In some countries, transgender care is difficult to access or even completely absent. Belgium offers a wide range of specialized transgender care, whether you have already started or are just at the beginning of your care journey. Below, we list a number of steps that are best to go through when looking for transgender care in Belgium.

Find a general practitioner

The first step is finding a general practitioner (GP; NL: huisarts). A GP plays a central role in Belgian healthcare and can help you with an initial assessment of your care needs. The GP can refer you to specialized transgender care, such as endocrinologists, psychologists, multidisciplinary gender teams, etc.

If you have previously received transgender care in your home country, provide your new GP with as much medical information as possible (for example, a summary of your medical file, referral letters, lab results, medication prescriptions, contact details of the doctors who previously treated you, ...). Preferably, this information is translated into English, French or Dutch.

You can find a GP working in your area via:

You can also drop by a general practice or contact them by phone or email, and ask whether they are still accepting patients. Many GPs have a patient cap and are temporarily not accepting new patients. 

If you do not yet have health insurance through a health insurance fund (e.g. CM, Solidaris, OZ,...), you pay the full price for a GP consultation, without reimbursement. If you are affiliated with a health insurance fund, a large portion is reimbursed and you often pay only a few euros yourself.

If you are staying in an asylum center or LOI

If you are staying in an asylum center (Fedasil, Red Cross,...) or local reception initiative (LOI), you are also entitled to care.

  • Each center works with GPs or has its own medical service.
  • You usually receive medical care within the center or through a doctor the center works with.
  • For specialized care, you receive guidance and a medical card or authorization through the center.

If you have no papers

As a person without legal residence in Belgium, your options are more limited, but you always have the right to urgent medical care (DMH). This is established in legislation, and implementation is handled by local authorities. How do you obtain DMH?

  • Obtain a "medical necessity" certificate

Make an appointment with a (general) practitioner and ask for a certificate of 'urgent medical care' stating that medical care is necessary. 

  • Submit an application to an OCMW/Social House or CPAS

Make an appointment at the OCMW/Social House or CPAS of the city or municipality where you are staying and provide them with the previously obtained 'urgent medical care' certificate. You can also go directly to the OCMW/Social House or CPAS and ask for a referral to a (general) practitioner without having to pay yourself. 

A social investigation is conducted to assess whether you are truly without legal residence in Belgium and have no financial resources. 

  • Wait for the decision and payment commitment

If the OCMW/Social House or CPAS agrees, they issue a payment commitment (medical card). With this card you can have the medical care carried out without paying in advance. The OCMW/Social House or CPAS pays the care provider. 

Sometimes it may take a while before the approval is finalized. There is no fixed legal deadline. If it concerns a genuine emergency, the doctor at the hospital can immediately draw up a certificate and the OCMW must be contacted quickly, after which the procedure can be expedited. 

What is understood by "urgent medical care"?

The care provided within the 'urgent medical care' framework is broader than the term suggests. Urgent does not only mean life-threatening. The law does not specifically mention which types of care fall under this, so it is up to the treating physician to assess what care is needed to protect physical and psychological integrity. 

In practice, this concerns medical care, medication, diagnostics or preventive care for which reimbursement by RIZIV is provided for insured persons. 

Request a referral to specialized transgender care

In Flanders there are various care providers and centers specialized in transgender care, including:

Depending on your situation, your GP can refer you to an appropriate care pathway: psychological support, starting or continuing a hormonal treatment, social guidance, ... A diagnosis such as gender dysphoria or gender incongruence is required to obtain partial reimbursement.

In Belgium there is high demand for transgender care. Be aware of possible waiting times, especially at gender teams, where waiting times can range from several months to years. Your GP can carry out the necessary medical check-up in the meantime. 

Read what you can already do yourself while waiting.  

Not every gender team accepts foreign patients, due to the fact that there are already long waiting times for domestic patients. Or they have a separate waiting list for foreign patients, which is often longer.

A hospital may not refuse urgent medical care (e.g. emergency care), but for non-urgent medical care there may be restrictions. For example, hospitals can require advance payment. If you cannot present a health insurance card or proof of insurance, the hospital may postpone or refuse care until financial security is established. It is therefore strongly advised to join a health insurance fund and possibly take out a hospitalization insurance policy.

Convention transgender care

Of the 7 centers offering transgender care in Flanders and Brussels, 5 operate under the transgender care convention. This means that for patients with Belgian health insurance, the psychosocial sessions are almost fully reimbursed. This applies at: UZ Gent, ZOL Genk, VITAZ Sint-Niklaas, ZAS Antwerpen and Erasmus Brussel-Anderlecht.

Foreign patients who do not have Belgian health insurance cannot benefit from this favorable arrangement. However, this is separate from access to care: they can still be seen there but at the full rate.

Care brochure

The Transgender Infopunt developed a care brochure in 7 different languages . This care brochure contains concise information about transgender care in Flanders. Be sure to read it. Should you have more specific questions, or wish to have help finding good care, you are always welcome to contact the Transgender Infopunt. You can reach us by:

For an in-person or (video)chat appointment it is best to first make an appointment by email or phone, so that we can be sure to set aside enough time for you. You are welcome to bring an interpreter or a trusted person, or we can arrange an interpreter for you.

Starting medical care with a foreign referral letter

Medical specialists, such as endocrinologists and surgeons, often require a referral letter from your psychosocial care provider before proceeding with gender-affirming hormone treatment or a procedure. A diagnosis of gender dysphoria or gender incongruence is not required for access to care in Belgium (but is often required for reimbursement).

Ask your non-Belgian care provider to include as much information as possible in the referral letter. View here the information document that outlines what such a referral letter should ideally look like.

Continuing medical care in Belgium

A previously started hormonal treatment can be continued, but be aware that not every gender team or endocrinologist is willing to do so. If, for example, you come from a country where hormones were difficult to obtain, it is possible that you have applied self-medication via the internet or other sources. In such cases, doctors often choose to propose a new, safer treatment.

If you are temporarily residing in Belgium with, for example, a student or work visa, you may wish to continue the treatment you already started in your home country. This is especially the case with a hormonal treatment that naturally must be continuously monitored. You can contact a GP or endocrinologist to monitor your blood values.

Medication prescriptions from abroad can in some cases be used in Belgium, but there are important restrictions and conditions. Here are the main points:

European prescriptions

A prescription from a doctor in another EU or EEA country may be accepted in Belgium, but:

  • Not every Belgian pharmacy accepts it automatically;
  • The pharmacy must know the medication and be permitted to dispense it in Belgium;
  • The prescription must comply with European guidelines. 

Preferably use a "cross-border prescription". This is a standardized prescription intended to be recognizable throughout the EU.

Non-European prescriptions

Belgian pharmacies may not dispense medication on the basis of prescriptions from non-EU countries. You will therefore need to consult a Belgian doctor for a new prescription, even if you are already using your medication.

Inquire about costs and insurance options

If you are legally residing in Belgium, you are often entitled to join a health insurance fund. This gives you access to partial reimbursement of medical costs. In addition to that membership, you can also take out a supplementary health insurance and/or a hospitalization insurance through your health insurance fund or a private insurer. The latter is particularly useful if you wish to have a surgical procedure and will be staying in hospital for a period of time.

Are you still in a procedure or do you have an unclear residence status? In some cases you may be entitled to reimbursed urgent medical care, which can also include transgender care. Contact a CAW or OCMW in your area for guidance.

Without legal residence you are excluded from health insurance. You can then only obtain care through the separate system of 'urgent medical care'. Certain Dutch insurance policies do provide reimbursement for care received in Belgium.

Most gender teams have a social worker who can assist you with all practical and financial matters. All public hospitals have a social service or desk where you can go with all your questions regarding costs. You can also request a quote there. Note: administrative fees may be charged for this.

On our web pages on insurance you will find extensive information about the costs associated with consultations, medication, hospital admissions and procedures. 

Medical costs for asylum seekers are reimbursed by Fedasil if you are staying in a reception center, and reimbursed by OCMW if you are staying in a LOI. If you have already started hormone treatment in your country of origin, you will receive reimbursement for the continuation. You are not entitled to reimbursement if you are starting for the first time in Belgium.

Inquire about an interpreter or language assistance

Not all care providers speak multiple languages. If Dutch is difficult for you, ask whether there are care providers who speak English or your native language. In hospitals or official institutions you can call on an interpreter. You request this from the hospital or the service itself. You can often find information about this on the institution's website, or inquire about it at the social service.

If you are looking for a care provider via our care map , you can filter by language (Dutch, English, French, Spanish, Portuguese and German).  

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