Gabi Calleja from the Malta Gay Rights Movement. Photo: Matthew Mirabelli

Gender reassignment surgery is being evaluated by a government committee that will make recommendations on whether to offer it as part of the national health service.

“The advisory committee for healthcare benefits will be submitting its recommendations to the Parliamentary Secretary for Health for his consideration,” a secretariat spokeswoman told this newspaper.

The measure had been mentioned in the Budget last November.

The spokeswoman said the advisory committee was looking into various options that included offering the surgery at Mater Dei for free or paying for treatment overseas.

Health Parliamentary Secretary Chris Fearne said gender reassignment surgery on intersex children (born with ambiguous genitalia) had been carried out on the NHS for a number of years. In such cases, surgery was done to assign male or female genitalia following discussion by a multidisciplinary team and the parents.

“Genital gender reassignment surgery, on the other hand, is not performed in Malta,” he pointed out, noting that this was what the committee would be looking into.

Gabi Calleja, from the Malta Gay Right’s Movement, said the movement was aware of the evaluation.

At the end of the day, people who undergo this surgery need it because they have a disorder

As things stand today, only parts of the reassignment process are available for adults in Malta but only in private clinics. These offer surgeries such as mastectomies and breast implants.

Surgery on genitalia was not available in Malta and patients had to travel abroad and pay out of their own pockets. Such surgery could cost between €15,000 and €25,000, she said.

Ms Calleja added that it would be great for such patients to have access to surgery in Malta because it would mean that they would be able to have the support of friends and family.

Joanne Cassar, who had the surgery 13 years ago, knows what it feels like. She spent three weeks recovering from her surgery in the UK, which cost her about €23,000.

“It would be fantastic if this surgery were offered for free. It would also help a great deal if the government paid for half of it. At the end of the day, people who undergo this surgery need it because they have a disorder.

“We don’t choose to be born with the disorder and the surgery is the only way we can get on with our lives,” said Ms Cassar, who has become something of a spokeswoman for transgender people.

She was the driving force that led to legal amendments allowing people who undergo reassignment surgery to get married. The amendment was made after she agreed to drop proceedings in the European Court of Human Rights where she was fighting for her right to marry. Ms Cassar pointed out that even though her surgery took place more than a decade ago, whenever she heard the story of someone having the experience she could still recall the pain and loneliness.

“We are born in the wrong body. We are bullied at school and we struggle to be accepted by friends and families and to find jobs. Then, to add to all this, in order to be happy, we have to face a financial burden.

“And, even after surgery, there are so many risks because it can go wrong,” she said, adding that she knew of people who ended their lives because they never had the opportunity and support to tackle their gender identity disorder.

What is gender identity disorder?

Gender identity disorder is defined by strong, persistent feelings of identification with the opposite gender and discomfort with one’s own assigned sex.

People with the disorder desire to live as members of the opposite sex and often dress and use mannerisms associated with the other gender. It is distinct from homosexuality as homosexuals generally identify with their sex or gender, according to Psychology Today.

Many individuals become socially isolated and suffer from depression. Some opt to remedy the situation by having gender reassignment surgery that essentially matches their external looks to the gender they identify with.

In such cases, they have to undergo rigorous psychological testing to ensure they are prepared for such life-changing surgery, which is usually preceded by hormone therapy.