The Gender Well-being Clinic has been without the services of a psychiatrist for the last seven months, a situation that has had a negative impact on the continuation of gender-affirming care, the Malta Gay Rights Movement (MGRM) said.

The public health entity, which caters to the various needs of transgender people, in particular throughout their transition, can only do so much with its team of nurses and social workers, as the psychiatrist has a crucial role in allowing transgender people to access more concrete gender affirming care, the MGRM said.

In spite of this shortcoming, it was only a few days ago that a call for tenders was issued for the employment of a psychiatrist.

Speaking to The Malta Independent on Sunday, the MGRM said that though the service provided is good overall with “all healthcare workers doing their utmost to provide a standard of care which is acceptable”, the absence of a psychiatrist for at least seven months, since EuroPride 2023, has disrupted the process for transgender individuals seeking access to therapy and surgery for transitioning, consequently hindering their ability to obtain essential care.

MGRM explained that the clinic’s psychiatrist is responsible for assessing the person’s situation and making sure they are mentally capable of their decision to transition. Furthermore, without the psychiatrist’s go-ahead, transitioning persons are unable to access hormone therapy and gender-affirming surgery.

It was stated that it is unjust for certain people, who have waited on the gender-affirming surgery waiting list, possibly for years, to finally reach their turn only to be unable to proceed due to the absence of a psychiatrist. MGRM noted that the clinic continues to offer support to transgender individuals through psychotherapy and other means. However, the obstacle to such treatment resulting from the absence of a psychiatrist severely hampers the necessary care.

MGRM has always kept an eye on the situation of transgender people in Malta, it said, and only found out about the situation on being approached by transgender people who couldn’t receive the psychiatric services first-hand. Furthermore, MGRM found that the transgender persons who reached out had had their appointments cancelled and not rescheduled. Ultimately, they were barred access to hormone therapy and the possibility of gender affirming surgery, it said.

MGRM reached out to the Ministry for Health last January to air their concerns, however the only reply it received was an email of thanks. It added that it has not received any update to date.

While MRGM lauds the efforts being carried out currently by the Gender Well-Being Clinic, it stated that they are pushing for the psychiatric service to be resumed urgently and emphasised its need.

The Malta Independent on Sunday has also reached out to persons attempting to start the gender-transition process via the Gender Well-being Clinic.

Their journey hasn’t been smooth so far, they said, and despite two referrals from two GPs, they have been waiting for a reply for at least three weeks. They also tried to call the numbers given by the clinic’s website and “nothing, no one ever answered the calls”, they said.

MGRM said that in their experience and through members of their team, who have used the clinic's services, the clinic has answered emails within a week when contacted via email directly.

“The phone is not manned at all times, but emails are the best method of reaching the clinic,” it concluded.

The person attempting to receive care finds it “sad” that despite “taxes flying off [their] paycheque” they cannot get the help they need. They added that the country should be getting the healthcare it needs just as swiftly as taxpayers contribute their funds. 

When questioned about the importance of this care, they said that in the first place gender-affirming care isn’t exclusive to the LGBTQ+ community. People of all sexualities could require such care that they believe “aligns better with their gender”, they said, and went on to cite breast enhancement surgery.

The lack of care has repercussions on mental health, they said. They currently do not feel that they are doing well and feel that something is “missing”, the latter being the care that could help them lead a more “fulfilling” life. They expressed that they cannot keep living this way, living in a body within which lives another gender.

At this point, MGRM referred to a document, published in 2023, by Deputy Prime Minister Chris Fearne, which clarifies what “transgender” means: “An inclusive umbrella term referring to people whose gender identity and/or gender expression differ from the sex/gender they were assigned at birth… which does not meet the societal and cultural expectations placed on gender identity.”

The document also reiterated the importance of gender affirming care: “Evidence has shown that transgender persons frequently report bad overall health, increased patterns of substance abuse, sexually-transmitted infections, mental distress with also high rates of suicidal ideation. Furthermore, research shows that transgender persons are reported to have actually attempted suicide more often than the general population.”

The person attempting to receive care urged people to think of their own families and the possibility that some day, someone they love could require help from the Gender Well-Being Clinic and the detrimental consequences of a delay in that care.

On 19 April, a call for tenders was issued in the Government Gazette for consultant psychiatrist with Special Interest in Gender Identity and Sex-characteristics related conditions at the Office of the Chief Medical Officer.