The Malta Independent 26 April 2019, Friday

Transgender Healthcare: Leaving nobody behind

Chris Fearne Sunday, 13 January 2019, 09:23 Last update: about 4 months ago

The mantra associated with the Sustainable Development Goals is that of leaving nobody behind. In taking bold steps to develop health care services for transgender persons, we are effectively giving testimony to the fact that, for this Government, leaving nobody behind is not merely a slogan but is something we work to achieve assiduously every day.

Transgender inclusive health care can profoundly increase the quality of life for transgender persons. This service may only have an impact on a few hundred persons and their families but, for us, every single individual and their needs is of paramount importance.

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Earlier this week I had the pleasure of witnessing first-hand the clinic for gender well-being delivering services to transgender persons. This service is the result of months of hard work by a multi-disciplinary team of health and social care professionals who took up the challenge of planning clinical services for transgender persons. The development of these services is being implemented as laid out in the transgender health care policy document.

The document was launched for consultation in April last year and in-depth discussions were held with transgender persons and civil society organisations representing them. We also liaised with the LGBTIQ Council and the Malta Gay Rights Movement. I believe that the manner in which we worked to formulate this policy is an excellent example of the way in which health systems will continue to be shaped in the 21st century.

In the design and development of services for transgender persons, health professionals embarked on a process of co-creation. This means that while scientific evidence remains the backbone of clinical services, planners and health system policy-makers are increasingly acknowledging that service users are experts in their own right and have a clear contribution to make in service design. I am grateful to the professionals and the service user representatives who worked closely to develop clinical pathways that will primarily ensure the safety and effectiveness of the interventions provided but will also respect the dignity and legitimate expectations of service users.

At the start of the year we changed the legislation on entitlement to medication by including gender identity and sex  characteristics-related conditions in the list of conditions for free treatment. As a consequence, transgender persons who have had to pay for their treatment for years are now able to obtain treatment free of charge through the gender clinic.

However, transgender persons do not merely require medication or surgical interventions. Indeed, the social, psychological and emotional support provided to transgender persons as they embark on the difficult gender transitioning journey are equally important to ensure success. In fact, persons may be referred to access services  by doctors, psychologists or social workers, since some persons will opt only for psycho-social support and intervention whilst others will opt to undergo surgical interventions to align their physical characteristics with their gender identity.

In developing these services, we have drawn on the experience and assistance of other countries, tailoring the programme to fit our contextual realities and our legal framework. There is still, however, much that remains to be achieved. In the coming months we aim to continue providing training for our multi-disciplinary team, as well as more generic awareness training throughout our health service. We will also start offering surgical interventions where these are required. We aim to eventually have a service that will be considered a model for other countries to follow.

None of this would have been achieved had we not put in place the necessary legal framework that makes it possible to change legal gender. We sought to transform civil liberties in this country and we did. Our track record speaks for itself.

 

Mr Fearne is the Deputy Prime Minister and the Minister for Health


 

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