About the Project

While Malta has one of the best legal frameworks worldwide with respect to the recognition and protection of LGBTIQ (lesbian, gay, bisexual, trans, intersex and queer) persons, the process of mainstreaming these legal provisions across all public services is still ongoing.

When LGBTIQ people access health services, practitioners often assume heterosexuality and cisgenderism while the language used is reflective of these assumptions. Heteronormative and cisnormative assumptions mean that LGBTIQ people experience exclusion and invisibility when accessing services. 

For trans and intersex people, health professionals using pathologising language and misgendering can result in avoidance of healthcare, as well as other problems.

The Fundamental Rights Agency (FRA)’s LGBTI II Survey of 2020 found that 47% of all trans respondents living in Malta are not open about their gender identity to any health care provider or medical practitioner. Another 34% only disclose this detail to just a few practitioners. The same survey also found how 40% of all trans respondents in Malta have experienced difficulties when using or trying to access healthcare services due to their gender identity.

Given the evidence indicating the ongoing difficulties faced by LGBTIQ persons in accessing healthcare, the Human Rights Directorate (HRD) within the then Ministry for Justice, Equality and Governance (MJEG) submitted an application under the Rights, Equality and Citizenship (REC) Programme of the European Union (EU) to access funding in order to enhance LGBTIQ persons enjoyment of equal and non-discriminatory access to health services by building the awareness and capacity of those involved in mainstream healthcare provision to meet their needs.

The project TRANSFORM: Raising standards of healthcare service provision for LGBTIQ people was implemented between November 2019 and February 2022 (extended from October 2021 due to the limitations posed by the Covid-19 measures). It took inspiration from the Health4LGBTI Project of the European Parliament and utilised the research and adapted the training resources developed through this project thus building on existing good practice. 

This project has been implemented in collaboration with multiple organisations and entities. The Sexual Orientation, Gender Identity, Gender Expression and Sex Characteristics (SOGIGESC) Unit at HRD within the Ministry for Equality, Research and Innovation (MFER) served as the project leader,  with its main partners being the Office of the Deputy Prime Minister and Ministry for Health (ODPM), Ghent University Hospital (GUH), the Malta College of Family Doctors (MCFD) and the Malta Union of Midwives and Nurses (MUMN).  This list is joined by other organisations and entities affiliated to this project as associate partners, being the European Region of the International Lesbian, Gay, Bisexual, Trans and Intersex Association (ILGA-Europe), Transgender Europe (TGEU), Steward Health Care (SHC), the Gender Wellbeing Clinic (GWC), Ghent Transgender InfoPoint (TIP) and the Council of Europe’s Sexual Orientation and Gender Identity (SOGI) Unit.

The main objectives of this project were to:

It aimed to do so primarily by enhancing the capacity of a range of health practitioners to address the health needs of LGBTIQ patients in a sensitive manner that acknowledges the specific challenges often encountered by LGBTIQ persons in their everyday life which impact on their health and wellbeing and by making practitioners more aware of heteronormative assumptions that result in inequalities in access to healthcare of LGBTIQ persons. These were achieved through multiple training sessions and awareness raising campaigns organised throughout the two-year period of this project.

The project also benefitted from the exchange of good practices through partnership with the GUH’s TIP and the GWC’s Multi-Disciplinary Team. Through this partnership, it helped in building the knowledge base of General Practitioners (GPs) and Family Doctors who are often the first point of call for all persons, including LGBTIQ persons suffering from generic ailments or requiring medical advice or referral to a specialist healthcare provider. Specialised training was also provided to emergency services personnel. These trainings were complimented by the website, www.transhealth.gov.mt to which health practitioners can refer for information on trans patient healthcare as well as signposting to specialist services such as those provided through the GWC where required.

The project also conducted awareness raising activities aimed at the LGBTIQ community and provided resources that can assist healthcare providers in communicating their services as safe and inclusive spaces for LGBTIQ patients needing their care. Several resources are aimed at the LGBTIQ community, based on the increased likelihood of them experiencing a number of health-related conditions such as mental health; sexual health; substance misuse; as well as inform on existing trans-specific health services and how to access them.

The project Transform: Raising standards of healthcare service provision for LGBTIQ people started its implementation in November 2019 with its end date initially scheduled for October 2021. An extension of four months was granted as a result of various initiatives having to be delayed due to the mitigation measures imposed as a response to the Covid-19 pandemic. This shifted the end date of the project to end of February of 2022. 

A Project Coordinator, responsible for the running of this project was recruited on 18th February 2020 on a full-time basis. 

The project had a maximum budget of €246,541.98, being 80% co-funded by the REC Programme 2014-2020 of the EU and 20% through National Funds. The allocated budget was split among five work packages and administered by five main partners including the lead at MFER.

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