GENDER INCONGRUENCE Did you experience issues at school in connection with the way you identified yourself?

‘Present the information and let them decide for themselves’

When did you first realise you were transgender?

When I started thinking about the concept I was about eight or nine years old, so I was very young.

Back then, I didn’t see it as a concept of gender; it was more of ‘Who am I?’ and ‘Who am I attracted to?’ Kids at school would ask me if I wanted to be a boy; my mother would ask too.

I remember a particular situation in which she asked me if I actually wanted to be a boy. I said no, because I still didn’t feel like a boy, but it was understandable because my gender expression was closer to that of a boy.

Was there any friction when you started being open about feeling this way?

It wasn’t easy. There were two moments when I had to come out to my mother in my life: once coming out as gay, and then coming out as non-binary. When I came out as gay, my mother wasn’t happy at first.

Being non-binary needed a longer explanation. In fact, when I told my mum for the first time she asked me if I was happy, because that was what mattered most to her. Nowadays she embraces who I am. For example, when she sends me a message she says ‘Intom ġejjin?’, correcting herself when she says ‘Inti ġejja?’

Once I had come out, I felt that I could start expressing my gender identity more freely. I was questioning it myself at the time (the distinction between sexual orientation and gender identity); I did not know there was something called ‘non-binary’. I went to a government school – mixed in primary, girls-only in secondary, and I experienced some form of bullying in both situations. In secondary school, I eventually developed charm as a defence mechanism. That seemed to get people on board and the bullying stopped.

At primary school I had kids calling me ‘tomboy’, ‘mara-raġel’typical Maltese words. Nowadays, I think that it’s more likely that this mentality is instilled from home or the culture we’ve been brought up in.

Would you say there is a connection, or an overlap, between sexual orientation and gender identity?

In my world, they do overlap because I was born with the body of a woman and I am also attracted to women. If it is someone who is born with the body of a woman and is attracted males, but identifies as non-binary, they might not overlap. Nowadays, I do think they are two different concepts.

You mentioned that your mother says ‘Intom [ejjin?’ rather than ‘Inti [ejja?’ How does one go about finding an appropriate pronoun in gendered languages?

It’s difficult to find the appropriate words in gendered languages, as even things like ‘mejda’ (table) or ‘siġġu’ (chair) are split into male and female.

The people that come into contact with me every day use the plural pronouns. To be respectful, even at my workplace, people that I am closer with try to use the plural to address me. For example, ‘Int ġejjin illejla’ or ‘Intom ġejjin illejla?’, so they use ‘they’ as well.

Lots of people tell me it’s difficult, and I completely understand. Imagine you’ve been told one thing your whole life and then I come along and ask for something completely different.

So if someone agrees to address you as ‘they’ because they wish to show you the dignity and respect you feel you deserve, but still would not recognise your interpretation of gender (being on a spectrum rather than binary), is that something you can accept?

Who am I to tell anybody that they have to do it? I mean, it ultimately boils down to respecting the person in question.

This is similar to when someone starts transitioning from male to female (or vice versa). They’d have started taking hormones but haven’t had surgery yet. In this situation, you address them how they wish because that’s how they identify.

Addressing me as I ask to be addressed, in spite of not being in agreement, would be better than anything I could imagine. I have also been in situations where I’d explain to them why I identify as I do, and after I’m done, they’d insist on calling me ‘she’ as they don’t agree with me.

Can you see that it wouldn’t necessarily come from a place of ignorance or hate? It could just be the belief in the Sociobiological Theory (biological sex, gender identity and expression are connected) rather than the Gender Schema Theory (individuals become gendered through society).

I think that ultimately we live in a democratic society, so everyone is entitled to an opinion. Personally, I believe that the more you open up your world, the more you realise that there is so much diversity, and that you cannot just stick to one theory.

I would prefer people thinking about being open to the fact that there is more than one theory. We have been taught that black is black, and white is white. We have been taught that it’s either tea or coffee, or red wine or white. But there’s also rosé and cappuccino in between.

I see gender the same way. I might have been told that because I have a female body, I need to identify as a female. But I see myself as being in between.

We need to give people all the available information and allow them to come to their own decision. If you impose beliefs on someone, they tend to resist more.

In the ICD11, the World Health Organisation (WHO) moved Gender Incongruence (previously Gender Dysphoria) from the Mental Health chapter to the Sexual Health chapter. Was this a good

move?

Definitely. When I saw the interview they did with Dr Lale Say, she mentioned that one of the reasons they did this was to remove the stigma. We still see medical professionals that stick to just the label, still seeing it as a mental health issue while removing any other possibility. People are not just a label, they are also a person with unique experiences.

Through the Gender Identity, Gender Expression, and Sex Characteristics (GIGESC) Act of 2015, the Maltese government took this a step further and stated that “the pathologisation of any form of sexual orientation, gender identity and, or gender expression... shall be null and void in Malta.” Would you say that the World Health Organisation should also take this step?

The GIGESC involved different aspects. It involved transgender people who are going to transition, and then you also have transgender people like me, who end up in the category like who are non-binary.

One of the reasons why the WHO kept the label was also because of the high cost of medical treatment. If you remove the label from the ICD, people wouldn’t be entitled to NHS medicine like hormone therapy.

Some would say that the LGBTIQ community in Malta wants the best of both worlds on this issue; they don’t want transgender people to be pathologised, but still want them to receive statefunded medical treatment. How would you justify this oxymoronic situation?

First of all, before it was in a chapter (mental health) that was putting stigma on these persons. We know from history and recent research that if you’re transgender, it doesn’t necessarily mean you have a mental health issue.

Being transgender, you can still end up with depression, for example. You have to come to terms with the fact that you identify with an identity that isn’t the one you were given at birth, you have to come out to your parents; you have to take in the emotions of your peers and the rest of the world, which can bring a certain amount of mental health issues with it.

To clarify, if someone is suffering from a medical issue, basically no one would object to them receiving certain statefunded medical treatment. But medicine is only required for people who are sick. If there is no medical issue, then wouldn’t the treatment be cosmetic?

Ultimately this is not a cosmetic treatment. This was possibly why it was put in the mental health chapter in the first place. Once you don’t alter the changes of how you actually identify, this will bring on mental health problems.

So mental health problems come after you realise that you’ve been assigned the wrong gender?

You might get a mental health issue if you are not allowed to alter how your body looks to reflect how your inner self looks at yourself.

And how would that be different from any other form of cosmetic surgery?

Right now, the consultative committee is working on a Gender Clinic. When someone goes to the Gender Clinic, any other mental health issue a person might have are ruled out. Once you find what issue is causing most distress in a persons’ life, then that’s when they are granted things like hormone therapy.

In 2016, the executive director of Transgender Europe suggested that the childhood diagnoses be removed from the ICD 11. What do you think parents should do if their child is exhibiting patterns of behaviour in line with Gender Incongruence?

Children should be allowed to explore themselves and their world. Parents shouldn’t encourage or discourage such behaviour.

Why would you impose something on your child if it might cause them distress?

We should treat them the same way – we present the information and let them decide for themselves.

Now that you’re an adult and the law has changed, do you think that Maltese society is at the point where it has understood these changes? What has your experience been in this regard?

This is one of the main reasons why I, along with other members, founded LGBTI Gozo. The law is great. Unfortunately, the mentality is there, and the knowledge is still limited. With time, I think people will truly understand the law.

Where do you start from the mentality or the law?

Before, I was the kind of person who would start with the mentality and then go with the law. Throughout years, I’ve seen that if you have the law, you are reassuring a certain number of people, making sure they are safe and recognised.