A significant number of transgender people are turning to prostitution to help fund hormone treatment and gender reassignment surgery, social workers and NGO workers have told MaltaToday.

Sources who work closely with transgender clients say that ‘at least 75% of the cases they see’ have resorted or are resorting to sex work to have access to hormone treatment.

People who engage in sex work may become vulnerable to drug trafficking or addiction. “Shame that comes from working in prostitution can lead to drug taking, making individuals vulnerable to addiction and increasing their chance of being arrested,” the source continued.

Transgender individuals also resort to an online black market, where they can access hormones at a lower price. “Doctor’s prescriptions and endocrinologists’ advice is disregarded in an effort to get access to treatment as quickly and cheaply as possible,” Colette Farrugia Bennett from Malta Gay Rights Movement (MGRM) has said.

The situation seems to be changing however, as awareness grows and society becomes more accepting. “Most of the people I met who turn to prostitution are now in their thirties or forties. They felt unprotected by the laws and needed to turn somewhere for some financial safety,” said the MGRM representative.

Gilbert Calleja, the photographer and author of Liminal – a photographic exposé into the Maltese transgender community – warns against generalisation. “Social background, stigma and support from family can result in loss of job opportunities, leaving people with no other choice than to turn to prostitution,” Calleja said.

There are currently no statistics on the number of transgender individuals incarcerated for loitering.

Transgender individuals desiring gender reassignment surgery currently have to travel abroad for the operation, incurring costs of €25,000 to €30,000, Farrugia Bennett estimates.

Free gender reassignment surgery would facilitate access to surgery, which “is not cosmetic, as many seem to think. For those who need it, [surgery] is therapeutic”, a source said.

Hormone treatment can average €100- €500 every three months, depending on the physical development of the client. Mater Dei does not currently offer hormone therapy, although the Labour party revealed plans for state-funded hormone treatment prior to the election.

The Health Department is currently preparing a medical brief on gender reassignment surgery for discussion with relevant stakeholders, the Ministry for Health confirms.

The situation “does not at all surprise” according to Lauren Salerno, an openly transgender individual who moved to Malta after facing discrimination in her home country, the UK.

“I lost my job because of my identity,” she said. “I went from a state government job in the UK to having no job”.

Upon moving to Malta, Salerno struggled to find work after being told, “no one will employ [someone transgender] for a customer-facing job”.

“I was also told that I wouldn’t get some jobs because in the uniform I would look different than other women,” said Salerno.

A 2008 study by Malta Gay Rights Movement (MGRM) shows that transgender people reported very negative work experiences. “Many trans people are found within the lower-skilled jobs, not necessarily because they are less skilled but for the simple fact that they are not hired,” said one respondent. “When left with no option, some resort to doing sex work.”

“Since many of us don’t find a job, many end up in prostitution,” said another. “It’s a bad image but you don’t blame them because if you don’t find a job and you need money… you can never know what could happen to me!”

The study continued to argue that trans employees who had recently started transitioning were forced to leave their jobs either by their employers or through the conditions at work.

Under the Equality for Men and Women Act, the National Commission for the Promotion of Equality protects transgender people from discrimination in the workplace.

It outlines discrimination as being “based on sex or… gender expression or sex characteristics, and includes the treatment of a person in a less favourable manner than another person is, has been, or would be treated on these grounds.”