On this page you’ll find some handy information special for transgender asylum seekers and refugees, but also for other foreigners, about the health care situation in the Netherlands in general, for transgender people, for asylum seekers in general and for transgender asylum seekers. Followed by information on activities by Transvisie for trangender asylum seekers and refugees, and activities by other organisations.
- Refugee: a refugee is someone who has a legitimate fear of being persecuted because of religion, political beliefs, sexual preference, race or social class.
- Asylum seeker: an asylum seeker is someone who asks another country for protection by requesting asylum.
- Status holder = permit holder: asylum seeker who has been recognised as a refugee and has been granted a residence permit.
- Naturalised: when a non-citizen in a country acquires nationality of that country.
In the Netherlands asylum seekers are granted a residence permit only if they come from unsafe countries, or if someone is in danger because of individual causes. Being LGBT is dangerous in some countries. The IND has information on how this is tested and the Rijksoverheid has information on safe countries. The country of first arrival, where you will be identified, will have to consider your request (Treaty of Dublin). If you want to travel to the Netherlands a visa is required in most cases.
The application process goes as follows:
- Registration (Ter Apel): First hearing, the reason of flight will not be discussed. It is not necessary to talk about your LGBT background during the first hearing.
- Asylum COA AZC: resting and waiting time, you get a lawyer
- General asylum protocol (8 days by the IND), potential prolongation
- When you get no residence permit: go back to the country of origin by yourself or with the help of the Dienst Terugkeer en Vertrek (DT&V)
- When you get a residence permit: you will go back to the asylum, wait for a residence, work and family reunification.
Request by a person who is LHBT: werkinstructie IND.
- You don’t need to tell the reason LHBT in the first hearing, you can tell that later.
- The IND will not ask you for pictures as prove or ask questions about details of your sex life.
Transvisie, Transgender Netwerk Nederland (TNN), COC and some single volunteers shares knowledge and experiences and undertakes action to improve the situation of transgender refugees. If you are in search of more information than the health care information on this page, please refer to the English webpage of TNN for more general information.
Health care in de Netherlands in general
- In the Netherlands there is a wide availability of GP’s, therapists, hospitals, health practitioners and dentists offering all sorts of care.
- Everybody form 18 years and older, living in the Netherlands is obliged to have a health insurance. Children under 18 year are also obliged to have a health insurance but they pay no insurance premium.
- Health insurance is semi-commercial in the Netherlands. It is mandatory with an ‘eigen risico’ (a limited, but fairly big amount (€385 a year) to pay for yourself) and one or more mandatory contributions. The ‘eigen risico’ doesn’t apply to GP health care.
- The baseline health insurance is defined by our government (‘basisverzekering’). It covers GP, hospital care, psychological care and some other health practitioners (partly). Dental care is not covered. All health insurance companies offer this ‘basisverzekering’, rates and conditions vary.
- On top of that, health insurance companies offer extra insurance modules (‘aanvullende verzekeringen’) to cover all kinds of other health costs like dentists, extra sessions with a physiotherapist, etc.
- To get a health insurance, you need a bank account and a BSN (social security number). To get a BSN you need a refugee-permit (‘status’). For asylum seekers still in procedure, there are special health provisions (read ahead).
- For a proper health insurance, please don’t take a ‘budget polis’! You need a so called ‘restitutiepolis’! in order to have more of your expenses covered.
- If you work in the Netherlands or when you study over here and you don’t have a sufficient income you can get “zorgtoeslag” from our tax organisation (Belastingdienst).
- Students from another EU/EER country, who are insured in the country of origin, can contact CZ Zorgverzekeringen (046 4595812) to get acces to Dutch health care without paying for a Dutch insurance.
- Students not from a EU/EER country can temporarily insure themselves through a Schengen Visitors assurance by Oom-verzekeringen.
- Students who are also working in the Netherlands need a Dutch health insurance.
Health care in the Netherlands for transgenders
- You need a referral from your GP/doctor to go to a specialist transgender care practitioner.
- The transgender health care is provide in the Amsterdam UMC (VUmc), UMC in Groningen and a few other practitioners. See our webpage ‘behandelaars‘.
- The Amsterdam UMC and the UMCG offer psychology, hormone treatment and surgery. Both hospitals have long waiting lists. Not only for the first psychological session, but also before hormone treatment and before surgery.
- Hormone treatment for MtF is based on estradiol (oestrogen) and a testosterone-suppressant.
- Hormone treatment for FtM is based on testosterone, injectable or gel.
- If you have a Dutch health insurance, treatment is nearly fully covered. There are some limitations though. For instance not all sorts of testosteron are covered by the ‘Basisverzekering’. There are more limitations, so ask for information about this at te hospital. The ‘Basisverzekering’ covers psychological help, hormone treatment (the hormones itself as well as the monitoring by the doctor) and the SRS (surgery) (see also our page (in Dutch) ‘Zorgverzekering-vergoedingen‘.
- For MtF the health insurance also covers facial hair removal (limited) and facial surgery (under strict conditions). Breast enhancement is not covered.
- For FtM the health insurance also covers mastectomy, hysterectomy and colpectomy.
- You need approval from the genderteam from the hospital and their psychologist before any surgary is being performed.
- If you have been diagnosed as ‘genderdysphore’ in your country of origin, the possibility exists that the hospital adopt this diagnosis.
- If possible, bring as much possible information from psychologists, doctors etc. in English from your country of origin.
- If possible, take sufficient hormone medication or a prescription with you to cater for at least 1 1/2 year.
Activities by other organisations for (transgender) asylum seekers and refugees
- The COC has buddy projects for (transgender) asylum seekers and refugees. See for information.
- I-psy has started a LGBTI-team in Amsterdam for LGBTI-migrants, expats and refugees with a psychic complaints. See for information their website.
- Stichting Trans United Nederland organizes a peer group in Amsterdam special for transgenders with another cultural background.
- Asylun Support for information and buddy’s.
- Rijksoverheid: Page at Play Store to an App with information for refugees about their rights in The Netherlands (several languages).
Health care in the Netherlands for asylum seekers
- As long as you, as asylum seeker, are still in procedure, you cannot get regular health insurance.
- There is a special health insurance for asylum seekers. It is defined by our government and described in the RMA (‘Regeling Medische Zorg Asielzoekers‘) (in Dutch!). It covers GP, specialistic health care, psychological care.
- RMA covers psychological support for transgender persons as well as hormone treatment (as long as you already had this treatment in your country of origin). Not covered in the RMA are starting hormone treatment or other treatment or surgery for transgender persons.
- This insurance is provided by Arts en Zorg via RMA healthcare en GZA healthecare. GZA in English en GZA in Arabic.
- For GP health care there are special doctors at or near the AZC.
- There is no ‘eigen risico’ and no other contribution at the RMA.
Current issues in transgender health care for asylum seekers
- Only very few GP’s at the AZC’s have specific knowledge of transgender issues. Of course they have some basic knowledge but not enough for treatment. In general, they don’t know that some transgender health care is covered by the RMA insurance.
- GP’s at the AZC experience limited access to colleagues at the Amsterdam UMC (VUmc) or UMC in Groningen to help them to offer care.
- Since there are almost no independent endocrinologists available outside the AUMC and UMCG, GP’s from the AZC have limited options for referral.
- AUMC and UMCG have an unclear policy about quick entry for asylum seekers who were diagnosed as genderdysphore and who were having hormone treatment in their country of origin.
- It really depends on the individual GP what they can achieve for you.
- You can only register at the hospital if you have a formal status.
- Our organisation tries to solve these issues by advocacy and deliberation with COA, government, health carers and insurance company.
Activities by Transvisie for trangender refugees
Transgender refugees can meet other trangenders at the peer groups from Transvisie. Transvisie has a lot of peer groups all over the country. See our page ‘onderling contact‘.
Transvisie offers support to transgender asylum seekers and refugees. We answer questions regarding safety or transgender healthcare for asylum seekers (see contact details).
If you would like to have direct contact with one of our employees, you can also apply for them to visit you at the asylum centre. You can e-mail email@example.com
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