The Dutch Approach of Clinical Management of Children and Adolescents with Gender Dysphoria


VU University Medical Center, Center of Expertise on Gender Dysphoria, Amsterdam, Netherlands


Over the last decades, the number of children and adolescents that come to the Center of Expertise on Gender Dysphoria at the VU University Medical Center in the Netherlands for assessment, counseling and treatment, has substantially increased. This increase is in line with referral rates to other specialty gender clinics in Europe and North America.

The presentation will briefly introduce relevant terminology, then go deeper into gender conforming and gender nonconforming development in children and adolescents. It will show what is known about the ‘course’ of gender dysphoria and gender nonconformity and it will discuss the processes and factors associated with the desistance and persistence of pre pubertal childhood gender dysphoria and gender nonconformity in children and adolescents.

After providing theoretical knowledge about gender identity development, clinical information of our patients is presented. Gender dysphoric feelings often cause great distress in children and adolescents; psychological functioning and comorbidity rates vary and seem to be associated with the level of social tolerance and acceptance of gender nonconformity.

The presentation will then focus on the Dutch approach on clinical management of children and adolescents with gender dysphoria, in which children can be eligible for puberty suppression around the age of 12 years, cross sex hormone treatment around the age of 16 years and gender affirming surgery after age 18. Additionally, data on follow up studies will be provided.