The Maltese Body: Gender, Sex and catholicism, Pt1

- Episode 20- Transcript

Georgie Williams, voiceover: Trigger warnings for this episode include the discussion of infanticide, non-consensual medical interventions, misogyny, femicide and murder. Please proceed with caution.

In the heart of the Mediterranean is a country like no other. Its language of both Arabic and Latin origin and its history influenced by their colonisation under the British, French, Sicilians and Spanish to name a few; Malta is in itself a cultural phenomena. But the thoroughly modern Maltese are carving paths for inclusion and progressivism in impressive ways; excelling in matters of gender & sexuality rights compared to many European countries. 

So how is it that a country can be both ahead of the curve on transgender and intersex rights, but behind the curve on reproductive freedoms? In this two-parter, we are investigating the tapestry of histories and cultures present in this country, and we are asking the question- who defines and who controls the Maltese body? Welcome to Episode 20 of /Queer. You’re here with me, your host, Georgie Williams.

If you were with us back in Season One- or you’ve been doing your homework- you might have noticed that Malta is a country whose name has been mentioned before on the /Queer podcast. Back in Episode 13, where we investigated the state of intersex rights in the UK, we referenced Malta as one of only five countries in the world who granted intersex individuals- individuals with differences of sexual development- bodily autonomy. Although intersex welfare will not be the central focus of this episode, I will reiterate our original definition of this term. Intersex individuals are individuals born with a hormonal, chromosomal, gonadal or genital variation which is considered outside of the male and female norms. The occurrence rate for this variation is estimated to be 1.7% of the global population. Largely, intersex individuals are treated as second-class citizens and are often victims of non-consensual medical interventions, sterilisation and even infanticide. The other four countries where the right to bodily autonomy is granted to intersex individuals are Albania, Uruguay, India and Portugal- but whenever I have spoken on this subject in a professional capacity I have often asked myself, why Malta? How did this small country, a nation which occupies an area of just over 300 square kilometres, end up in this exclusive club of intersex-conscious countries? 

As you will know from our previous episode, my seafaring approach to this project was inspired partly by my desired ship of passage having already charted a course from France to Malta. As you may also know, serendipity has long been a friend of the /Queer project- it was whilst still working as a deckhand aboard the Götheborg of Sweden from last episode that I made our first important connection to Malta’s sociopolitical climate. 

Wendy Green was, at the time of us meeting aboard the Gotheborg, the US Ambassador to Malta. She was the first person who gave me her time on these matters when I arrived in Valletta, and we met whilst I was entertaining high profile guests aboard ship- in my best historical attire, no less. Wendy was one of the first people to inform me what I had only heard about from a distance; that although Malta seemed to lead the field on a subject as complex as intersex rights, the status of women in Malta was, at best, substandard. Wendy was the first to tell me that if I wanted to understand the culture surrounding gender & sexuality diversity in Malta, I also needed to ask questions about the status of women in this country. As it so happens, I had arrived just in time for an important and tragic anniversary for Malta. 

Daphne Caruana Galizia was a prominent journalist and anti-corruption activist in Malta, who in 2016 and 2017 revealed links between a number of Maltese politicians and The Panama Papers. The Panama Papers were the 11.5 million leaked encrypted confidential documents that exposed a network of over 214,000 tax havens. Many former and, at the time present heads of state across Europe were exposed in the process of these papers being leaked and a great number of prominent political figures were accused of tax evasion and fraud based on the evidence which had emerged. In October 2017, Caruana Galizia was murdered with a car bomb. On the night I met Wendy, just two days shy of the fifth anniversary of this incident, two men were sentenced to 40 years in prison for her murder- I was informed by individuals at the event that these two killers have been closely linked to Chris Cardona, the Maltese government’s former Minister for Economics. Cardona has not been charged for his alleged involvement.

Caruana Galizia’s sister, Corinne Vella, went on record at an event about women journalists in 2021 to say that a campaign had long existed to dehumanise Caruana Galizia- and that attacks and abuse towards women in this industry have continued even after her death. Prominent Maltese academic Marceline Naudi from the Department of Gender Studies at the University of Malta has also recently stated in an interview that Maltese culture inherently frames women as being of lesser status in society and that many cases of femicide in Malta could have been avoided with adequate social and legal responses. Femicide is a term used to describe the killing of women and girls, simply for their status as female. Once I began to learn about these issues in Maltese culture, I became increasingly concerned about what I would and would not find on this leg of the project.

I have been introducing myself to locals by, for safety reasons, vaguely describing my work as human rights research. I continue to be told, I’m in the right place for it- just not the easy place. To understand the climate around gendered and sexualised bodies in Malta, I knew that I was going to need to talk to someone at the very heart of Maltese healthcare- after all, to understand how the body is treated medically is to understand the politics a state or nation imposes upon a body. In the end I sought council with perhaps one of the most significant voices in the push for reproductive and transgender rights in Malta’s medical community. 

Chiara Frendo-Balzan, in interview: I am Chiara Frendo-Balzan, I am a gynaecologist by profession- She/Her. I am Maltese but I've done my specialization in my medical field in the UK for eleven years and I’ve returned to Malta, now coming up to four years. So, I'm finding my Maltese roots again! As to what I do, I've worked in the public hospital, main hospital in Malta, and I've worked there within the Department of Obstetrics and Gynaecology- obviously seeing mainly women doing Obstetrics, pregnancy, labour ward and gynaecology. And more recently, I was then involved in the Gender Wellbeing Clinic and that was within the public sector. So I was a gynaecologist, one of the gynaecologists in the multidisciplinary team that was taking care of the Gender Wellbeing Clinic. And as part of the Willingness team, I also give gynaecology services within that team. So this is within the private sector and I also see transgender patients here. And we have a multidisciplinary team that takes care of this in the private practice.

Georgie Williams, voiceover: Naturally, the first question I had wanted to ask Chiara was based around this increasingly evident disparity between intersex rights and reproductive rights. I wanted to understand why it was that Malta was one of the first countries in the world to recognise the bodily autonomy of people with a difference of sexual development, but was also so far behind on recognising the fundamental rights of women. In response to my inquiries, Dr Frendo-Balzan was more than willing to broaden my awareness of what Malta’s climate of inequality looked like from an inside perspective. 

Chiara, in interview: Yes. So this is quite an interesting question. So I feel like I've got two views- I left Malta in January 2008, returned end of 2019- 2018, actually. 2018. So the Malta I left is not the Malta I returned to. And that goes for everything, for commercial stuff- for not, not just for health care, for just being, living in Malta. And over those years, we've had a lot of advancements in gender rights, same-sex marriage… and Malta, as you are well aware, is in the forefront of all of this. 

Now, regarding health care, female health care is very good, but there's some gaps. There's some gaps. Malta is one of those countries where abortion is still illegal. And with this being said, we still don't have free contraceptive services or even subsidised contraception and there are technically no contraception services in the hospital. So this obviously goes against preventing pregnancies but then what do we do if we have one that's unwanted? So that's with the female health care, that I think is almost lacking. Right?  But as with everything else regarding pregnancy, regarding gynaecology, I think we're doing not too bad. Obviously I'm going to be comparing with the UK, where things are driven by nice guidance and there’s guidelines on every single topic. Malta's not there with the female healthcare. 

As regards… gender health care or intersex health care, or transgender or non binary or… something is being done. Something is being done. As you know, it's a new medicine, it's a new specialty. So even us within the medical community, we are discovering things. If you can understand, it's still new. We have trans men who are pregnant, who have got pregnant. This is very few and far between. So there's not a lot that is known about these people who are pregnant, who have birthed. So all in all, it's still somewhat a new medical specialty. However, when we… even being the gynaecologist within the team, we were being trained, we were given training mainly from America, who was leading in all of this. And as a gynaecologist, there's things I cannot do on my own. 

We need the endocrinologist, we need the plastic surgeons. There's a whole team. There's the psychologist, so there's a whole team. And luckily we do have a very good clinic that's available within the public health system or the NHS, if you want, okay. Where the person doesn't need to pay for the treatment and there's very good support. Now, the limiting factor there is how comfortable is that person going to be, attending the clinic? Because still there's what is perceived as a taboo. So much so that this clinic is held at separate premises. It cannot be held at the Gynae clinic. 

Georgie Williams, voiceover: Although one can never attribute a singular cause behind why a country may deny rights to a particular social group, many Maltese citizens that I spoke to agreed that the main cause behind Malta’s criminalisation of abortion was almost certainly Malta’s status as a Catholic country. The story that is told is that around 2000 years ago, Saint Paul was shipwrecked on one of the original islands of Malta, and this event led to the spread of Christianity throughout this small country. As of 2019, 95.2% of Maltese citizens describe themselves as Christian with Catholicism as the main denomination- accounting for 93.9% of the population. Although allegedly rarely enforced, Maltese law still stipulates that anyone on the island who undergoes an abortion can be jailed for up to three years, and anyone assisting can be jailed for up to four years. But with a population where Catholicism is so widespread and accepted as the norm, the punishment for undergoing or even assisting in an abortion extends beyond the legal and likely also becomes social, given how stigmatised the subject remains in this country. Chiara had more to say about how social pressure and judgement surrounding reproductive health services have impacted people sometimes quite publicly. 

Chiara, in interview: There was once a little episode… This was all over social media in Malta. This person wanted to attend the Gynae clinic. She had an appointment. And this was during COVID times where there was restrictions and the security person was stopping people as they were coming in according to the appointment time, right. Only allowing people in 15 minutes ahead. And this person at the door showed the security person the appointment letter and they were told, “since when are men being seen at the Gynae clinic?” Just because she was masc and presenting as a male. And this blew up over social media because of this ignorance. Ignorance as a non educated person just having that stereotype that Gynae is for women. And also, as a gynaecologist, I actually don't like saying Gynae services. And I say Gynae services because I think it's the one that is closest. But I do see men, I do see trans men, and Gynae is so associated with the feminine- and I don't have another word for these services, but I see trans men who still have a vagina, still have a cervix, and they need Gynae services, they need a smear test. And, things are done, mistakes are done as well,  but I think it's the learning curve. It's a learning process. 

Regarding healthcare, it is available. I would like to also take this opportunity, using your podcast to encourage men with a vagina, with the cervix to attend to a gynaecologist- because we're not all bad. And what I've experienced, this is a very close community and if I do have a client, normally they encourage their friends to attend the Gynae because it's important.

Georgie Williams, voiceover: Naturally, given Chiara’s awareness of transgender and also women’s healthcare on the island, I wanted to press her on the subject of intersex healthcare. I was conscious here of how her medical education in Wales may be a potential positive or negative influence- but what Chiara had to share made it clear how intersex welfare has not been an exclusively medical issue in Malta. Once in Maltese history, intersex welfare was a religious issue. 

Chiara, in interview: In the past, like a few decades ago, right? Because even when I was in medical school, this was talked to us this way. We were talking about these ambiguous genitalia at birth. So you cannot assign if it's a female or male neonate that was born. The whole idea within the medical community was to assign a female because there's no penis, even though there's no labia as such. And as there's no penis, it's easier to give a female life because otherwise will be a non-functioning male. And I'm sure there was a lot of these people who felt that internally they are male. But they were brought up a tomboy? And it's interesting that in Malta, we had this community of spinsters that would go as Catholicism teachers, so not nuns, but they would remain spinster and wear these dark clothes and all of this. But yeah, if you had to check the chromosomes, probably will be XY. Duttrina was the Catholicism classes, but this was a phenomena and I remember learning about this and even when I was doing my specialisation and talking about what to assign. But in Malta now we've got this birth certificate where you can actually tick no gender, which is amazing! And last year there was one that was… a parent actually applied not to assign a female or male, which is quite progressive, isn't it? 

But Malta being so Catholic, staunch Catholic, and there's a lot of people who are naive in everything else. Where it's wrong, even just being gay, because, no, "you're not meant to love someone who is like you". You’re meant to be a man and a woman because you meant to procreate. But I think there's been a lot of repressed anger. And if you see, we only had divorce not so long ago, three years back, and lots of married couples would live separate, maybe because they were attracted to the other sex- but you were forced to marry someone of the opposite sex. I think we've come a long way, but the view is not I think, it's not yet universal. There's not enough discourse, there's not enough discussion out there that makes it ‘normal’, if that makes sense. So we need to be more open and speak about this because there's so much misconceptions, I think. 

Georgie Williams, voiceover: The Catholic classes that Chiara mentions, Duttrina, were oftentimes conducted by these supposed spinsters. Duttrina is the Maltese word for doctrine and it is, to say the least, highly interesting that the Maltese Catholic Church created social roles for these intersex individuals where they were tasked with preaching a conservative doctrine. There is substantial literary weight behind Dr Frendo-Balzan’s assertion that these individuals may have been considered “non-functioning” as males if they did not have what was recognised as a penis at birth. In Stephen Kerry’s Intersex Men, Masculinities and ‘Disabled’ Penises, Kerry situates hir research within what is described as a “phallocentric society”- a society which is not only patriarchal in nature, but values above all else the assumed power of the male sexed body. This value, of course, requires scrutiny- not all individuals of presumed male sex will meet the standards of what is considered a masculine enough body- and naturally, one of the most central sites of this scrutiny is male genitals. Kerry writes that many men who are intersex have to navigate “pluralised masculinities”, often because their genitalia is considered inadequate, both pre or post surgical intervention. It seems reasonable to state that, under a patriarchal institution such as the Catholic Church, there would have been no choice for an intersex person with a supposedly inadequate penis to live as a man. We should, therefore, resist any inclination we have to describe this involvement of intersex individuals in the Catholic Church as inclusion or acceptance. 

In 2015, the Maltese government passed the Gender Identity, Gender Expression and Sex Characteristics Act, which protects particular rights for transgender and intersex individuals. However, the Equality for Men and Women Act was also passed in 2003, which stipulates that “the treatment of a person in a less favourable manner than another person” constitutes discrimination- but, evidently, restriction to essential medical services such as abortion is not considered less favourable treatment. Although on paper, particular protections exist for women and transgender and intersex Maltese citizens, there is only so much that these legislations can ensure when it comes to reasonable reproductive healthcare. Furthermore, there is only so much this legislation can do to influence wider social opinions on the value of women, transgender individuals and intersex individuals in Maltese culture, as Chiara made evident to me. 

Chiara, in interview: It's quite interesting because I've only been in Malta for four years, so I'm seeing some aspects of things, even through my own social circle, as regards to rights or legal rights on what you're entitled to... Legally, we have a lot to improve. It's super interesting because as we're just talking, like through my head, I'm seeing flashes of how women are not treated properly in Malta- case in point, tax. If you get a tax back on something, it goes to your husband or you get a separation. Good luck with that, cause it goes to him! I know, even I was shocked. I'm not married, obviously this has not affected me, but when I'm hearing... "What? Is this real? Is it?" Yes. And you can't go to your bank and say anything because it's both of you and he would receive the tax back. So yeah, there we go. It's very interesting. 

I don't do speculation, as you said, but it's quite popular. It's the modern things to accept to accept sexuality in its various forms. And even having your surname... there was a bit of a kerfuffle with having your surname, when you went to... so when you're married in Maltese culture, you normally take your husband's surname, right? And obviously with same sex marriages. Now what happens? And a question that is often asked is "so who's the man?" but even if they’re both men, "But one of them needs to be the man, no?" And it's like, when I hear it I cringe, I think, "but how do you ask such a question?" This goes through, we need to talk more about this. But yes, going back to the surnames. So then you could choose to either combine the two or choose either/or. But there needs to be a family name. So then this moves on to even hetero couples getting married. So now you can either take his surname, You can take her surname. So far, I've not seen a couple who has taken his surname, but they can join surnames- and it's a big thing for a man to take the woman's surname. How random is that? Right?

So, yes. So there's are a few things. I don't know if you're uncovering a few things, speaking to people in Malta, I feel like we are trying to change things to be the popular party in politics, maybe, because if you say something that is not accepted, then you don't get the vote. And there's a lot of things like that for Malta, so a lot of politics is for votes. Right. And I'm sure there's those countries that are like that. But, yes, I think that, listen, we're doing this because it's popular. No, we need to do this because it's that person’s rights. And that person could be intersex, could be female. And we should have equal rights. We need to be diverse and equal. 

In my job as an obstetrician, seeing pregnant women who, if I get this couple who ask me, can you please tell us the gender? And we have to have this gender reveal and tell us if it's a boy or a girl. And I jokingly do tell them, "oh let's see if it's still a girl!'. Because you know.. "what do you mean? If it's still a girl?” No. And I have had couples tell me "if he wants to change, I'll kick him out." Like okay, wow. Wow. Do you know what I mean? So there’s still that… almost un-acceptance, or maybe naivety, right. But I kind of make a joke out of it because obviously it's not happening, it's not serious. But I personally believe that in five years time, couples won't be asking me for gender. I think that's the way Malta's heading. Probably not in the UK, when I was working in the UK. Probably not there yet. I think the UK is quite strict. “We like as we are, we don't want anything else, like anything external.” But, yes, I generally believe that in a few years time, we're going to be more open to allowing kids to see what they feel like and maybe that's fluid. But I think things are moving, things are changing. In the last four years, I've seen improvement in even being comfortable in your own skin- going outside, going to a posh restaurant and actually wearing whatever you want to wear. If you're queer and you want to show who you are to the world. Do it. Do it! And you know what? When I see this, I'm like, yeah, what you wearing?! Well done you! 

And this was all hidden in the past. This was all hidden. And it's sad to think because this is not something new. This is not something new. How you feel within yourself, is not something of this time, It's always been- centuries. And to feel, to think that it was so hidden. Someone must have suffered so much internally going through conversion therapy just to be someone who they're not. So, yeah, I think there's improvement. It's improving. Come back in five years time and we'll see. 

Georgie Williams, voiceover: I was inspired by the optimism Chiara held for the direction of gender consciousness in Malta- the belief she had that parents may, sooner rather than later, become less interested in placing often rigid sex-based expectations upon their children. Nevertheless, Dr Frendo-Balzan also gave me significant insight into the influence of the Catholic Church on both the politics and cultures of this community. The regulation of what the body could look like seemed more progressive than other countries, based on their protection of intersex bodily autonomy. But what the body could do, or should be used for, was evidently a more taboo subject. It is worth noting that many intersex individuals are sterilised in the process of the non-consensual surgeries that are forced upon them as babies in most countries. Chiara noted the importance of procreation under Catholicism; an argument often used with homophobic intent. So was the protection of intersex bodily autonomy somehow connected to the criminalisation of abortion? Were these values somehow grounded in preserving the idealised ‘natural’ body at all costs? These were points of speculation- and they demanded we further our research in Malta.

My interview with Chiara couldn’t possibly be our final interview in Malta. To understand the complexities of the climate around gender, sex, sexuality, the body and the power of religion in this country, we had to bring in more voices. To do this story justice, we needed to expand the arena- and in our next episode I will be bringing those voices to you, from people who know the culture of identity politics in Malta both personally and professionally. Join us next time for part two, where we will learn more about what differentiates Malta from the currents of change in Europe and how it is that this small and unique country has developed into a sociocultural anomaly. Our investigations into what makes the Maltese body continue. 

This episode of the /Queer Podcast was edited by Sam Clay, transcribed by Bronya Smith, scripted, produced and hosted as always by me, Georgie Williams. A very special thanks to Dr Chiara Frendo for her insightful contributions to this episode, as well as Former US Ambassador to Malta, Wendy Green, for her time and wisdom. 

I want to take a moment here to make a call for support; as you’ll know by now, I’m back on the road for research and whilst our team is working away at bringing these episodes to you back home, I’m doing a lot of time travelling to interview locations and eating mediocre instant packets of oatmeal between research engagements.We love doing what we do here at /Queer, which is bringing you education and resources on a sensitive subject to your ears for free- but running this project is very costly.

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You can find our /Queer merchandise on Threadless and we are still accepting donations via Ko-fi- the links to both are in the description for this episode. This episode was recorded on location in Valletta, Malta. Music in this episode was composed by our resident audio king, Sam Clay. If you enjoyed this episode or have any feedback, please get in touch on Instagram or Twitter at @SlashQueer or email us at slashqueer@outlook.com. As our quest continues- stay kind, stay radical and stay queer.