The new Federal Government Agreement in Belgium pays a lot of attention to LGBTQIA+ people and their well-being, but does not include everyone. Flemish umbrella organisation Çavaria is ready as a partner to strengthen the policy in all departments and to address the gaps in the coalition agreement. 

The NGO read and analysed the document.

Step forward

Çavaria is pleased that the new coalition agreement pays specific attention to the protection of intersex people and the regulation of surrogate parenthood. 

“We are also satisfied with the proposed approach to violence against LGBTI+ people and the care of LGBTI+ victims of sexual violence. These are important steps forward”, the organisation says

Strengthening trans people is positive

“We also welcome improvements in healthcare, such as the low-threshold offering of PreP (preventive method against the HIV virus). The strengthening of care for trans people is also positive; these investments should provide çavaria with a solution for all care needs of both young and adult trans people. We see in the coalition agreement an ambition that is necessary for an inclusive society.”

What about recognition of non-binary people and LGBTI+ people in vulnerable situations?

“Nevertheless, we remain critical. We miss a long-awaited, broad recognition of non-binary people. We are particularly concerned about LGBTI+ people in vulnerable situations, such as refugees. The new government’s plans regarding asylum and migration threaten to create additional barriers for them and endanger their personal safety.”

Strong and financial commitment needed for international solidarity

International solidarity is another concern. Although the government is committed to defending human rights worldwide, this must be accompanied by concrete investments. The global decline in support for LGBTI+ organisations, partly due to the consequences of the policy of US President Donald J. Trump, requires a strong and financial commitment from Belgium. Development cooperation must not be the victim of budget cuts.”

Cuts to Unia are worrying

In addition, the announced cuts to equality institutions such as Unia are worrying. 

“If the government really wants to tackle violence and discrimination, we need strong institutions that support victims and ensure that discrimination and violence can be easily reported. Without sufficient resources, the government is undermining its own ambitions in the fight against inequality.”

Çavaria as a partner

“It is now up to the new government to ensure that LGBTI+ rights and inclusion are anchored throughout all policy areas. Çavaria is ready as a partner to strengthen policy in all departments and to address the gaps in the coalition agreement.”

Battleground: hormones?

After çavaria made its statement, newspapers reported the new ‘Arizona’ Gorverment wants to review how trans teens are helped, or not helped.

The use of puberty blockers for young people who do not feel comfortable with their biological sex has been reduced in several European countries. The new federal government now intends to commission an investigation into this controversial treatment.

The number of children and young people registering with the paediatric gender team at Ghent University Hospital has increased significantly. Between 2021 and 2023, more than 250 boys and girls who felt discomfort with their birth sex sought help each year. Until 2016, this number was fewer than fifty per year.

Similar to trends in other Western countries, there has been an exponential rise in the number of young people seeking assistance for gender-related distress. The new federal government plans to instruct the Federal Knowledge Centre for Health Care (KCE) to study the care provided to young people experiencing gender dysphoria.

Belgium will join other countries in critically evaluating medical treatments prescribed for young people with this condition.

The coalition agreement states that the use of hormone blockers in young people must be examined based on scientific evidence. These drugs prevent children from developing secondary sexual characteristics, such as breasts, beards, or changes in voice.

At Ghent University Hospital, approximately 14 per cent of young people supervised by the paediatric gender team since 2007 have been prescribed puberty blockers. Among girls who have taken or are taking these drugs, half began treatment before the age of 12. Among boys, half started before the age of 14.

For the majority of young people who take puberty blockers, this is the initial step in their medical transition. Most later begin hormone treatments that align with their gender identity, according to figures from Ghent University Hospital.

The office of Minister of Health Frank Vandenbroucke (Vooruit) stated that the research aims to ensure the best possible care for young people with gender dysphoria.

There is an ongoing debate within society and among medical professionals regarding the use of hormone blockers. Questions have been raised about when treatment should begin and what impact it has on the human body. For this reason, the KCE has been asked to compile all available international scientific evidence.

Other countries have already conducted similar reviews. Last year, the United Kingdom restricted the use of puberty blockers in young people after an extensive study concluded that the treatment was based on weak evidence. The study found no clear indication that puberty blockers reduce mental health issues or suicidal thoughts in teenagers with gender dysphoria. An independent expert group also stated that prescribing these drugs to children posed unacceptable safety risks.

Denmark, Finland and Sweden have also severely restricted the use of puberty blockers and other hormone treatments for young people with gender dysphoria.

These policy changes followed findings that the number of prescriptions had risen sharply, particularly among teenagers born as girls. The reasons behind this increase remain unclear. It could be due to greater societal openness encouraging more trans young people to seek help, or it could be influenced by social factors, including exposure to discussions on social media.

In Belgium, Patrik Vankrunkelsven, director of the Centre for Evidence-based Medicine (Cebam), has repeatedly called for a more critical examination of puberty blockers. He has raised concerns with Minister Vandenbroucke, stating that the treatment is drastic for young people who are still developing and lacks strong scientific backing.

He believes that previous studies from reputable research institutions have already demonstrated this and argues that additional research by the KCE would be unnecessary. Vankrunkelsven has advocated for a ban on prescribing puberty blockers to adolescents, suggesting instead that more focus should be placed on providing psychological support. He also noted that teenage girls presenting with gender dysphoria often have other underlying issues, such as ADHD or autism spectrum disorder.

The paediatric gender team at Ghent University Hospital has expressed willingness to cooperate with the research. Paediatric endocrinologist Martine Cools emphasised the importance of a nuanced discussion on the topic and voiced concerns about the growing opposition to trans people globally.

She stated that the young people treated at the hospital are highly vulnerable and welcomed any initiative aimed at improving their care. However, she warned that restricting the use of puberty blockers without providing additional support could leave young people struggling with gender dysphoria without adequate care.

Cools expressed confidence that the research would confirm that her team has always acted cautiously in prescribing hormone blockers. She explained that treatment decisions are made collectively by a team, including a child psychiatrist, following a lengthy evaluation process. She also stressed that the goal was never to prescribe puberty blockers to as many young people as possible.

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