Hands off

THE Australian Human Rights Commission (AHRC) has released a report of 12 recommendations to protect the human rights of intersex people. 

Published in October 2021, Ensuring Health and Bodily Integrity forms a human rights-based approach to decision making with an aim to protect intersex children who do not have the legal capacity to consent to medical intervention.

Intersex people are born with bodies that do not align with typical binary notions of male and female. 

Differences are identifiable in sex chromosomes, hormones, reproductive organs, and sexual anatomy. 

Commission President and Emeritus Professor Rosalind Croucher said the report emphasises the right to bodily autonomy. 

“We acknowledge these issues are difficult, emotional and complex, and that clinicians and parents are taking the action they believe is best for their children and patients,” she said. 

“This is why our recommendations have been informed by a human rights approach, to improve decision-making processes,

So intersex people can live their lives with the dignity and autonomy they deserve.” 

In the current medical system, intersex children are subject to medically unnecessary surgery to ‘normalise’ the appearance of genitalia. 

Interventions range from hormone treatments to surgically shaping genitalia.

Without patient informed consent, surgery can be life-altering and impact one’s gender identity and bodily autonomy in adulthood.  

An anonymous participant in the AHRC report, born with variations in their sex characteristics, said medical intervention provoked life-long suffering. 

“The effect of having the realisation that my body was at the whim of others is a realisation of the gross indifference in power,” said the participant. 

“This has led me to be diagnosed with Post Traumatic Stress Disorder and impact my ability to form relationships and gel with society.” 

The report aims to propose better oversight and approval mechanisms for medical intervention. 

In particular, casting light on grey areas in patient informed consent. 

Recommendation four in the AHRC report claims medical intervention without patient consent is permissible if the procedure is medically necessary. 

The 12 recommendations follow this pattern of outlining and clarifying the multi-faceted nature of decision making in the medical field. 

This is to guide practitioners, intersex children, and their guardians when deciding on surgery. 

Intersex medical intervention has faced criticism in the past.   

In October 2013, the Australian Senate Committee condemned medical interventions for intersex people, claiming the procedure is “involuntary or coerced sterilisation.”

In response to this, Intersex Human Rights Australia released a set of human rights expectations for intersex people in 2017, known as the Darlington Statement. 

The AHRC addresses the Darlington Statement as a term of reference to ensure recommendations in the report appease the interests of vital stakeholders.

“The report is the culmination of over three years of extensive consultations with people born with variations in sex characteristics,” Professor Croucher said. 

“The Commission’s report reinforces the notion that these people have a right to make decisions about any medical interventions on their bodies.

“This includes children and young people.”

Although no formal alterations to the national guidelines in clinical practice have been made, the AHRC report and recommendations reveal the need for current practices to be refreshed.