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Moving in from abroad and continuing treatment

Your knowledge of the Dutch language is a bit rusty or non existent, and Google Translate doesn't cut it for you?
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kirari-love
Berichten: 5
Lid geworden op: 09 nov 2022, 19:11
Gender: Trans MtF
Voornaamwoorden: she

Moving in from abroad and continuing treatment

Bericht door kirari-love »

Hii all, I am kirari and just moved here from abroad a few weeks ago
I am looking to continue my treatment in the netherlands

I had a few questions:

- Which health insurance should i get?
- Whats the strategy to continue hrt treatment or get it?
- Can a GP give me treatment?
- is there a way to get hrt faster?
- which type of hrt do they offer here? (monotherapy, injections, patches etc)
- do the doctors give progesterone? ( i use this as a testosterone blocker)

about me:
I am 27 years old
20 months in HRT
My name and gender is already correct
I have about 6 months of supplies of hrt.
I live in den hague

(onderwerp verplaatst naar Engelse sectie door admin)
Frederieke
Berichten: 816
Lid geworden op: 15 feb 2021, 12:45
Gender: Vrouw
Voornaamwoorden: zij/haar
Locatie: Drenthe

Re: Moving in from abroad and continuing treatment

Bericht door Frederieke »

Wow, you've got quite a lot of questions ... I'll try to answer as many as possible in one go.

Health insurance is a legal requirement in the Netherlands. And definitely worth a topic on its own. We've got quite a few providers and also various options per provider. If you're only interested in visiting GP's and general hospitals, choose the cheapest one. Otherwise, you'll have to look for the insurance provider that covers a specific hospital or health provider that you choose. Look for contracted health providers.

A GP can give you HRT treatment, but as a rule will refrain from it. They're basically bullied away from it by endocrinologists in hospitals. However, in greater cities such as The Hague, you're much more likely to find one who will supply you with it. Just ask around is my advice. And having a prescription from abroad will help you, I'm sure.

Get HRT faster? I think many people on this forum would like to, but faster than a GP? Small chance... You'll need an endocrinologist from a hospital, but there are waiting lists across the board. Sorry.

The type of HRT offered depends on your age. Since you're less than 30 years old, probably you'll get estrogen pills instead of patches or gel. As testosterone blocker, you'll either get cyproteronacetate pills, but much more likely, injections of triptorelin (decapeptyl / pamorelin).

Progesterone is not part of the standard treatments, as it has a higher risk of causing intravenous thrombosis.

Hope this helps.

Frederieke.
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_sanne_
Berichten: 167
Lid geworden op: 26 mar 2022, 01:45
Gender: Trans MtF
Voornaamwoorden: zij/haar
Locatie: Utrecht

Re: Moving in from abroad and continuing treatment

Bericht door _sanne_ »

Wait what? Are you telling me that, unless you go on the grey circuit, anyone moving in from abroad is forced to detransition because GP’s are still too scared to continue an established HRT treatment plan? That’s some BS right there. You don’t need and endo for an established regimen. You just need to continue it and monitor levels. Any GP should be able to do that.

I thought in the Netherlands they were trying to save on healthcare costs by taking stuff away from specialists and putting it into the hands of GP’s.

This sucks, especially since there’s a real chance I have to remigrate next year. No way I’m going to wait 2 years on some waitlist before I can continue my HRT regimen…
Frederieke
Berichten: 816
Lid geworden op: 15 feb 2021, 12:45
Gender: Vrouw
Voornaamwoorden: zij/haar
Locatie: Drenthe

Re: Moving in from abroad and continuing treatment

Bericht door Frederieke »

Disclaimer: I was born and raised in the Netherlands.

Of course, I'm not suggesting to detransition. Never in my life. But from what I've heard, it's not easy, unless you can bring your medical history. Then you're safe.

That is the crucial part I missed in @kirari-love's post. Hopefully I wrongly assumed this from her post and scared you unnecessarily.

Love, Frederieke.
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_sanne_
Berichten: 167
Lid geworden op: 26 mar 2022, 01:45
Gender: Trans MtF
Voornaamwoorden: zij/haar
Locatie: Utrecht

Re: Moving in from abroad and continuing treatment

Bericht door _sanne_ »

No I’m not saying you’re suggesting detransition. But if it’s true that for us from abroad there’s no “inside track” and GPs just refuse to take over treatment that’s what’s left for us. Which to me sounds inhumane but also strictly in line with the enormous amount of gatekeeping and waitlisting involved with gender affirming care.

I’ll be sure to get everything from my therapist and endo if it comes to remigration. This is another reason for me to pray that won’t happen though…
Frederieke
Berichten: 816
Lid geworden op: 15 feb 2021, 12:45
Gender: Vrouw
Voornaamwoorden: zij/haar
Locatie: Drenthe

Re: Moving in from abroad and continuing treatment

Bericht door Frederieke »

Paperwork is a life saver. Literally. When you've got that, you're good. Don't rely on the mail, electronic or otherwise. Bring it with you. A physical copy I mean. Preferably a spare one as well. Just to be sure. And then you're good.
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Marijntje
Berichten: 38
Lid geworden op: 02 dec 2017, 23:32
Gender: Trans MtF

Re: Moving in from abroad and continuing treatment

Bericht door Marijntje »

If you have a problem finding a GP, or just want one you can feel a bit safer with you can search on this website with a list of LHBTI+friendly doctors and GPs. https://www.rozeinwit.nl/zoek-arts/. It's in Dutch, yet I hope you can manage. Otherwise in the second drop-down 'Specialisatie' choose 'huisarts'. And under 'regio' the province you're in.

(Roze in wit means Pink in White)
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kirari-love
Berichten: 5
Lid geworden op: 09 nov 2022, 19:11
Gender: Trans MtF
Voornaamwoorden: she

Re: Moving in from abroad and continuing treatment

Bericht door kirari-love »

Hello everyone I am going to post an update now a few weeks afterwards, all of your comments where super usefull to get more insight into the system and I am very gratefull of them


After the first of november i was finally able to register with health insurance after getting registered for my bsn.

After 3 weeks I found a general practictioner available near my house in den hague and made an appointment this was by the start of december.

After visiting her she really couldnt tell i was trans and was wondering if I wanted to transition to male and told me she didnt knew what to do and then i explained her my situation and that I wanted to continue my treatment while living in the netherlands, she asked for some papers that my other doctort sent but the systems dont carry the same drugs because I take a combination of progesterone and estrogren enanthate that are not available in the system.

Today on the 27 I got my appointment to visit the doctor at the hospital but it is until april 13 which is pretty far away and I risk running out of meds by then, So I told that to the lady of the hospital and she told me to talk again with my GP and ask her for the medications


The problem is that she wants a recommendation on what to give me made by another doctor but preferebly one from the netherlands but since my doctor has no knowledge of the names of the drugs here its not easy for him to make a recommendation for the gp here.


So I am back now to convincing the huisarts to give me the meds but preferibly would like to get a letter on what is recommended.

Maybe i can get my doctor in mexico to write a recommendation letter for triptorelin and estrogen pills/patches?
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Irene_de_Vreede
Moderator
Berichten: 3606
Lid geworden op: 23 mei 2012, 22:26
Gender: Transgender
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Re: Moving in from abroad and continuing treatment

Bericht door Irene_de_Vreede »

It will be pretty difficult to get a prescription for medicines that are not registered over here.
Irene
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_sanne_
Berichten: 167
Lid geworden op: 26 mar 2022, 01:45
Gender: Trans MtF
Voornaamwoorden: zij/haar
Locatie: Utrecht

Re: Moving in from abroad and continuing treatment

Bericht door _sanne_ »

Oh my gosh, April? I'm so sorry to hear that! But how wonderful it must have been to have your GP wondering whether you were talking about FTM transition...

Anyway, you could start here:https://transfemscience.org/articles/e2 ... ent-doses/ for dosage equivalents.

As far as I know progesteron isn't part of the protocols in the Netherlands so you'll probably have to go without.

Are you using an anti-androgen right now, or is that achieved with the progesterone and sufficient estrogen levels? I don't think they particularly like mono therapy in the Netherlands either, but I see you're asking for triptorelin so maybe you're not doing mono right now'?

If you could get your doctor in Mexico to write you a recommendation for an equivalent regime in triptorelin and estrogen pills / patches / gel it certainly wouldn't hurt.

Any endocrinologist worth their salt shouldn't be fazed by having to convert estrogen enanthate SC/IM to some equivalent in pills / patches / gel / ... but I do understand their hesitancy, especially your GP's.. (And I remember having to convince my endo about gel instead of patches...)