Submission to Involuntary and Coerced Sterilisation Senate Inquiry

Last week, in amongst the craziness of the Sex Discrimination Amendment Bill, and the US Supreme Court marriage equality decisions, the Organisation Intersex International (OII) Australia put out the call for people to make submissions to the Senate Community Affairs Committee Inquiry into the Involuntary and Coerced Sterilisation of People with Disabilities in Australia.

So, on Saturday afternoon I put together the below submission. Given the rush it is admittedly not my best work, but I am glad to have put something in with respect to this important inquiry, and today OII Australia tweeted that they appreciated my effort, so that’s good enough for me. The submission was published on the Senate’s website this morning, so here it is:

I would like to make a brief submission in relation to this important inquiry.

Specifically, in my submission I will address the second term of reference for the inquiry, namely:

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.

In doing so, I will be drawing heavily on the submission provided by the Organisation Intersex International Australia.

I am writing this submission as a gay man, and someone who does not have any personal experience of what it is like to be an intersex individual. However, that does not mean I cannot recognise the fundamental human rights of others, or support broad principles according to which each and every person should be able to live their life.

These principles include the right to personal autonomy – to have physical control over one’s body – including the right to determine whether to consent, or not to consent, to medical procedures (wherever possible). This is especially important for procedures which can have long-term, and often permanent or irreversible, impact on core matters such as sex and reproduction. These principles also include the right for individuals to be different, including differences of sexual orientation, gender identity and intersex status, and for these differences to be respected by the medical profession, the Government and society at large.

Sadly, it seems that for far too many intersex Australians they have been unable to live their lives with the benefit of these principles or rights.

It is disturbing to read the following quote from pages 3 and 4 of the OII submission dated 15 February 2013:

“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.”

For any individual to experience any of these interventions is disturbing. That every member of OII Australia has experience of at least one (and possibly more than one) is genuinely shocking.

That is why I have no compunction in backing the recommendations made by OII in their submission. In particular, I support their Medical protocol recommendations on pages 20 and 21, namely:

“1. Medical intervention should not assume crisis in our difference, nor normalisation as a goal.

2. Medical, and in particular surgical, interventions must have a clear ethical basis, supported by evidence of long term benefit.

3. Data must be recorded on intersex births, assignments of sex of rearing, and of surgical interventions.

4. Medical interventions should not be based on psychosocial adjustment or genital appearance.

5. Medical intervention should be deferred wherever possible until the patient is able to freely give full and informed consent; this is known as the “Gillick competence.”

6. Necessary medical intervention on minors should preserve the potential for different life paths and identities until the patient is old enough to consent.

7. The framework for medical intervention should not infantilise intersex, failing to recognise that we become adults, or that we have health needs as adults.

8. The framework for medical intervention must not pathologies intersex through the use of stigmatising language.

9. Medical protocols must mandate continual dialogue with intersex organisations.”

I also endorse their call for a review of terminations on the basis of intersex differences – as intersex status should not be used as the basis for an otherwise undesired termination (in the same way that, if pre-natal tests were to become available at a later date to determine homosexuality, bisexuality or transgender status, I would ethically object to these tests being used as the basis for terminations).

Similarly, I support OII Australia’s call for a review of the use of off-label use of dexamethasone (and note with concern the possibility that this steroid could be used to prevent physical masculanisation and to “prevent homosexuality” – as highlighted on page 11 of the OII Australia submission).

I also have no qualms in supporting their Legal recommendations on page 21:

“We wish to live in a society where we are not obliged to conform to binary sex and gender expectations, where our biological distinctiveness is not treated as it it’s an errant behaviour, where we are protected despite our innate differences, and where intersex people are also not singled out or “othered” as a class. We wish to live in a society where our sex assignments are mutable, and not problematized, and where we (and others) can choose to remain silent on the matter of our sex, through an “unspecified” sex classification.

We seek recognition that our treatment by the medical profession and by the state is a human rights issue. We seek explicit inclusion in human rights and anti-discrimination legislation on the basis of our biological distinctiveness, without our having to submit either to medical intervention, nor a requirement that we “genuinely” identify as one gender or another.”

Of course, it is pleasing to observe that at least some of these recommendations have been achieved since that submission was written, with the passage this week of the Sex Discrimination Amendment (Sexual Orientation, Gender Identity and Intersex Status) Bill 2013, as well as the recent release of the Australian Government Guidelines on the Recognition of Sex and Gender. But other work, especially with the medical profession, remains to be implemented.

Finally, I would like to strongly endorse the Community support recommendations of OII Australia on page 21 of their submission. The recent history of OII Australia demonstrates that it has had incredible success in firstly, drawing attention to some important, but hitherto largely ignored, human rights issues and secondly, to achieving some key victories (such as the recent passage of federal anti-discrimination protections, which was a world first at federal level).

The fact that it has done so as a small, member and volunteer-run organisation, with no government funding, is truly impressive. With many issues yet to be resolved, hopefully the Commonwealth can see fit to provide an ongoing funding source for OII Australia.

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