The Gender Wellbeing Clinic has been operating without a psychiatrist for more than a year, preventing patients from accessing gender-affirming treatments.
Frustrated by long delays and lack of progress, patients have expressed their outrage, with some waiting years for essential care.
On Saturday, October 12, members of the LGBTQI community gathered outside the ministry of health to protest, demanding immediate government action to resolve the issue and honour promises made regarding access to care.
The role of a psychiatrist is critical in this process, as they must assess a patient’s mental fitness before more concrete treatments, such as hormone therapy or surgeries, can proceed. Without a psychiatrist, patients are left in limbo, unable to move forward with their transitions.
Times of Malta spoke to two patients at the clinic, both of whom requested anonymity due to concerns about their personal safety.
Patient A, a 24-year-old trans non-binary person, has been waiting four years for top surgery. “I’m still waiting for the top surgery. I have been placed on the waiting list since my first appointment,” they said. Their first consultation took place in 2020, but despite years of anticipation, they remain stuck in the system.
“When I initially heard about the gender clinic, it was like a light at the end of the tunnel,” Patient A said. “It sparked hope after years of wanting to start medical transition but lacking the financial means to do it.”
However, the long wait has taken a toll. “If I had the money to go private, I would have done it already,” they added.
Patient B, a 19-year-old trans man, shared a similar experience, highlighting the mental and physical strain of waiting for treatment. Although he had seen all the necessary professionals, including the psychiatrist, it still took nearly a year-and-a-half to access testosterone hormone therapy from the clinic.
“The longer you wait, the more time your body goes through the puberty you don’t want it to. It makes it much harder to tackle after,” Patient B explained.
Inability to access treatment doesn’t just have a physical impact but also a mental one: “Mentally, it’s a lot of anxiety because I might not pass [look like a man], and even when I look in the mirror, I don’t feel like myself.”
Both patients expressed a desire for the health ministry to take swift action. The Malta Gay Rights Movement (MGRM) also issued a statement, calling for immediate steps to resolve the situation. “No more delays, no more excuses. It’s time for the government to act,” the organisation said, urging the minister of health and the government to appoint a qualified psychiatrist to the Gender Wellbeing Clinic as soon as possible.
In response to the mounting criticism, the minister, Jo Etienne Abela, acknowledged the problem but pointed out the difficulty in finding a psychiatrist willing to take up the position. The ministry had issued calls “but it seems no one wants to do the job”, he told Times of Malta.
Abela suggested that the sensitivity of the work acts as a deterrent. “This is a sensitive area and I feel like our psychiatric professionals are scared to offer the service because they fear litigation.” He noted that a gender clinic in London had ended up in a sticky legal situation, and since Maltese medicine follows the British system, it has made professionals wary.
The minister was likely referring to the Tavistock Centre in the UK, a clinic that faced legal action after accusations of fast-tracking patients into medical transition. The scandal raised concerns about inadequate psychological assessment, leading to professional caution in gender-affirming care.
Abela also noted that the government has tried to ease the burden by offering the position on a contract-for-service basis rather than a full-time role. “It’s not for lack of trying, but we know this is an issue that must be resolved,” he said. Abela added that the ministry is actively seeking psychiatrists from outside the public health system to fill the role.
The minister said augmentation procedures are offered in Malta while, for complicated operations, the ministry has been in contact with clinics abroad and the costs have been worked out. “As minister, I have no objection to these operations being performed abroad,” said Abela.