The federal Senate’s Community Affairs References Committee is currently conducting an inquiry into the involuntary or coerced sterilisation of people with disabilities in Australia, and now also including the sterilisation and sexual health of intersex people.
The terms of reference for the inquiry were updated on 15 February to include:
2. Current practices and policies relating to the involuntary or coerced sterilisation of intersex people, including:
(a) sexual health and reproductive issues; and
(b) the impacts on intersex people.
Our submission has now been published and is available here (PDF, direct download).
In our submission we note that:
Intersex people are medicalised, stigmatised and suffer discrimination due to our distinctive biological characteristics. Intersex variations affect perceptions of our realness as men or women, and society still generally requires people to live and identify as male or female. As a result, intersex bodies do not meet societal expectations and intersex people experience homophobia and prejudice. Cultural, familial and medical attitudes towards our differences from sex norms govern which sex we are assigned, and what surgical and other medical interventions will be made to ensure we conform to those norms. Medical interventions seek to erase intersex differences.
We also note that members of OII have experienced non-consensual medical intervention.
Members of OII Australia have a range of medical diagnoses, including Congenital Adrenal Hyperplasia, 47,XXY (often diagnosed as Klinefelter Syndrome), Androgen Insensitivity Syndrome, and other related conditions.
Every individual member of OII Australia has experienced some form of non-consensual medical intervention, including the following:
- Pressure to conform to gender norms and to be a “real man” or “real woman”.
- Involuntary gonadectomy (sterilisation) and clitorectomy (clitoris removal or reduction)
as an infant, child or adolescent.
- Medical and familial pressure to take hormone treatment.
- Medical and familial pressure to undertake genital “normalisation” surgery.
- Surgical intervention that went outside the terms of consent, including surgery that
was normalising without consent.
- Disclosure of non-relevant medical data to third parties without consent.
We arrive at a number of medical, legal and community support recommendations. Our recommendations for medical protocols include the following principles:
- Medical intervention should not assume crisis in our difference, nor normalisation as a goal.
- Medical, and in particular surgical, interventions must have a clear ethical basis, supported by evidence of long term benefit.
- Data must be recorded on intersex births, assignments of sex of rearing, and of surgical interventions.
- Medical interventions should not be based on psychosocial adjustment or genital appearance.
- Medical intervention should be deferred wherever possible until the patient is able to freely give full and informed consent; this is known as “Gillick competence”.
- Necessary medical intervention on minors should preserve the potential for different life paths and identities until the patient is old enough to consent.
- The framework for medical intervention should not infantilise intersex, failing to recognise that we become adults, or that we have health needs as adults.
- The framework for medical intervention must not pathologise intersex through the use of stigmatising language.
- Medical protocols must mandate continual dialogue with intersex organisations.
Download the Inquiry reports on involuntary or coerced sterilisation
- Our initial thoughts on the Senate report, “Involuntary or coerced sterilisation of intersex people in Australia”, 25 October 2013
- Intersex report: Download report on the involuntary or coerced sterilisation of intersex people, 25 October 2013
- People with disabilities report: Download report on the involuntary or coerced sterilisation of people with disabilities, 17 July 2013
- German proposals for a “third gender” on birth certificates miss the mark
- Clinicians acknowledge lack of justification for surgeries on intersex infants in Australia a compilation of quotes from submissions by the Australasian Paediatric Endocrine Group and the Royal Children’s Hospital, 15 July 2013
- Update on Senate Inquiry on involuntary and coerced sterilisation 13 July 2013, including data on Female Genital Mutilation
OII Australia submissions
- About our fifth, concluding, submission to the Inquiry
- Our fifth submission, dated 29 August 2013 (PDF) a concluding submission, taking into account recent developments
- About our fourth submission a response to the submission by the Australasian Paediatric Endocrine Group, and new data from the Council of Europe
- Fourth submission, dated 30 June 2013 (PDF)
- About our third submission focusing on the rationales for involuntary surgery on intersex infants, and comparisons with Female Genital Mutilation; also presenting information on the M.C. legal case in the US and the 2005 City of San Francisco human rights investigation
- Third submission, dated 3 June 2013 (PDF)
- On our second submission which focused on a case detailed by the Chief Justice of the Family Court, but also the new Victorian Health Department report, and the Senate’s report on the Human Rights and Anti-Discrimination Bill
- Second submission, dated 8 March 2013 (PDF)
- About our first submission
- First OII Australia submission, dated 15 February 2013 (PDF)
AISSGA and National LGBTI Health Alliance submissions
- AISSGA submission, dated 12 March 2013 (PDF)
- Third National LGBTI Health Alliance submission, dated 9 July 2013 (PDF)
- Second National LGBTI Health Alliance submission, dated 15 April 2013 (PDF)
- First National LGBTI Health Alliance submission, dated 12 March 2013 (PDF)
- Australasian Paediatric Endocrine Group (APEG), dated 27 June 2013 (PDF)
- Royal Children’s Hospital (RCH), dated 10 July 2013 (PDF)
- Office of the Public Advocate, Victoria, dated 13 September 2013 (PDF)
- Ms Diana Bryant AO, Chief Justice of the Family Court of Australia, first submission dated 22 February 2013 (PDF)
- Ms Diana Bryant AO, Chief Justice of the Family Court of Australia, second submission dated 2 September 2013 (PDF)
Documents tabled by OII Australia
- Swiss National Advisory Commission on Biomedical Ethics, ‘On the management of differences of sex development’ (PDF)
- Anne Tamar-Mattis (Advocates for Informed Choice), ‘Report to the Inter-American Commission on Human Rights: Medical Treatment of People with Intersex Conditions as a Human Rights Violation’ (PDF)
- Victoria, Department of Health, ‘Decision-making principles for the care of infants, children and adolescents with intersex conditions’ (PDF)
- OII Australia, ‘Response to Victorian Health Department framework document’ (PDF)
- National LGBTI Health Alliance policy statement on the Victorian Department of Health approach to intersex young people (PDF)
- City and County of San Francisco, Report of a 2005 Human Rights Investigation into the medical “normalization” of intersex people (PDF)
- All submissions to the Senate Inquiry on involuntary sterilisation
- Terms of reference for the Senate Inquiry
- Transcript of the public oral hearing on intersex issues on 28 March 2013 (HTML and PDF) witnesses represented OII Australia, AISSGA and the National LGBTI Health Alliance
- Article on the public hearing of the Senate Inquiry on involuntary sterilisation
- Opening statement at the Senate hearing on involuntary or coerced sterilisation, 29 March 2013
- Press coverage of the intersex aspects of the Senate Inquiry, by The Age newspaper, 20 June 2013
- The OII Australia submission was written by our secretary, Morgan Carpenter.