Human Rights Commission submission on intersex policy reform and services

Late last year, the Human Rights Commissioner announced a survey and consultation to explore key rights and services issues affecting LGBT and intersex people in Australia.

OII Australia consulted our members, board and broader constituency, and we have made a submission today that covers the key intersex-specific issues for policy and services that we have identified as a result.

We present personal experiences of trauma, discrimination and related concerns in home and work lives, access to healthcare, and in parenting. We present examples of legislation, policies and practices by government that unduly restrict rights, including:

  • Failure to act on human rights violations in medical settings.
  • Flawed implementations of third gender recognition.
  • Concerns regarding funding actions and focus.
  • Failure to recognise birth sex assignment, for example, in sport.

We have to recognise a difficult environment for intersex-led organisations, including reliance upon volunteers who are constantly on the edge of burnout due to excessive demands, vicarious trauma and prior life experience, and no reward.

We make the following proposals:

Health policy issues

  • Australian governments must implement the 2013 Senate Community Affairs Committee report on the “Involuntary or coerced sterilisation of intersex people in Australia”. Implementation would be consistent with the 2015 concluding remarks of the UN Committee on Rights of the Child in observations on Switzerland.
  • Australia must develop and enact national uniform legislation prohibiting the sterilisation of children, regardless of whether or not they are intersex or not, in the absence of their prior, fully informed and free consent, except where there is a serious threat to life or health.
  • Psychosocial rationales for surgical and hormonal interventions on persons with intersex variations must no longer be regarded as acceptable or therapeutic.
  • Intersex women and girls must be subject to the same policy arrangements on Female Genital Mutilation as non-intersex women and girls, with no medical exemptions that permit interventions for social and cultural reasons such as future marriage prospects.
  • Australian governments must develop clinical treatment protocols that meet international human rights obligations, covering healthcare from prenatal diagnosis through to adolescence, and with long term follow up; such protocols must be developed with community participation.

Health service issues

  • Service delivery must include long term, peer and psychological support. This must be integrated with, but outside, the clinical environment.
  • Services must provide particular support for parents and prospective parents, including those using genetic counselling services.
  • Services must provide particular support for individuals who suffer epistemic injustice, a legacy of isolation, secrecy and shame.
  • These recommendations are consistent with the 2015 concluding remarks of the UN Committee on Rights of the Child in observations on Switzerland.

Education and awareness raising policy and services

  • Education policies must contain adequate recognition of the existence of intersex bodily diversity.
  • Media and public awareness is poor and generally associates intersex with gender identity issues; no independent mainstream attention was paid to the human rights concerns raised by the Senate inquiry.
  • Intersex-led services need funding to promote inclusion in education, and help develop greater public and media awareness.

Sex and gender recognition policy

  • Policy must respect the diversity of intersex gender identities, and prevent possibilities of involuntary assignment to a third sex or gender classification. Third classifications should be streamlined and labelled “X”, “indeterminate” or “non-specified”. A third classification should not include the term “intersex”.
  • Our policy goal is a situation where sex or gender, like race and religion, should no longer appear on birth certificates, and where persons able to give voluntary and informed consent are, in the meantime, free to choose a gender marker through a simple administrative procedure.
  • These policy recommendations are consistent with an emerging international consensus, including a 2013 declaration by the Third International Intersex Forum, 2015 Maltese ID proposals, and a 2014 international guide to good practice on recognition of trans rights, published by Open Society Foundations.

Policy on redress

  • In line with the statement of the Committee on the Rights of Child, we call for attention to issues of redress and compensation for persons who have undergone involuntary or coerced medical treatment.

Community development

  • Intersex-led organisations (OII Australia and AIS Support Group Australia) need to be resourced to contribute to policy development and service delivery in the above areas.

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