitis B by having sex. Especially if you don’t use a condom. You can get very sick from it. Get vaccinated for free at the municipal health service (GGD) so that you don’t catch this STI.
