Just Read: Transgender Adolescents develop into well adults with comprehensive care (“The Dutch Model”)

I thought I had posted about this study following our visit to Vancouver Coastal Health as part of KPLantern, where I found out about it (Thank you Gail Knudson, MD!), but I hadn’t, so here it is.

What’s the Dutch model?

A protocol designed by Cohen-Kettenis and Delemarre-van de Waal14 (sometimes referred to as “the Dutch model”) considers adolescents, after a comprehensive psychological evalua- tion with many sessions over a longer period of time, eligible for puberty suppression, cross-sex hormones (CSH), and gender reassignment surgery (GRS) at the respective ages of 12, 16, and 18 years when there is a history of GD; no psychosocial problems interfering with assessment or treatment, for example, treatment might be postponed because of continuous moving from 1 institution to another or repeated psychiatric cri- ses; adequate family or other support; and good comprehension of the impact of medical interventions.

This is a study of 55 young adults who are transgender, treated with this protocol, and assessed at three points (before, during, 1 year post-gender affirmation surgery) for psychological functioning, social functioning, and subjective assessements such as satisfaction and quality of life.


Results of this first long-term evaluation of puberty suppression among transgender adolescents after CSH treatment and GRS indicate that not only was GD resolved, but well-being was in many respects comparable to peers.

Compared to controls, interestingly, the subjects in the study were more likely to be pursuing higher education.

Clinicians should realize that it is not only early medical inter- vention that determines this success, but also a comprehensive multidisciplinary approach that attends to the adolescents’ GD as well as their fur- ther well-being and a supportive environment.

In other words, properly delivered multidisciplinary care – at the right point in an adolescent’s life – can product excellent health and productive lives. Sounds like a good reason for health care to exist 🙂

1 Comment

Ted Eytan, MD