I'm from the Netherlands and while generally the quality of trans health care is good here, and most areas are accepting, the problem is accessing it. I regularly hear about friends and their friends etc who have been stuck on waiting lists at the main clinics for years. The most dangerous part in my opinion is a lack of information. There are other options besides the two main ones, but barely any GPs are aware of this, so you get referred there anyway and the list gets longer and longer.

You have to get HRT through a doctor, be it from a clinic or GP, and I'd say 99% of the time you need a gender dysphoria diagnosis for that. GPs are discouraged from giving trans people HRT by the main clinics who recommend they, the experts, handle everything. The diagnosing process can be quite lengthy, several months of appointments here and there before you get one.

As for legal document changes, you need a diagnosis and an expert's evaluation. You can just lie at the evaluation, so the diagnosis is the hardest part. There's also a fee which differs depending on whether you get it done through a clinic or independently. From what I've heard an X marker is still very hard to get, though it has been done.

Surgery is only possible after you've been on HRT for a while, and only through official clinics. I don't know the exact marks for everything, but top surgery requires 6 months of HRT before a referral, which then places you on yet another waiting list. Exceptions can technically be made for non binary people, but binary thinking is still common. Bottom surgery has a few years long waiting list from what I've seen. There is of course the option of going to a private clinic in another country, but that's not something many people can afford.

In terms of insurance, I'd say things are handled well. Trans healthcare is considered essential and the basic health insurance covers almost everything. I think some things like laser hair removal might not be included.

Personal experience:

Finally came out in feb 2021, let my GP put me on a main clinic's waiting list, found out about the waiting period and decided they could go fuck themselves and I was gonna find an alternative. Let my GP put me on a waiting list for a trans support psychologist, and started treatment there in August. In the meantime I had found out legal document change was possible without a clinic, so since my psychologist had diagnosed me I was able to get it done. I had it sorted in October and iirc it cost me ~225 euros total. A little while later I started speech therapy to have something to do while waiting.

My psychologist who's of course active in medical trans circles, found out a new (18+) clinic was opening and told me about it, recommending I'd apply quickly before word spread further. I did, and the doctor there turned out to be amazing, he told me to get my blood checked after which I could start HRT. I started early January. When it comes to social acceptance, I've only ever been misgendered on accident.

Others' experiences:

My best friend is still underage so their options are way limited. They'd been on the main clinic's waiting list for about 4 years and finally had a first appointment late last year. They had to go to a mental health clinic first to work on their mental health, which I thought was stupid since adequate trans health care would help them a lot more. The waiting has been seriously hard on them.

Another friend had been on the main clinic's waiting list for 3 years and he was recently contacted to make a first appointment.

A classmate I ended up talking about trans health care with turned out to have been rejected by the main clinic when she was a kid, because she was still questioning at the time and everything was really new for her. These days she has been unable to access trans care.

A trans woman I used to go to school with mentioned she was on a waiting list for a different clinic, that then went bankrupt. She has been diagnosed and gets HRT through her GP now.

Summary:

Socially everything's decent, medically the quality is too, but the access is horrible and has cost people their lives.