Speaking ahead of Intersex Awareness Day, 26 October, a group of United Nations and international human rights experts* has called for an urgent end to human rights violations against intersex** children and adults. They urge Governments to prohibit harmful medical practices on intersex children, including unnecessary surgery and treatment without their informed consent, and sterilization.
In countries around the world, intersex infants, children and adolescents are subjected to medically unnecessary surgeries, hormonal treatments and other procedures in an attempt to forcibly change their appearance to be in line with societal expectations about female and male bodies. When, as is frequently the case, these procedures are performed without the full, free and informed consent of the person concerned, they amount to violations of fundamental human rights.
Parents of children with intersex traits often face pressure to agree to such surgeries or treatments on their children. They are rarely informed about alternatives or about the potential negative consequences of the procedures, which are routinely performed despite a lack of medical indication, necessity or urgency. The rationale for these is frequently based on social prejudice, stigma associated with intersex bodies and administrative requirements to assign sex at the moment of birth registration.
Profound negative impacts of these often irreversible procedures have been reported, including permanent infertility, incontinence, loss of sexual sensation, causing life-long pain and severe psychological suffering, including depression and shame linked to attempts to hide and erase intersex traits. In many cases intersex people do not even have access to their own medical records or original birth certificates.
While awareness of the existence and rights of intersex people is slowly growing thanks to the work of intersex human rights defenders, only a handful of countries have taken concrete measures to uphold their rights and protect them from abuses.
States must, as a matter of urgency, prohibit medically unnecessary surgery and procedures on intersex children. They must uphold the autonomy of intersex adults and children and their rights to health, to physical and mental integrity, to live free from violence and harmful practices and to be free from torture and ill-treatment. Intersex children and their parents should be provided with support and counselling, including from peers.
Intersex children and adults should be the only ones who decide whether they wish to modify the appearance of their own bodies – in the case of children, when they are old or mature enough to make an informed decision for themselves. They should have access to support as well as to medical services that respond to their specific health needs and that are based on non-discrimination, informed consent and respect for their fundamental rights. In this connection, it is critical to strengthen the integration of these human rights principles in standards and protocols issued by regulatory and professional bodies.
States should investigate human rights violations against intersex people, hold those found guilty of perpetrating such violations accountable and provide intersex people subjected to abuse with redress and compensation.
Ending these abuses will also require States to raise awareness of the rights of intersex people, to protect them from discrimination on ground of sex characteristics, including in access to health care, education, employment, sports and in obtaining official documents, as well as special protection when they are deprived of liberty. They should also combat the root causes of these violations such as harmful stereotypes, stigma and pathologization and provide training to health professionals and public officials, including legislators, the judiciary and policy-makers.
*The signatories include:
UN Committee against Torture (CAT): http://www.ohchr.org/en/hrbodies/cat/pages/catindex
UN Committee on the Rights of the Child (CRC): http://www.ohchr.org/en/hrbodies/crc/pages/crcindex.aspx
UN Committee on the Rights of People with Disabilities (CRPD): http://www.ohchr.org/en/hrbodies/crpd/pages/crpdindex.aspx
UN Subcommittee on Prevention of Torture and other Cruel, Inhuman or Degrading Treatment or Punishment (SPT): http://www.ohchr.org/en/hrbodies/opcat/pages/opcatindex.aspx
UN independent experts: Mr. Juan Méndez, Special Rapporteur on torture and other cruel, inhuman, or degrading treatment or punishment, Mr. Dainius Pῡras, Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health, Ms. Dubravka Šimonovic, Special Rapporteur on violence against women, its causes and consequences: http://www.ohchr.org/en/hrbodies/sp/pages/welcomepage.aspx