Carpenter: “Intersex variations, human rights, and the International Classification of Diseases”

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This open access paper published by Harvard’s Health and Human Rights Journal highlights how international clinical classifications facilitate or specify practices that violate the human rights of intersex people. It also provides some analysis of a recent Family Court case, analysed from a slightly different perspective to recent papers in Bioethical Inquiry.

The ICD-11 introduces additional and pathologizing normative language to describe [intersex variations] as “disorders of sex development.” Current materials in the ICD-11 Foundation also specify, or are associated with, unnecessary medical procedures that fail to meet human rights norms documented by the WHO itself and Treaty Monitoring Bodies. This includes codes that require genitoplasties and gonadectomies associated with gender assignment, where either masculinizing or feminizing surgery is specified depending upon technical and heteronormative expectations for surgical outcomes. Such interventions lack evidence. Human rights defenders and institutions regard these interventions as harmful practices and violations of rights to bodily integrity, non-discrimination, equality before the law, privacy, and freedom from torture, ill-treatment, and experimentation. WHO should modify ICD-11 codes by introducing neutral terminology and by ensuring that all relevant codes do not specify practices that violate human rights.

Morgan Carpenter. 2018. Intersex variations, human rights, and the International Classification of Diseases. Health and Human Rights Journal, 20(2). Open access.

Each of these papers highlights concerns with evidence for claims of changes to clinical practices, and a lack of accountability and transparency.

Acknowledgements

This publication was produced in connection with Morgan’s studies at Sydney Health Ethics, Faculty of Medicine and Health, University of Sydney, and his role with GATE.