Intersex legislative issues – a brief summary

Please note that this document has been superseded by federal legislation, a 2013 community consensus statement and a Senate committee report on the “Involuntary or coerced sterilisation of intersex people“.

Summary of legislative issues for intersex people

OII Australia has recently been asked to summarise our position on a range of legislative and health issues. We published a paper on health on 1 September, and this summarises other issues, with the exception of relationship recognition.

Introduction

Intersex is a term which relates to a range of natural biological traits or variations that lie between “male” and “female”. Historically, the term “hermaphrodite” was used, originating in classical mythology. The Greek historian Diodorus Siculus wrote, in the first century BC:

Hermaphroditus, as he has been called, who was born of Hermes and Aphrodite and received a name which is a combination of those of both his parents. Some say that this Hermaphroditus is a god and appears at certain times among men, and that he is born with a physical body which is a combination of that of a man and that of a woman, in that he has a body which is beautiful and delicate like that of a woman, but has the masculine quality and vigour of a man. But there are some who declare that such creatures of two sexes are monstrosities, and coming rarely into the world as they do they have the quality of presaging the future, sometimes for evil and sometimes for good. [32]

The term intersex was coined by Richard Goldschmidt in 1901, and is used by science to describe human beings whose biological sex cannot be classified as clearly male or female; the term hermaphrodite is used to describe characteristics not seen in mammals.

Historically, there were no medically-established distinctions between lesbian, gay, bisexual, trans or intersex. Siobhan Somerville in Queering the Color Line reports that, as late as 1921, medical articles declared that a physical examination of lesbians “will in practically every instance” disclose “abnormally prominent” genitalia, and this is “particularly so in colored women” [34].

A key change happened in the 1950s, when New Zealand doctor John Money declared that sex equals nurture, not nature [35]. Surgical cosmetic “normalization” has since been the standard medical protocol, despite a paucity of long term impact studies and no sound evidence of the benefits of normalization [36][37]. For example, Alice Dreger, former co-director of the Intersex Society of North America, has said that “I have never met an intersex adult who was entirely happy with their surgery” [39]. There is no evidence of harm caused by absence of cosmetic surgical intervention [38].

Many intersex differences, pathologised as “disorders of sex development”, are apparent at birth, and the most common intersex variations can now be diagnosed, if tested, via amniocentesis. Some intersex variations become apparent at puberty, when trying to conceive, or through random chance.

Fausto-Sterling puts the intersex prevalence figure at a minimum of 1.9% of the population [29]. Genetic researchers state that it may be as high as 4% [30].

This document is a brief summary of government issues around intersex by Morgan, board member, OII Australia. It aims to give a very brief overview of areas where changes to the treatment of intersex people could significantly improve our lives.

Data and identity documents

Although intersex people represent a significant percentage of the population, there is little substantive recognition of intersex people in legislation at federal level, or by states and territories.

Registration at birth

Sex is defined in the Australian Health Data Dictionary as including “male”, “female”, “intersex or indeterminate”, and also “not stated/inadequately described” but it is not reported in “people aged 90 days or greater”:

CODE 3 Intersex or indeterminate
Is normally used for babies for whom sex has not been determined for whatever reason.
Should not generally be used on data collection forms completed by the respondent.
Should only be used if the person or respondent volunteers that the person is intersex or where it otherwise becomes clear during the collection process that the individual is neither male nor female.

CODE 9 Not stated/inadequately described
Is not to be used on primary collection forms. It is primarily for use in administrative collections when transferring data from data sets where the item has not been collected. [27].

Not all jurisdictions permit the recording of a birth using codes 3 or 9. The ACT Law Reform Advisory Council note that:

The forms for notification and registration of a birth – ‘Notification of Birth not Occurring in a Hospital’ (Form 218) and ‘Birth Registration Statement’ (Form 201) – are legislative instruments that must be complied with. The forms currently require that the sex of a child be marked as either ‘male’ or ‘female’.

… for a child who 
is known to be intersex at or soon after their birth, the legislation requires a decision must to be made, within short time limits, to record the child’s sex within the female/male binary.

Parents may choose not to register their child as intersex, and it is common for parents, in consultation with medical practitioners, to assign a gender identity to an intersex child; this often involves surgery and medical treatment to ‘confirm’ the chosen gender identity. The chosen gender identity is the ‘sex’ that is recorded when formally notifying and registering the child’s birth. It will not be known until the child matures whether the assigned sex which was assigned at birth and implemented through surgery and medical treatment, does in fact accord with the child’s gender identity. [28]

This means that:

the definition of an intersex person characterises their sex as a medical ‘condition’ which departs from the binary sexual identity of female and male. [28]

This characterization is stigmatizing.

Given the social stigmatization of gender nonconformity, OII Australia supports the provisional assignment of a binary gender to infants. We don’t believe that this should be regarded as essential. We have seen no evidence of harm arising from alternative approaches, and we would like to see research on this issue.

In our health paper [1], we show that, while infant surgeries are carried out in Australia on the basis that they are life preserving, this is often on the basis of poorly substantiated generalisations regarding risk and is not supported by international experience, notably that of the UK. We recommend a very conservative approach to surgical and medical treatment, and propose that future potential for different life paths must always be preserved until a child is old enough to consent after counselling.

We support the right of intersex people to identify themselves as intersex, and choose a different binary or non-binary gender identity. We believe we are entitled to live with our bodies as we were born, without surgical or hormonal modifications, and still enjoy full and equal rights as citizens. We believe that we are entitled to adopt the sex role (gender) that we are most at ease with, even if that should conflict with social expectations.

Data collection, without creating a third sex

OII Australia does not support any mandatory classification of intersex people to a third sex or gender category. We regard a third gender as stigmatizing. It is likely to further entrench unnecessary cosmetic surgical intervention, in an effort to avoid such classification. Nevertheless, data on intersex numbers and experience is scarce, yet the collation of data on intersex people’s numbers and experiences is vital for community development, and the tackling of barriers to our full participation in society.

We would strongly welcome the wider inclusion of intersex in health data, possibly treating this as an additional designation, used alongside a provisional binary gender. Beyond health data, we would strongly welcome the establishment of a broader “not specified” or “not stated” sex or gender identifier available to adults wherever gender data is required in government forms and documents.

We do not believe that an opt out category would create a third gender.

Passports

Intersex people, and other people whose sex or gender is indeterminate or unspecified, are currently able to choose, if they wish, a passport indicating an “X” in the field for sex under liberalised regulations introduced on 14 September 2011 [18]:

A passport may be issued to sex and gender diverse applicants in M (male), F (female) or X (indeterminate/unspecified/intersex). [20]

The first person to be granted an “X” passport was Alex Macfarlane in 2003, on the basis that Alex has a birth certificate issued in Victoria showing that Alex’s sex at birth was indeterminate [19]. We understand that the first person granted an X passport since the then Foreign Minister relaxed previous rules requiring a birth certificate was a trans person and not intersex.

We would like to see the existing passport regulations governing the issuing of such passports streamlined and extended.

Streamline the definition

The word intersex should not appear in the definition, as inserting this word misgenders intersex people who are men or women.

Consistency across government

Intersex people may not identify themselves as such in the Australian census, or when accessing government services, such as registering with Medicare or Centrelink.

The use of sex or gender designations should be consistent across government and government-funded entities. People with an “X” sex indicator on their passport should not be required to enter different information in one realm than they are in another. “X” for sex should be available in all areas where data is sought on a person’s sex or gender.

Avoid de facto creation of a third gender

Not all intersex people wish to obtain an “X” on their passport, and we believe such categorisation should never be mandated, due to social stigmatisation of gender nonconformity. The creation of a third sex or third gender is neither sought nor welcomed by OII Australia. Children of school age should not be automatically assigned as “intersex” or “indeterminate” due to their biological characteristics; rather, travel between these and the more common gender categories should be supported, on request, for people able to give informed consent.

An “X” sex marker should be freely available as a “non specified” sex or gender marker to anyone who chooses not to specify their sex or gender. It should do so without requiring medical confirmation of their physical status or identity. We believe that this is essential to avoid the de facto establishment of a third sex or gender through the granting of “X” passports to intersex people.

We believe that it’s impractical to limit “X” passports to intersex people. We recommend an option that allows people to accurately record their non-binary physical sex or gender identity, such as that afforded by a “not specified” category.

Changing gender on birth certificates

Any future, nationally consistent, approach to changing gender that requires medical confirmation must continue to facilitate the administrative correction of birth certificates for intersex people.

Intersex people are currently able if we wish, in most states and territories, to obtain an administrative correction of our birth certificate on the basis that there was an error in the original document.

In New South Wales, the Births, Deaths And Marriages Registration Act 1995 Section 45 states:

(1) The Registrar may correct the Register:

(a) to reflect a finding made on inquiry under Division 2, or

(b) to bring an entry about a particular registrable event into conformity with the most reliable information available to the Registrar of the registrable event.

(2) The Registrar must, if required by a court, correct the Register.

(3) The Registrar corrects the Register by adding or cancelling an entry in the Register or by adding, altering or deleting particulars contained in an entry. [21][22]

Tony Briffa, currently mayor of Hobsons Bay, Victoria, provides the first case of an administrative correction of which we are aware. The New South Wales Births Registry has provided us with information and a case study regarding administrative corrections in NSW [22].

The main exception to administrative correction is in Western Australia. Under Western Australian law, intersex people who reject their birth assignments have no choice but to comply with the rules contained in the Gender Reassignment Act 2000 (GRA) [23]. There is no provision for administrative correction of birth certificates.

Compliance with WA’s GRA entails, as it does for transsexual and transgender individuals, that sufficient parts of an intersex person’s anatomy should be removed or modified so that they might be seen to be appropriately bodied for the sex they wish to live as.

When a sex assignment is made on an intersex child there can be no certain way to predict how that child might express their gender role as an adult. Many intersex people will have experienced non-consensual cosmetic surgery as an infant to reinforce an assigned sex. For those who discover their intersex as adults there is no certain way to say how their differences should inform their choice of gender roles.

Children and adults, with a perspective of fundamental human rights, must be able to retain both their right to choose and their right to bodily autonomy.

The Australian Human Rights Commission report “The Sex Files” contains a recommendation for a gender recognition panel that appears to be somewhat similar to the Gender Reassignment Board established by the GRA in WA [24]. This paper did not take the intersex experience of administrative correction into account, and we fear the inadvertent removal of this facility should legislation change.

We believe that any nationally consistent approach to legally changing gender must facilitate the right of intersex people to an administrative correction of the details on birth certificates.
Intersex people should not be forced, as in Western Australia, into a situation where we must surgically or hormonally modify their body to conform to the expectations of male or female gender.

Access to services and employment

Little data exists on discrimination in the provision of services or in employment, as existing data rarely includes intersex as a category or, if it does, it doesn’t separately identify intersex people. For example, the National LGBTI Health Alliance notes:

For people of diverse sex and/or gender identity, there is no mention in nationally significant health data. [26]

The “Gender Diversity in the ACT” survey found that:

Transgender and intersex people living in the ACT are six times more likely to be unemployed than the rest of the population and have difficulty accessing health services [25]

We can point to extensive personal experience by members of OII Australia including, in employment:

  • Being blackmailed with the threat of being outed.
  • Being refused employment and being dropped from representation by recruiters after learning we are intersex.
  • Being thought too visibly and audibly different to be employed in any capacity despite experience and qualifications.
  • Being thought to have a “far too challenging history” to be employed.
  • Being fearful of participating in casual conversations about family, friends, weekends and vacations lest one outs oneself and becomes a pariah.
  • Being too frightened to attend social events of any kind for the same reason.
  • Being fearful of explaining one’s possible need for medical leave; suffering from medical protocols with mixed outcomes that are poorly understood with nearly no long-term follow ups.
  • Being simply incapable of conforming.
  • Being singled out as a freak, verbally and physically abused on a daily basis.
  • Demands by an employer to stand up in front of all the other employees in order to apologize for being different.
  • Hiding oneself away in silence.
  • Performing poorly as the result of living and working in fear.
  • Feeling invisible, unrecognized and worthless.
  • Being unable to simply be oneself.
  • Appearing, sounding and behaving too female to be male, too male to be female, or appearing too young to be credible in a career, as hormonal differences can make intersex people look 10 to 15 years younger than their age. [6]

In access to services, members of OII Australia report:

“I was laughed at by staff at a health insurer for the nature of a necessary medical examination.”

“Being left standing at the counter at Medicare. The staff member simply walked away. I was expecting them to come back but after fifteen minutes realized they would not. The other counter staff said ‘she’s gone for lunch, you had better get back in line’”.

“I can’t book a flight on an Australian airline with a gender that matches my Australian passport. My passport shows my sex as “X”, not specified.”

“My mother is in an aged care facility. She has to sit in silence while disparaging remarks are made about intersex people – during the Caster Semenya incident especially. Mum feels both vulnerable and isolated because of this.”

“Less than full in-home services provided to the person I cared for because of the religious conviction of the organization providing aged care in our town.”

“While in hospital for life-preserving surgery, an aged care community visitor provided by a religious organization removed the person I was responsible for was taken from the home to a solicitor, had an intervention order taken out against me, had a power of attorney revoked and attempted to have the will of the person I was caring for changed. The visitor had told my old friend I had left for good and would never come back. My friend was understandably devastated. She had forgotten I was only in hospital. The organization that provided the visitor was unapologetic. The whole business cost in excess of $4,000 in legal fees that I had to spend on getting the intervention order dismissed, the power of attorney reinstated, the will reverted and regaining my guardianship from the guardianship tribunal.”

“Refusal to provide me with assistance getting respite and in-home care when I was ill by the aged care assessment team, and aged care package provider. Both of them are religion-based and are contracted by the Government to provide the service. They are legally able to discriminate against me as I have no protection at law as an intersex person”.

“Being refused a forklift driver’s license with a changed name. It required an appointment with the regional chief of the responsible agency to rectify the problem … the renewal notice three years later required the same solution” [6]

In addition to visible and audible differences, many intersex people now also have identity documents, such as passports and birth certificates, that identify us as neither wholly male nor wholly female. This means that we are not able to marry under current federal legislation. It also exposes us to discrimination when we supply documentation to prove our identity, to recruiters and employers – and we are not currently protected from discrimination anywhere in Australia.

Including intersex in anti-discrimination legislation

The Anti-Discrimination Board (ADB) of New South Wales has acknowledged that intersex people are not currently included in anti-discrimination legislation anywhere in Australia. Form the ADB 2008-2009 Annual Report:

Intersex discrimination – intersex people are not protected against discrimination anywhere in Australia. [10]

This is evident in state anti-discrimination legislation. Section 38A of the NSW Anti-Discrimination Act 1977 No. 48 defines:

“a recognised transgender person … (c) who, being of indeterminate sex, identifies as a member of a particular sex by living as a member of that sex”. [12]

Similarly, the Victorian Human Rights Commission reports:

The Equal Opportunity Act 2010 protects gender identify as a personal characteristic. Under the Act, gender identity is about people of one sex identifying as a member of the other sex, or people of indeterminate sex identifying as a member of a particular sex. People can do this by living, or seeking to live, as a member of a particular sex, or assuming characteristics of a particular sex. This could be through their dress, a name change or medication intervention, such as hormone therapy or surgery. [17]

And in Queensland’s Anti-Discrimination Act 1991, the Schedule Dictionary defines “gender identity as follows:

gender identity, in relation to a person, means that the person–

(a) identifies, or has identified, as a member of the opposite sex by living or seeking to live as a member of that sex; or

(b) is of indeterminate sex and seeks to live as a member of a particular sex. [12]

A casual read might suggest that these provisions would protect intersex people but, in fact, they require people to identify as either men or women, and do not protect those whose innate biological sex is intersex. This is for two reasons, apparent in a legal appeal by Norrie, a trans person, seeking a gender neutral birth certificate:

  • Sex is interpreted as a binary. The case of Norrie v Registry of Births Deaths and Marriages [2011] NSWADT 102[11] found that references to “sex” are:

    
…premised on a binary division between the sexes into “male” and “female”…
In my view the Act is predicated on an assumption that all people can be classified into two distinct and plainly identifiable sexes, male and female.

  • The intention of legislation was to provide for transgender people, not intersex people. The NSW Administrative Decisions Tribunal reports in the case of Norrie v Registry of Births Deaths and Marriages [2011] NSWADT 102:

    Part 5A of the Act deals with changes of sex. Part 5A (not including sections 32DA – 32DD) was inserted into the Act by the Transgender (Anti-Discrimination and Other Acts Amendment) Act 1996 on 3 October 1996. The same Act also inserted Part 3A (‘Discrimination on transgender grounds”) into the Anti-Discrimination Act 1977. The second reading speech for the underlying Bill stated that its purpose was “to provide for the legal recognition of post-operative transgender persons”, in particular “to enable persons who were born in this State and have undergone sexual reassignment surgery to apply for new birth certificates showing their new sex” (Hansard, Legislative Assembly, Minister Yeadon, 1 May 1996). 
[11]

Current legislation similarly fails to provide protection for people, like Norrie, with a gender identity that is neither male nor female.

Intersex people are protected from discrimination in South Africa, and possibly also in the US.
Recent federal case law in the US has determined that discrimination on the basis of “gender non-conformity” constitutes sex discrimination [14].

In South Africa, Judicial Matters Amendment Act, 2005 (Act 22 of 2005) amended the Promotion of Equality and Prevention of Unfair Discrimination Act, 2000 (Act 4 of 2000) to include intersex in its definition of sex:

(a) by the insertion in subsection (1) after the definition of “HIV/AIDS status” of the following definition:
 “ ‘intersex’ means a congenital sexual differentiation which is atypical, to whatever degree;”; and

(b) by the insertion in subsection (1) after the definition of “sector” of the following definition:
 “ ‘sex’ includes intersex;” [15]

The NSW Anti-Discrimination Board recommendation

OII Australia supports the recommendation of the NSW Anti-Discrimination Board:

The Anti-Discrimination Board recommends broad, inclusive coverage of sexual orientation, gender identity, sex characteristics, and gender expression under a Consolidated Federal Act.

Any definition should ensure that it includes variations in sex characteristics, and people who are neither wholly male nor wholly female. In this way people who are intersex, androgynous and other individuals who do not fit within the current binary approach to defining sex would be afforded protection under anti-discrimination law in this context. The Board recommends that broad and inclusive language be used in any definitions of discrimination. In particular, any definition should be wide and inclusive enough to cover people who are intersex without a requirement that any person should identify as either male or female. Discrimination should be prohibited on grounds of actual or perceived sex, sexual orientation and/or gender identity. [9][8]

We would also wish for the explicit inclusion of people with passports and/or birth certificates indicating their sex as intersex or indeterminate.

Religious exemptions

Intersex children, like intersex adults, may or may not conform to expectations of their assigned gender. Intersex, like being a man or woman, or being a member of an ethnic minority, entails a biological difference. Intersex people are born, and our differences are readily apparent in amniocentesis testing, and from birth, even where we are not diagnosed at birth.

This ability to identify us before or at birth makes intersex distinctly different from LGBT peoples. Sexual orientation and gender identity are not, certainly with current technologies and genetic understandings, identifiable at birth, even though gender nonconforming behaviours in childhood might be thought to be associated with LGBT identities. The stigmatisation of intersex differences, through diagnosis with “disorders of sex development” and the pathologisation of gender nonconformity, takes place from the time of diagnosis.

We believe that intersex people should be afforded the same rights as any other biologically distinctive group and should not be subjected to religious exemptions.

Intersex infants and children must, for example, be afforded the same educational opportunities as all other children.

Health issues

We seek patient-centred healthcare that does not assume crisis in our differences, or normalization as a goal.

We recommend a very conservative approach to surgical and medical treatment, and propose that future potential for different life paths must always be preserved until a child is old enough to consent after counselling.

Please refer to the specific “Intersex health issues” paper [1] and the OII Australia/OII Aotearoa submission on the draft Diagnostic and Statistical Manual of Mental Disorders 5th edition (DSM-5) and the World Professional Association for Transgender Health 7th Standards of Care (WPATH SOC) [2] for detailed information on health issues for intersex people.

Relationship recognition

The Brisbane Family Court in 1979 annulled a marriage on the basis that an intersex person cannot be legally married because marriage can only be between someone who is seen to be 100% man and someone who is seen to be 100% woman [40].

OII Australia has made numerous submissions to government regarding marriage equality [41], and this issue is not discussed in this paper.

Relationship with LGBT/LGBTI

Intersex people share some commonality with members of LGBT communities, due to shared experience of homophobia. Indeed, we believe that the experience of intersex people shows what happens when a group of people with a “disorder” (“disorders of sex development”) are found to be “born this way” [3]. However, there is no consistent or settled view on our inclusion. For example:

  • Language relating to “sexual orientation and gender identity” does not include intersex people. Intersex is a matter of biological sex differences, not gender identity [31].
  • Despite an active involvement in national campaigns around marriage equality, intersex people were not included in the Tasmanian government’s move at the end of August to legislate for same-sex marriage [4].
  • There is no public funding for any intersex organisation, and no substantive representation in LGBTI/LGBT organisations, with resulting lack of capacity. There is no funding for any specific health bodies (a situation which can be contrasted with the NSW trans-focused Gender Centre, and LGBT health councils in each state). It is our experience that intersex persons are often the only ones representing unfunded or non-public organisations during inter-agency consultations.
  • Some funded LGBT organisations are beginning to include intersex, such as NSW’s ACON domestic violence initiative[6], where they are led by federal and state funding requirements.
  • LGBT initiatives suffer from a lack of consideration of intersex needs – organisational objectives and programmes are often only peripherally relevant to us and our major health concerns (see [1][2]).
  • Intersex people are often not included in LGBT community studies, such as the GLHV/Beyond Blue/La Trobe “Private Lives 2” study [5].
  • Intersex people often don’t contribute to such studies or organisations as the relevance is unclear, they are not personally familiar with LGBT community organisations, and because intersex people often don’t perceive ourselves as belonging to an LGBTI community. The latter is also true of many men who have sex with men (“MSM”), a core target group for LGBT health bodies.

Our experience of homophobia means that we need to be included in many actions for LGBTI people – notably campaigns around health and social services practices and policies, and employment protection. However, many of our health and other needs are distinctly different. LGBTI organisations lack the personnel, skills, experience and understanding to adequately represent intersex issues, and we need to be able to contribute to policy debates directly.

For more information on intersex intersectionalities with LGBTI please see [3].

Downloads in PDF format

References

[1] OII Australia, August 2012, Intersex health issues – a summary, https://oii.org.au/21019/intersex-health-issues/, accessed 1 September 2012.
[2] OII Australia and OII Aotearoa, 7 June 2012, Submission on the DSM-5 and SOC-7, https://oii.org.au/20360/submission-release-on-the-dsm-5-and-soc-7/, accessed 7 June 2012.
[3] OII Australia, 5 February 2012, Intersex intersectionalities with LGBTI, https://oii.org.au/16690/intersex-intersectionalities-lgbti/, accessed 5 February 2012.
[4] OII Australia, 31 August 2012, “Same sex marriage” is not “marriage equality”, https://oii.org.au/21016/same-sex-marriage-is-not-marriage-equality/, accessed 1 September 2012.
[5] OII Australia, 5 April 2012, Taking part matters: NSW people and relationships survey, and the Private Lives 2 survey, https://oii.org.au/19878/nsw-relnships-vic-private-lives/, accessed 5 April 2012.
[6] Personal communications, 2011 and 2012.
[7] ACON, 2012, Another Closet, http://www.anothercloset.com.au, accessed 1 September 2012.
[8] OII Australia, 21 March 2012, Why intersex is not a gender identity, and the implications for legislation, https://oii.org.au/17680/intersex-sex-not-gender-identity/, accessed 21 March 2012.
[9] OII Australia, 20 March 2012, Anti-Discrimination Board of NSW supports case for protection of intersex in federal law, https://oii.org.au/17524/nsw-antidiscrimination-board-support-intersex-in-federal/, accessed 20 March 2012.
[10] Anti-Discrimination Board of NSW, 2009, 2008-2009 Annual Report, http://www.lawlink.nsw.gov.au/lawlink/%20adb/ll_adb.nsf/vwFiles/ADBAnnualReport0809.pdf/$file/ADBAnnualReport0809.pdf, accessed 20 March 2012.
[11] NSW Administrative Appeals Tribunal, 2011, Norrie v Registry of Births Deaths and Marriages [2011] NSWADT 102, http://www.caselaw.nsw.gov.au/action/PJUDG?jgmtid%20=15184, accessed 26 February 2012.
[12] New South Wales Consolidated Acts, 1977, Section 38A of the NSW Anti-Discrimination Act 1977 No. 48, http://www.austlii.edu.au/au/legis/nsw/consol_act/aa1977204/s38a.html, accessed 1 September 2012.
[13] Queensland Consolidated Acts, 1991, Anti-Discrimination Act 1991 – Schedule – Dictionary, http://www.austlii.edu.au/au/legis/qld/consol_act/aa1991204/sch1.html, accessed 1 September 2012.
[14] United States Court of Appeals Eleventh Circuit, Glenn v Brumby, No. 10-14833, 10-15015, dated 6 December 2011.
[15] Republic of South Africa, 2005, Judicial Matters Amendment Act, 2005 (Act 22 of 2005), http://www.info.gov.za/view/DownloadFileAction?id=67875, accessed 21 March 2012.
[16] International Service for Human Rights, 26 March 2007, Yogyakarta Principles on the Application of International Human Rights Law in relation to Sexual Orientation and Gender Identity, http://www.yogyakartaprinciples.org/, accessed 26 February 2012.
[17] Victorian Human Rights Commission, 25 January 2012, Gender identity, lawful sexual activity, sexual orientation discrimination – Know your rights, http://www.humanrightscommission.vic.gov.au/index.php?
option=com_k2&view=item&layout=item&id=714&Itemid=543
[18] The Hon Kevin Rudd MP, Former Minister for Foreign Affairs, Getting a passport made easier for sex and gender diverse people, http://www.foreignminister.gov.au/releases/2011/kr_mr
_110914b.html
, accessed 1 September 2012.
[19] Western Australian, 11 January 2003, X marks the spot for intersex Alex, see http://www.bodieslikeours.org/pdf/xmarks.pdf, accessed 1 September 2012.
[20] Australian Passport Office, undated, Sex and Gender Diverse Passport Applicants Revised Policy, https://www.passports.gov.au/Web/SexGenderApplicants.aspx, accessed 1 September 2012.
[21] New South Wales Consolidated Acts, 1995, Births, Deaths And Marriages Registration Act 1995 – SECT 45 Correction of Register, http://www.austlii.edu.au/au/legis/nsw/consol
_act/bdamra1995383/s45.html
, accessed 1 September 2012. The Victorian equivalent is located at http://www.austlii.edu.au/au/legis/vic/consol_act/bdamra1996383/s43.html
[22] OII Australia, 13 November 2009, On administrative correction of NSW intersex birth registrations, https://oii.org.au/4856/on-birth-registrations/, accessed 13 November 2009.
[23] Western Australian Consolidated Acts, 2000, Gender Reassignment Act 2000, http://www.austlii.edu.au/au/legis/wa/consol_act/gra2000200/, accessed 1 September 2012.
[24] Australian Human Right Commission, March 2009, Sex Files: the legal recognition 
of sex in documents and government records, Concluding paper of the sex and gender
diversity project, I SBN 978-1-921449-10-9, http://www.hreoc.gov.au/genderdiversity/sex_files2009.html, accessed 1 September 2012.
[25] OII Australia, 7 May 2011, Canberra survey finds intersex people face high rates of discrimination and social isolation, https://oii.org.au/13319/intersex-inclusive-canberra-survey-finds-intersex-people-face-high-rates-of-discrimination-and-social-isolation/, accessed 7 May 2011.
[26] National LGBTI Health Alliance, 2012, Discussion Paper: Developing an ‘evidence-informed’ environment for LGBTI public policy, http://www.lgbtihealth.org.au/sites/default/files/
LGBTI%20Data%20-%20Consultation%20Paper%20June%202012%20PDF.pdf
, accessed 1 September 2012.
[27] Australian Institute of Health and Welfare, 2010, National Health Data Dictionary Version 15 (NHDD), http://www.aihw.gov.au/publication-detail/?id=6442468385. For details on “intersex or indeterminate” see pages 1465-1466 of the “Data elements: report at http://www.aihw.gov.au/WorkArea/DownloadAsset.aspx?id=6442458130, accessed 1 September 2012.
[28] ACT Law Reform Advisory Council, March 2012, Beyond the Binary: legal recognition of sex and gender diversity in the ACT, http://www.justice.act.gov.au/publication/view/1897/title/
beyond-the-binary-legal-recognition
, accessed 2 September 2012.
[29] Anne Fausto-Sterling, 2000, Sexing the Body: Gender Politics and the Construction of Sexuality, ISBN 0465077145.
[30] OII Australia, 22 January 2012, On the prevalence of intersex, https://oii.org.au/16601/prevalence-intersex/, accessed 22 January 2012.
[31] OII Australia, 21 March 2012, Why intersex is not a gender identity, and the implications for legislation, https://oii.org.au/17680/intersex-sex-not-gender-identity/, accessed 21 March 2012.
[32] Diodorus Siculus, Library of History IV chapter 6. Translated by C. H. Oldfather, 1935, Loeb Classical Library Volumes 303 and 340. Cambridge, MA, Harvard University Press; London, William Heinemann Ltd. http://www.theoi.com/Text/DiodorusSiculus4A.html#6, accessed 7 September 2012.
[33] OII Australia, 13 November 2009, Richard Goldschmidt: “Intersexuality and the Endocrine Aspect of Sex”, 1901, https://oii.org.au/4045/published-mention-intersex-1901/, accessed 13 November 2009.
[34] Mogul, Ritchie and Whitlock, 15 February 2011: Queer (In)Justice: The Criminalization of LGBT People in the United States (Queer Action / Queer Ideas) at Amazon.com, http://www.amazon.com/Queer-Justice-Criminalization-People-United/dp/0807051160, accessed 5 February 2012.
[35] William G. Reiner, Prenatal Gender Imprinting and Medical Decision-Making: Genetic Male Neonates with Severely Inadequate Penises, in Sharon E Sytsma (editor), 2006, Ethics and Intersex, ISNB 1-4020-4313-9.
[36] Birgit Köhler, Eva Kleinemeier, Anke Lux, Olaf Hiort, Annette Grüters, Ute Thyen and the DSD Network Working Group, 16 November 2011, Satisfaction with Genital Surgery and Sexual Life of Adults with XY Disorders of Sex Development: Results from the German Clinical Evaluation Study, The Journal of Clinical Endocrinology & Metabolism jc.2011-1441, http://jcem.endojournals.org/content/early/2011/11/10/jc.2011-1441.abstract, accessed 22 November 2011.
[37] Sarah M Creighton, Catherine L Minto, Stuart J Steele, 14 July 2001, Objective cosmetic and anatomical outcomes at adolescence of feminising surgery for ambiguous genitalia done in childhood, in The Lancet, Volume 358, Issue 9276, Pages 124 – 125, doi:10.1016/S0140-6736(01)05343-0, http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(01)05343-0/fulltext, accessed 1 May 2012.
[38] Alice Dreger and Ellen K Feder, 16 June 2010, Bad Vibrations, at Hastings Center Bioethics Forum, http://www.thehastingscenter.org/Bioethicsforum/Post.aspx?id=4730, accessed 3 May 2012.
[39] Katrina Karkazis, 14 November 2008, Fixing Sex: Intersex, Medical Authority, and Lived Experience, Duke University Press, ISBN 0822343185.
[40] OII Australia, 12 February 2012, An annulment of marriage due to being intersex – In the marriage of C and D (falsely called C), https://oii.org.au/16808/annulment-marriage-due-intersex-marriage-falsely-called/, accessed 12 February 2012.
[41] OII Australia, 25 June 2012 Senate inquiry supports marriage equality, talks about intersex, https://oii.org.au/20742/senate-committee-supports-marriage-equality/, accessed 25 June 2012.