Revolutionary Medical Transition Protocol for Young People in the Netherlands

In the 1980s, a groundbreaking shift in medical treatment for young people experiencing gender dysphoria took place in the Netherlands, spearheaded by Dutch clinical psychologist Peggy Cohen-Kettenis. At the time, therapy alone was not enough to address the struggles these teenagers were facing as their bodies developed in ways that did not align with their gender identity.

Cohen-Kettenis took a bold step by starting hormone treatments for some of her patients at the age of 16, rather than waiting until the standard age of 18. She closely monitored their progress and was amazed to see significant improvements in their well-being. This success led to the establishment of a treatment protocol that revolutionized the approach to medical transition for young people.

One of the first patients to benefit from this new protocol was referred to pediatric endocrinologist Henriette A. Delemarre-van de Waal at the age of 13. By putting the patient on puberty suppressants, they were able to pause the development of secondary sex characteristics, providing relief from the distress of going through the wrong puberty. This approach bought time for the patient to make decisions about further medical interventions, such as hormone therapy.

Despite facing opposition and accusations of recklessness from other doctors, Cohen-Kettenis and her team at the Amsterdam clinic remained steadfast in their commitment to providing comprehensive care for young people experiencing gender dysphoria. Through stringent screenings and assessments, they aimed to ensure that each individual received the most appropriate treatment, whether that be therapy, medication, or a combination of both.

The Dutch approach, known as “watchful waiting,” emphasized the importance of allowing young people the space to explore their gender identity while keeping the option open for them to change course if needed. This approach led to significant numbers of adolescents going on to receive hormone treatments and undergo surgery, ultimately helping them align their physical bodies with their true gender identity.

Despite the challenges they faced, Cohen-Kettenis and her team’s pioneering work in the field of medical transition for young people has had a lasting impact, paving the way for more inclusive and comprehensive care for individuals experiencing gender dysphoria.