Yesterday was the 85th anniversary of the death of Lili Elbe, the first person to undergo sex reassignment surgery. One year after the introduction of the Gender Identity Act, Malta has become a protagonist in the fight for the equality and support of all genders.

A recent film about a transgender artist could not have been better timed – after a year of Caitlyn Jenner and a new impetus for transgender rights.

The surprising true story behind The Danish Girl unfolded a century ago, when Lili Elbe became one of the first people to live openly as transgender, having undergone gender reassignment surgery.

Malta became the first European country to institute  legal protections for intersex, trans and gender diverse people to protect their bodily autonomy and civil equality, according to the International Lesbian, Trans and Intersex Association (ILGA).

The Gender Identity, Gender Expression and Sex Characteristics (GIGESC) Act was approved unanimously by Parliament last year. The law is the fruit of a long collaborative effort between LGBTIQ activists, politicians and other stakeholders.

Malta is the first country in which a law affirms the right to gender identity recognition and self-determination, promoting policies of anti-discrimination and equality, as well as bodily integrity and physical autonomy, says ILGA.

As a result, it is unlawful for medical practitioners or other professionals to conduct any sex assignment treatment or surgical intervention on the sex characteristics of a minor, which treatment or intervention is to  be deferred until the person concerned can provide informed consent.

The latest Eurobarometer survey on discrimination, published in 2015, shows that social attitudes, particularly towards trans persons, have shifted significantly towards greater acceptance, and this is likely due to the discussion surrounding the introduction of the GIGESC Act

Gabi Calleja, MGRM coordinator and LGBTIQ Consultative Council chairwoman told this newspaper: “The GIGESC Act was a major achievement, because it introduced rights for all – rights which affect especially the quality of life and well-being of trans, gender variant and intersex persons.

“Many trans men and women have already benefited from the new procedures for legal gender recognition, which are now much more accessible.”

One year on, the legislation has already given rise to the introduction of two government policies, one in the field of education and the other at the Corradino Correctional Facility.

The new education policy for trans, gender variant and intersex children includes two documents, a policy document and a procedures document, making Malta the first country in Europe to publish a comprehensive educational policy focusing specifically on trans, gender variant, and intersex children.

The policy document highlights key issues and needs that must be addressed in order to make schools inclusive for trans, gender variant and intersex students, such as the protection of privacy, adequate facilities, inclusive policies, regulations and language and access to counselling and information.

The procedures document addresses how schools should respond when a trans, gender variant or intersex student comes out or transitions and asks schools to implement detailed school support management and student transition management plans.

Another government policy was launched last month at the Corradino Correctional Facility. It provides the right for trans inmates to be accommodated in separate facilities and have access to the procedures of gender recognition, health services and mental health support.

Prison staff are to receive additional training and information on human diversity and gender identity. Also, searches of trans people must be carried out by a prison official of the appropriate gender.

“The latest Eurobarometer survey on discrimination, published in 2015, shows that social attitudes, particularly towards trans persons, have shifted significantly towards greater acceptance, and this is likely due to the discussion surrounding the introduction of the GIGESC Act.

“Certainly, more work is needed to change the hearts and minds of all, as well as to address certain difficulties still faced by trans persons, such as access to trans-specific healthcare, for example, but there is no doubt that the current political and social climate is much more accepting,” Calleja said.

In reality, there was little opposition to the introduction of GIGESC, other than from some religious quarters. The Bill enjoyed the support of both parties in the House.

“The challenge lay in ensuring that the law was in line with the way our public registry system operates.

“With respect to the right to bodily integrity and the protection of intersex persons,  there was the challenge of developing the legal text without much to rely on, given that Malta was the first to establish such protections.

“I believe that the ministry’s broad consultation with international organisations active in the field of LGBTIQ rights was hugely beneficial in this process and led to a best practice model which other countries can build on.

“Going through the GIGESC Act, the fundamentals are found in Article 3 which establishes that:

All persons being citizens of Malta have the right to:

(a) the recognition of their gender identity;

(b) the free development of their person according to their gender identity;

(c) be treated according to their gender identity  and, particularly,  to  be  identified  in  that  way  in  the documents providing their identity therein; and

(d) bodily integrity and physical autonomy.

“While financial gain or the lack of it should not determine whether a law such as GIGESC should be introduced in a country, a society that is more inclusive of trans, gender variant and intersex persons does benefit.

“It should, hopefully, lead to a reduction in early school leaving, increased access to the labour market and less need to resort to social benefits,” concluded Calleja.

 

Who was Lili Elbe?

Lili Elbe, born in Denmark in 1882 as a male, Einar Mogens Wegener, was the first known recipient of sex reassignment surgery.

A prolific artist, she decided to adopt the name Lili Elbe after her male-to-female sex reassignment surgeries in 1930.

She underwent a series of risky, unproven surgeries to remove her male organs and replace them with female reproductive organs in order to become a mother. Her ultimate wish was to be able to bear children.

Since little was known about the immune system and other bodily functions at the time of her operations, which were carried out in Paris, the surgical procedures that she went through could have been fatal.

For Lili, this turned out to be the case, as she died 14 months from her first operation. After her fifth intervention, her body rejected the replacement organs, and she died on September 13, 1931, aged 50.

A week before she died, Lili wrote a letter to an old friend, reflecting on her life: “That I, Lili, am vital and have a right to life I have proved by living for 14 months.

“It may be said that 14 months is not much, but they seem to me like a whole and happy human life.”

Civil Liberties Minister Helena Dalli piloted the Gender Identity, Gender Expression and Sex Characteristics Act

I am pleased that Maltese society has shown great maturity in understanding the government’s work in this area of policy and is supporting it.

In fact, last October’s Eurobarometer on discrimination showed that the understanding and support of gender identity equality of the Maltese soared to 85 per cent, the second highest overall; and at 17 per cent we achieved the fastest growth in any member state in the period of two years since the last survey.

More importantly, the system works, and trans persons who were previously unable to rectify their documents for one reason or another today have the right documents that allow them to function fully in our society.

The policies introduced across all government are further proof to the equality mainstreaming approach that we adopted in this field.

We worked closely with civil society organisations in Malta and at European level, as well as various human rights institutions and the Office of the Attorney General to guarantee that the law works in practice to the benefit of trans people without compromising any rights of third parties.

However, we are open to changes, and in fact we amended the law shortly after it was introduced to ensure that adopted persons have access to the same rights as everyone else, given that in their case the amendment needs to happen by court order.

We shall also be proposing a further amendment shortly to ensure that non-Maltese persons who are confined to gender segregated spaces (such as prison) who are unable to change their documents in their home country can still be placed in the right-gendered section following an affidavit.

The main elements of this law are its human rights principles and universal application to all persons without distinction. Through this law we did not provide an exceptional procedure to transpeople, as is often the case in other countries, but rather a set of rights that are applicable to all persons irrespective of their gender identity.

I strongly believe that we have now finally opened up as a nation to the trans minority and there is greater knowledge and understanding within society at large. I am certain that the beneficiaries of this law will benefit from it in various ways, including financially, as, apart from the protection of their privacy, the law introduced strong protection against discrimination and in favour of equality.

Persons are now encouraged to assert themselves and participate fully in society, including in higher education and employment leading to better incomes. Many of these persons were previously unemployed or underemployed, and their economic contribution to the country was way below their potential.

I also know that there may be indirect benefits for the country, too. Open societies prosper. Hence while the intentions behind this law revolved around the well-being of transpeople, as our country becomes increasingly recognised as an open society, we are likely to continue to attract creative persons and others who help generate economic growth to live and work here.