Introduction
Norway is often praised for having one of the best public healthcare systems in the world. It’s meant to be a safety net for all citizens—affordable, accessible, and equitable. But for some of us, especially trans people, this promise is not always fulfilled. Behind the glowing statistics and well-funded institutions lies a harsh truth: Where do you go when the system fails to meet your needs?

As a trans woman, I’ve experienced firsthand how a world-class system can still let you fall through the cracks. And like many others in my position, I’ve had to turn to private healthcare—because when your life is on hold, waiting isn’t always an option.

The Promise of Public Healthcare
Norway’s public healthcare system is often described as a model for the world. It offers universal coverage, well-trained professionals, and relatively low out-of-pocket costs. For most people, it works—and in many ways, it does provide a strong foundation for national well-being.

However, systems designed for the majority often neglect the needs of minorities. For trans people, the process of accessing gender-affirming care in the public sector is not just slow—it can be dehumanizing.

The Reality for Trans People
In Norway, public transition-related healthcare is centralized through the National Treatment Service for Transsexualism (NBTK) at Rikshospitalet. Theoretically, it’s supposed to guide and support us through our transition. In practice, it often feels like a gatekeeping institution rather than a place of healing.

Rikshospitalet does not take the time to understand our opinions, our frustrations, or the struggles we live with daily. There’s a deep disconnect between the clinicians and the lived reality of trans people. Many professionals making decisions about our lives have never walked in our shoes, yet they hold all the power.

What’s worse, they make life-altering decisions based on outdated information. They often deny treatment after spending very little time with a patient. Instead of listening to where we are now, they dig through medical records that are 10, 15, or even 20 years old—and base their decisions on that. We are treated like case files, not people.

A System That Owns Our Bodies
The worst part? In the public system, we don’t truly own our bodies. We must prove ourselves worthy of the care we’re asking for. We’re told to be patient, to follow their pace, and to accept their judgment of what’s “best” for us—even if it goes against everything we know about ourselves.

This lack of autonomy is deeply painful. It conveys that we cannot make informed decisions about our bodies and lives. It’s not healthcare—it’s control.

Why I Turned to Private Healthcare
Eventually, I realized I couldn’t wait anymore. I couldn’t let a system that didn’t see me, didn’t listen to me, and didn’t respect me continue to decide the course of my life. So, I turned to private healthcare.

It wasn’t an easy decision. It’s expensive, and not everyone can afford it. But the difference in how I was treated was immediate. I wasn’t seen as a problem to be solved—I was seen as a person. I had a say in what I wanted, and my voice mattered.

In private care, I finally felt like I owned my body again. I could make decisions based on informed consent rather than jumping through endless hoops for approval. The process still has restrictions, of course—but it’s a world apart from the rigidity and disempowerment of the public system. If I had to put it into numbers, I’d say the freedom in private healthcare feels like 85%, while in the public system, it’s more like 15%.

The Emotional Cost of Denial
Every delay, refusal, and time I had to explain my existence to someone who didn’t understand took a toll. I started to doubt myself. I felt I was being punished for wanting to live as I am. My mental health suffered. I felt like my future was always out of reach, dictated by people who had never lived a day in my skin.

Imagine trying to build a life when you’re stuck waiting years for permission to be yourself simply. For many trans people, the emotional toll is unbearable. We’re told to be grateful for the system, even as it systematically breaks us down.

It Shouldn’t Be This Way
I know I’m not alone. So many trans people in Norway have similar stories—of being ignored, delayed, denied, and disempowered. Some give up. Some go abroad. Others, like me, spend money we barely have on private healthcare just to reclaim control over our lives.

But the truth is, we shouldn’t have to. Transition-related care should be accessible, respectful, and person-centered. We should not have to fight so hard to be heard. We should not have to wait for years only to be rejected. We should not have to feel like strangers in our healthcare system.

A Call for Change
The public system needs to change. It needs to listen to trans voices, not silence them. It needs to recognize that autonomy is not a luxury—it’s a fundamental part of healthcare. Trans people know who we are. We don’t need to be “evaluated” for years to prove that.

We need a model of informed consent, more clinics with capacity, professionals trained in trans healthcare who treat us with empathy, not suspicion, and a stop to relying on decades-old records to decide our futures.

Conclusion
Norway’s healthcare system is one of the best in the world—but even the best can fail when it refuses to listen. For trans people like me, that failure isn’t just frustrating. It’s life-changing. It puts our futures on hold. It tells us we don’t matter.

Until things change, private healthcare is sometimes the only way forward. But that shouldn’t be the case. Everyone deserves to own their body, choices, and identity—regardless of income. Healthcare should empower us, not control us. And the first step toward that is listening.