Abstract

This study examines a 2014 policy change in the Netherlands that simplified the process to legally transition gender. Administrative data for 2006-2022 indicate that there was a 725 percent increase in transitions after the policy change, suggesting that legal gender transitions are elastic to costs and barriers. The policy change was followed by a ten-year reduction in the average age at transition and a reduction in the use of gender-affirming care in the three years prior to transitioning. This research sheds light on how policy changes can influence decisions related to gender transitioning and the use of gender-affirming care.

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