The current situation of intersex persons in Malta : shifting away from the medical paradigm towards social justice

Abstract

Traditionally, intersex persons' management was based on a concealment-centred medical model comprising of a range of medical and surgical procedures aimed at normalization. In the last decades, heightened awareness of adverse outcomes of these practices, as well as ethical and human rights implications, called for a review of conventional practices and for a cultural and legal shift. Malta was the first nation to outlaw unnecessary normalization procedures on intersex babies in March 2015, in the passage of the Gender Identity, Gender Expression and Sex Characteristics Act. This qualitative study, using the participation of six experts from the local medical and social field, aimed to yield practical knowledge regarding the current paradigm and the situation of intersex management in Malta, following its historical legal reform. Data was obtained through in-depth face-to-face audio recorded semi-structured interviews. Thematic analysis was employed to analyze the data. One overarching theme emerged being 'In limbo'. Primarily, this study brought into light the fact that intersex is not an abstract concept or merely a rare physiological condition in isolation, but a multi dimensional and emotionally and socially challenging lived experience of human beings and their loved ones. A two-sexed selective cultural context left this cohort of people in hiding and socially invisible, shrouding this experience with secrecy, stigma and shame. Findings also showed that two divergent perspectives-of whether intersex is a merely a normal variation to, or an abnormal deviation from, the standard biological norm-affect how arguments are positioned and as such, influence decision-making. This study also identified a gap between different bodies who are currently working in silos with no reciprocity. It also put into light the urgent need for the appointment of the interdisciplinary team and working group, as required by the new legislation, so that this law is transferred from paper into practice. In order to put this new law into motion, this study recommended a collective effort by all stakeholders so as to break down barriers - by moving away from their diverse standpoints and keeping the holistic needs of the growing child as the focal point at all times. This study also put into light the need for further societal awareness and education so as to eradicate stigma, prejudices and silence. In light of these findings, further recommendations for practice and research are put forward.