How Legislation Affirmed rather than Challenged Healthcare Practices in Malta

Malta’s Gender Identity, Gender Expression and Sex Characteristics Act 2015 (GIGESCA) was the first piece of legislation that framed genital surgeries on intersex children as ‘harm’. In doing so, it sought to challenge dominant conceptions of surgeries as ‘health’ by embedding bodily integrity and autonomy approaches into medical practice. This article uses qualitative data to explore the impact that this legislative reform in Malta has had on medical approaches towards intersex. Specifically, it traces the interaction between medicine and law in the post-implementation period of GIGESCA to consider the wider lessons that can be learned from Malta’s experiences. For those wishing to introduce similar types of legislation, careful thought in design, consultation and implementation practices must be given to reconcile (best) clinical practice, bodily integrity and autonomy and the right to health and deliver meaningful change.