{"id":50965,"date":"2022-05-24T09:20:42","date_gmt":"2022-05-24T09:20:42","guid":{"rendered":"https:\/\/www.humanium.org\/en\/?p=50965"},"modified":"2025-12-13T20:14:23","modified_gmt":"2025-12-13T20:14:23","slug":"diversity-of-bodies-intersex-childrens-rights-to-self-determine-their-own-bodies","status":"publish","type":"post","link":"https:\/\/www.humanium.org\/en\/diversity-of-bodies-intersex-childrens-rights-to-self-determine-their-own-bodies\/","title":{"rendered":"Diversity of bodies – intersex children’s rights to self-determine their own bodies"},"content":{"rendered":"\n

\u201cMedicine and society need to see intersex individuals as natural. I occur in nature and I demand to make my own decisions, the same as any other person. And I demand it for any individual who is born intersex.\u201d<\/p>– Karen A. Walsh (Davis, 2016)<\/cite><\/blockquote>\n\n\n\n

The term \u201cintersex\u201d is an umbrella term that describes bodily characteristics that cannot be assigned to the typical definitions of \u201cboy\u201d or a \u201cgirl<\/a>\u201d (United Nations & Commissioner, 2017). Intersex characteristics are often perceived as a medical condition that has to be \u201cnormalized\u201d. These \u201cnormalizing\u201d surgeries are frequently only performed for cosmetic purposes to meet the binary sex characteristics. <\/strong><\/p>\n\n\n\n

Children<\/a>\u2019s fundamental rights<\/a> are violated through these medical procedures. The Convention on the Rights of the Child (CRC)<\/a> promotes intersex children\u2019s autonomy to consent to unnecessary medical surgeries. Only in exceptional cases, when medically necessary, medical experts should be allowed to perform these operations. It is essential to interpret medical necessity separately from social expectations that children\u2019s bodies must conform to one of the binary genders.<\/strong><\/p>\n\n\n\n

\u201cNormalizing\u201d harmful surgeries on intersex children<\/strong><\/h2>\n\n\n\n

Usually, most medical laws require the person’s consent to undergo medical treatment (Dunne, 2018). In most countries, parents or legal guardians are empowered to consent to medical care on behalf of their children (Dunne, 2018). For intersex children<\/a>, this is highly problematic. Parents<\/a> often decide on the advice of medical experts that their children undergo “normalizing” medical operations which have only cosmetic purposes(United Nations & Commissioner, 2017). This purpose is especially to adapt their physical characteristics to the binary of the sexes of \u201cmale\u201d and \u201cfemale\u201d(United Nations & Commissioner, 2017).<\/p>\n\n\n\n

In countries around the world, intersex children are frequently subjected to irreversible procedures that can cause permanent pain, infertility incontinence, loss of sexual sensation, and lifelong mental suffering<\/a>, including depression (HRC, 2020; Agius, 2015). Empirical studies in Germany, for instance, had shown that many intersex children had received a gonadectomy, a reduction of their clitoris, a vaginal operation and a correction of their urinary tract (Agius, 2015). <\/p>\n\n\n\n

Moreover, these surgeries are regularly followed by a series of operations and post-operative complications (Agius, 2015). Many intersex persons report that these treatments were traumatizing for them (Davis, 2016). They encompassed humiliating procedures such as being exposed to large groups of medical experts studying intersex characteristics (Davis, 2016; Agius, 2015).<\/p>\n\n\n\n

Recognition of the interference with intersex children’s rights<\/strong><\/h2>\n\n\n\n

It is recognized by several human rights<\/a> bodies that these harmful surgeries violate intersex children\u2019s rights. For example, the Special Rapporteur on torture and other cruel, inhuman or degrading treatment stressed that States should repeal any law allowing intrusive and irreversible treatments, including forced genital-normalizing surgery (M\u00e9ndez, 2013).  <\/p>\n\n\n\n

In a statement in front of the Human Rights Council, 33 States \u201ccalled on governments as a matter of urgency, to protect the autonomy of intersex adults and children and their rights to health<\/a>, and to physical and mental integrity so that they live free from violence<\/a> and harmful practices\u201d (HRC, 2020). Also, the CRC Committee<\/a> and the CEDAW<\/a> Committee emphasized in their recommendations to States that cosmetic surgeries on intersex children need to be performed with the consent of the individual concerned (Committee, 2018; CEDAW, 2017).<\/p>\n\n\n\n

Determination of “medical necessity” apart from binary social \u201cnorms\u201d<\/strong><\/h2>\n\n\n\n

Human rights bodies stress the urge to prohibit these \u201cnormalizing\u201d surgeries on intersex children because their fundamental rights<\/a> are violated. Article 19 of CRC codifies that States shall \u201cprotect the child from all forms of physical or mental violence<\/a>, injury or abuse<\/a>\u201d (CRC,1989). Only within narrow limits, restrictions can be placed on this right. Regarding the medical interventions on intersex children, these may only be performed for reasons of medical necessity (Sandberg, 2018). Here, it is essential to determine the term \u201cmedical necessity\u201d in a way that effectively protects intersex children.<\/p>\n\n\n\n

\"\"<\/figure>\n\n\n\n

To do so, one has to unwrap the reason for the unnecessary harmful surgeries on intersex children. Binary gender \u201cnorms\u201d are the ones usually guiding the medical officers’ advice to parents to consent to children’s \u201cnormalizing\u201d treatments (Dunne, 2018). They believe that children must conform to the gender categories of “girl” and “boy” in order to avoid being stigmatized or discriminated<\/a> against (Dunne, 2018). Hence, the binary view of sexes in our society shapes the interpretation of medical necessity (Hegarty & Smith, 2021). <\/p>\n\n\n\n

To safeguard children\u2019s rights, \u201cmedical necessity\u201d has to apply only when treatments are essential for children\u2019s physical health<\/a>, as in the event of imminent danger to life<\/a> (Internationale Vereinigung Intergeschlechtlicher Menschen, 2020; OHCHR, 2019). In any other cases, surgeries on intersex children constitute a violation of the physical integrity under Article 19 CRC (Sandberg, 2018).<\/p>\n\n\n\n

Promoting bodily diversity<\/strong><\/h2>\n\n\n\n

Medical doctors\u2019 arguments that intersex children suffer from bullying<\/a> experiences or a sense of not belonging can never be a justification for performing surgeries (Hegarty & Smith, 2021). What is needed is an intensive examination in medicine of the physical diversity of bodies that do not have to be categorized.<\/p>\n\n\n\n

Intersex children face discrimination<\/a> (OHCHR, 2019) and thus, it is crucial to accurately address this discrimination within our society. It is necessary, to provide health care personnel – who are the closest involved in these surgeries \u2013with training,teaching them about the human rights<\/a> which are violated by these surgeries and the harmful consequences for intersex children (United Nations & Commissioner, 2017).<\/p>\n\n\n\n

Children are the agents of their bodies<\/strong><\/h2>\n\n\n\n

Especially, intersex children must be the agents of what happens with their bodies. Since they are the ones concerned, they have to decide whether a treatment should be performed (Dunne, 2018). Such a finding is supported by the underlying principle of the CRC: the autonomy of children (Sandberg, 2018). Children\u2019s autonomy is supported by Article 12 CRC<\/a>, which codifies children\u2019s right to participation in all matters affecting them as well as by the right to identity protected in Article 8 CRC<\/a> (Sandberg, 2018).<\/p>\n\n\n\n

Sex characteristics of children concern a part of their identity (Davis, 2016). By interfering with their bodies without children\u2019s consent, their right to identity is violated, as their identity<\/a> has to be preserved (CRC, 1989; Sandberg, 2019). Since self-determination of one’s own body is a core part of one’s identity, medical interventions must be delayed until children are of an age to give informed consent (Intersexuelle Menschen e.V. , 2020; United Nations & Commissioner, 2017). <\/p>\n\n\n\n

This decision-making process must be accompanied by peer consulting experts outside the medical setting (Intersexuelle Menschen e.V., 2020; Deutsches Institut f\u00fcr Menschenrechte, 2021). In this way, children are prevented from deciding to undergo medical procedures due to social pressure.  <\/p>\n\n\n\n

States have to comprehensively safeguard intersex children\u2019s rights<\/strong><\/h2>\n\n\n\n

That the “normalizing” procedures represent an inhumane condition is clear. What is needed now is for States to fully respond to these human rights-violating situations by creating laws<\/a> that meet the needs of intersex children (United Nations & Commissioner, 2017). In recent years, there have been improvements in their protection. Germany, for instance, passed a law in 2021 that prohibits the surgery of intersex children for the sole reason ofadapting their bodies to the binary understanding of sex (B\u00fcrgerliches Gesetzbuch (BGB), 2021).<\/p>\n\n\n\n

The German law is to be supported in the sense that it extends the protection<\/a> of intersex children (Deutsches Institut f\u00fcr Menschenrechte, 2021). However, the scope of protection for intersex children is not fully comprehensive. The power to decide whether children fall under the protected group of intersex children is still based on medical guidelines that pathologize intersex children (Internationale Vereinigung Intergeschlechtlicher Menschen, 2020). <\/p>\n\n\n\n

But, it is crucial to no longer measure treatments on intersex children by deviations from the binary genders (Internationale Vereinigung Intergeschlechtlicher Menschen, 2020). Instead, medicine and society need to recognize them as bodies that are not to be considered pathological, just as children\u2019s bodies that correspond to the binary sexes.<\/p>\n\n\n\n

\"\"<\/figure>\n\n\n\n

We at Humanium promote bodily diversity amongst children. Humanium is working on creating a world where intersex children autonomously decide over their bodies. Join Humanium by sponsoring a child<\/a>, making a donation<\/a>, or becoming a member or a volunteer<\/a>! <\/p>\n\n\n\n

Written by Louisa Steffen<\/em><\/strong><\/p>\n\n\n\n

References:<\/strong><\/h4>\n\n\n\n

Agius, S. (2015). Human rights and intersex people. Council of Europe Commissioner for Human Rights, retrieved from Council of Europe, accessed on 18 April 2022.<\/a><\/p>\n\n\n\n

B\u00fcrgerliches Gesetzbuch (BGB), \u00a7 1631 e, Bundesgesetzblatt Jahrgang 2021 Teil I Nr. 24, ausgegeben zu Bonn am 21. Mai 2021, Gesetz zum Schutz von Kindern mit Varianten der Geschlechtsentwicklung, retrieved from Bundesgesetzblatt online, accessed on 18 April 2022.<\/a><\/p>\n\n\n\n

CEDAW, C. (2017). Concluding observations on the combined seventh and eighth periodic reports of Germany. United Nations CEDAW\/C\/DEU\/CO\/7-8, retrieved from OHCHR, accessed on 18 April 2022.<\/a><\/p>\n\n\n\n

Committee, C. (2018). Concluding observations on the combined fifth and sixth periodic reports of Argentina. United Nations CRC\/C\/ARG\/CO\/5-6, retrieved from OHCHR, accessed on 18 April 2022.<\/a><\/p>\n\n\n\n

Convention on the Rights of the Child (adopted 20 November 1989, entered into force 2 September 1990). 1577 UNTC 3, retrieved from OHCHR, accessed on 18 April 2022.<\/a><\/p>\n\n\n\n

Davis, G. (2016). Normalizing Intersex, VOICES: Personal Stories from the Pages of NIB (Narrative Inquiry in Bioethics). Johns Hopkins University Press, retrieved from ResearchGate, accessed on 18 April 2022.<\/a><\/p>\n\n\n\n

Deutsches Institut f\u00fcr Menschenrechte, Monitoring-Stelle UN-Kinderrechtskonvention (2021). Stellungnahme zum Entwurf eines Gesetzes zum Schutz von Kindern mit Varianten der Geschlechtsentwicklung, retrieved from Bundestag, accessed on 18 April 2022.<\/a><\/p>\n\n\n\n

Dunne, P. (2018). Towards Trans and Intersex Equality: Conflict or Complementarity? In J. M. Scherpe, A. Dutta, & T. Helms, The Legal Status of Intersex Persons (pp. 217-240). Intersentia, accessed on 11 April 2022.<\/p>\n\n\n\n

Hegarty, P., & Smith, A. (2021). Public understanding of intersex: an update on recent findings. IJIR: Your Sexual Medicine Journal (pp. 1-6), retrieved from Europe PMC, accessed on 18 April 2022.<\/a><\/p>\n\n\n\n

HRC (2020). United Nations Human Rights Council \u2013 45th<\/sup> Session. Statement by the Kingdom of the Netherlands. Follow-up and implementation of the Vienna Declaration and Programme of Action, retrieved from Permanent Representations, accessed on 18 April 2022.<\/a><\/p>\n\n\n\n

Intersexuelle Menschen e.V. (2020). Stellungnahme zum weiteren Gesetzgebungsverfahren eines \u201eGesetzes zum Schutz von Kindern mit Varianten der Geschlechtsentwicklung\u201c, retrieved from Intersexuelle Menschen e.V.,accessed on 18 April 2022.<\/a><\/p>\n\n\n\n

Internationale Vereinigung Intergeschlechtlicher Menschen – OII Germany e. V. (2020). Stellungnahme IVIM – OII Germany zum Gesetzentwurf der Bundesregierung \u201cEntwurf eines Gesetzes zum Schutz von Kindern mit Varianten der Geschlechtsentwicklung\u201d vom 23.09.2020, retrieved from OII Germany, accessed on 18 April 2022.<\/a><\/p>\n\n\n\n

M\u00e9ndez, J. E. (2013). Report of the Special Rapporteur on torture and other cruel, inhuman or degrading treatment or punishment. A\/HRC\/22\/53: United Nations General Assembly; Human Rights Council, retrieved from OHCHR, accessed on 18 April 2022.<\/a><\/p>\n\n\n\n

OHCHR. (2019). Background Note on Human Rights Violations against Intersex People. United Nations Human Rights Office of the High Commissioner, retrieved from OHCHR, accessed on 18 April 2022.<\/a><\/p>\n\n\n\n

Sandberg, K. (2018). Intersex Children and the UN Convention on the Rights of the Child. In J. M. Scherpe, A. Dutta, & T. Helms, The Legal Status of Intersex Persons (pp. 515-535). Intersentia, accessed on 11 April 2022.<\/p>\n\n\n\n

United Nations, H. R., & Commissioner (2017). FREE & EQUAL; United Nations for LGBT Equality. FACT SHEET Intersex, retrieved from UNFE, accessed on 18 April 2022.<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"

\u201cMedicine and society need to see intersex individuals as natural. I occur in nature and I demand to make my own decisions, the same as any other person. And I demand it for any individual who is born intersex.\u201d – Karen A. 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