Intersex human rights#Physical integrity and bodily autonomy

File:ILGA conference 2018 Intersex Awareness Day group photo.jpg]]

Research indicates a growing consensus that diverse intersex bodies are normal—if relatively rare—forms of human biology,{{cite book|first= Stephen |last = Zderic|title=Pediatric gender assignment : a critical reappraisal; [proceedings from a conference ... in Dallas in the spring of 1999 which was entitled "pediatric gender assignment - a critical reappraisal"]|year=2002|publisher=Kluwer Acad. / Plenum Publ.|location=New York, NY [u.a.]|isbn=978-0306467592}} and human rights institutions are placing increasing scrutiny on medical practices and issues of discrimination against intersex people. A 2013 first international pilot study. Human Rights between the Sexes, by Dan Christian Ghattas,{{cite web | url = http://www.boell.de/sites/default/files/endf_human_rights_between_the_sexes.pdf | title = Human Rights Between the Sexes | first1 = Dan Christian | author2-link = Heinrich Böll Foundation | last1 = Ghattas | author-link1 = Dan Christian Ghattas | last2 = Heinrich Böll Foundation | date = September 2013 | access-date = 2015-07-19 | archive-date = 2015-09-23 | archive-url = https://web.archive.org/web/20150923223221/http://www.boell.de/sites/default/files/endf_human_rights_between_the_sexes.pdf | url-status = live }}{{cite web | url = http://oiieurope.org/a-preliminary-study-on-the-life-situations-of-inter-individuals/ | title = A preliminary study on the life situations of inter* individuals | work = OII Europe | date = 4 November 2013 | access-date = 19 July 2015 | archive-date = 4 July 2015 | archive-url = https://web.archive.org/web/20150704015158/http://oiieurope.org/a-preliminary-study-on-the-life-situations-of-inter-individuals/ | url-status = live }} found that intersex people are discriminated against worldwide:

{{blockquote|Intersex individuals are considered individuals with a "disorder" in all areas in which Western medicine prevails. They are more or less obviously treated as sick or "abnormal", depending on the respective society.}}

The Council of Europe highlights several areas of concern:

• Equal right to life and prevention of medical treatments without informed consent including treatments considered unnecessary;
• Removal of Intersex as a curable medical condition but one which can have medical treatments with informed consent
• Equal treatment under the law; including specific legal provision similar to other classes covered;
• Access to information, medical records, peer and other counselling and support;
• Self-determination in gender recognition, through expeditious access to official documents.{{Citation| last1 = Council of Europe| last2 = Commissioner for Human Rights| title = Human rights and intersex people, Issue Paper| date = April 2015| url = https://wcd.coe.int/ViewDoc.jsp?Ref=CommDH/IssuePaper(2015)1&Language=lanEnglish&Ver=original| author1-link = Council of Europe| access-date = 2022-03-09| archive-date = 2016-01-06| archive-url = https://web.archive.org/web/20160106203349/https://wcd.coe.int/ViewDoc.jsp?Ref=CommDH%2FIssuePaper%282015%291&Language=lanEnglish&Ver=original| url-status = live}}

{{main|Intersex and LGBT}}

Multiple organizations have highlighted appeals to LGBT rights recognition that fail to address the issue of unnecessary "normalising" treatments on intersex children, using the portmanteau term "pinkwashing". In June 2016, Organisation Intersex International Australia pointed to contradictory statements by Australian governments, suggesting that the dignity and rights of LGBTI (LGBT and intersex) people are recognized while, at the same time, harmful practices on intersex children continue.{{cite web | title = Submission: list of issues for Australia's Convention Against Torture review | url = https://oii.org.au/30546/loi-cat-review/ | work = Organisation Intersex International Australia | date = June 28, 2016 | access-date = September 4, 2016 | archive-date = September 9, 2017 | archive-url = https://web.archive.org/web/20170909233430/https://oii.org.au/30546/loi-cat-review/ | url-status = live }}

In August 2016, Zwischengeschlecht described actions to promote equality or civil status legislation without action on banning "intersex genital mutilations" as a form of "pinkwashing".{{cite web | title = "Intersex legislation" that allows the daily mutilations to continue = PINKWASHING of IGM practices | url = http://stop.genitalmutilation.org/post/Intersex-politics-that-ignore-the-daily-mutilations-PINKWASHING-OF-IGM-PRACTICES | work = Zwischengeschlecht | date = August 28, 2016 | access-date = September 4, 2016 | archive-date = September 19, 2016 | archive-url = https://web.archive.org/web/20160919050911/http://stop.genitalmutilation.org/post/Intersex-politics-that-ignore-the-daily-mutilations-PINKWASHING-OF-IGM-PRACTICES | url-status = live }} The organization has previously highlighted evasive government statements to UN Treaty Bodies that conflate intersex, transgender and LGBT issues, instead of addressing harmful practices on infants.{{cite web | title = TRANSCRIPTION > UK Questioned over Intersex Genital Mutilations by UN Committee on the Rights of the Child - Gov Non-Answer + Denial | url = http://stop.genitalmutilation.org/post/UK-Questioned-over-Intersex-Genital-Mutilations-by-UN-Committee-on-the-Rights-of-the-Child | work = Zwischengeschlecht | date = May 26, 2016 | access-date = September 4, 2016 | archive-date = September 19, 2016 | archive-url = https://web.archive.org/web/20160919045730/http://stop.genitalmutilation.org/post/UK-Questioned-over-Intersex-Genital-Mutilations-by-UN-Committee-on-the-Rights-of-the-Child | url-status = live }}

{{main|Intersex medical interventions}}

[[File:Protection of intersex children from harmful practices.svg|thumb|right|452px|

{{legend|#002255|Legal prohibition of non-consensual medical interventions}}

{{legend|#0066FF|Regulatory suspension of non-consensual medical interventions}}

{{legend|#E3E3E3|Physical integrity and bodily autonomy on intersex not legislated}}]]

Intersex people face stigmatisation and discrimination from birth. In some countries, particularly in Africa and Asia, this may include infanticide, abandonment and the stigmatization of families. Mothers in east Africa may be accused of witchcraft, and the birth of an intersex child may be described as a curse.{{cite web | url = https://www.bbc.com/news/world-africa-39780214 | title = The midwife who saved intersex babies | first1 = Helen | last1 = Grady | first2 = Anne | last2 = Soy | work = BBC World Service, Kenya | date = May 4, 2017 | access-date = June 22, 2018 | archive-date = May 15, 2017 | archive-url = https://web.archive.org/web/20170515044758/http://www.bbc.com/news/world-africa-39780214 | url-status = live }} Abandonments and infanticides have been reported in Uganda,{{Cite web| last1 = Civil Society Coalition on Human Rights and Constitutional Law| last2 = Human Rights Awareness and Promotion Forum| last3 = Rainbow Health Foundation| last4 = Sexual Minorities Uganda| last5 = Support Initiative for Persons with Congenital Disorders| title = Uganda Report of Violations based on Sex Determination, Gender Identity, and Sexual Orientation| date = 2014| url = http://www.hrapf.org/publications/research-papers/uganda-report-violations-based-sex-determination-gender-identity-and| access-date = 2017-05-14| archive-url = https://web.archive.org/web/20150503012642/http://www.hrapf.org/publications/research-papers/uganda-report-violations-based-sex-determination-gender-identity-and| archive-date = 2015-05-03}} Kenya, south Asia,{{Cite journal| doi = 10.1007/s11154-008-9084-2| issn = 1389-9155| volume = 9| issue = 3| pages = 227–236| last1 = Warne| first1 = Garry L.| last2 = Raza| first2 = Jamal| title = Disorders of sex development (DSDs), their presentation and management in different cultures| journal = Reviews in Endocrine and Metabolic Disorders| date = September 2008| pmid=18633712| citeseerx = 10.1.1.469.9016| s2cid = 8897416}} and China.{{Cite web| last = Beyond the Boundary - Knowing and Concerns Intersex| title = Intersex report from Hong Kong China, and for the UN Committee Against Torture: the Convention against Torture and Other Cruel Inhuman or Degrading Treatment or Punishment| date = October 2015| url = http://tbinternet.ohchr.org/_layouts/treatybodyexternal/Download.aspx?symbolno=INT%2fCAT%2fCSS%2fHKG%2f22156&Lang=en| access-date = 2017-05-14| archive-date = 2017-03-26| archive-url = https://web.archive.org/web/20170326052617/http://tbinternet.ohchr.org/_layouts/treatybodyexternal/Download.aspx?symbolno=INT%2FCAT%2FCSS%2FHKG%2F22156&Lang=en| url-status = live}} In 2015, it was reported that an intersex Kenyan adolescent, Muhadh Ishmael, was mutilated and later died. He had previously been described as a curse on his family.{{Cite web| last = Odero| first = Joseph| title = Intersex in Kenya: Held captive, beaten, hacked. Dead.| work = 76 CRIMES| access-date = 2016-10-01| date = December 23, 2015| url = http://76crimes.com/2015/12/23/intersex-in-kenya-held-captive-beaten-hacked-dead/| archive-date = 2016-04-25| archive-url = https://web.archive.org/web/20160425162007/https://76crimes.com/2015/12/23/intersex-in-kenya-held-captive-beaten-hacked-dead/| url-status = dead}}

Non-consensual medical interventions to modify the sex characteristics of intersex people take place in all countries where the human rights of intersex people have been explored. Such interventions have been criticized by the World Health Organization, other UN bodies such as the Office of the High Commissioner for Human Rights, and an increasing number of regional and national institutions. In low and middle income countries, the cost of healthcare may limit access to necessary medical treatment at the same time that other individuals experience coercive medical interventions.

Several rights have been stated as affected by stigmatization and coercive medical interventions on minors:

• the right to life.
• the right to privacy, including a right to personal autonomy or self-determination regarding medical treatment.
• prohibitions against torture and other cruel, inhuman and degrading treatment.
• a right to physical integrity{{Cite conference| publisher = United Nations| last1 = United Nations| last2 = Committee on the Rights of Persons with Disabilities| title = Concluding observations on the initial report of Germany (advance unedited version)| location = Geneva| date = April 17, 2015| url = http://tbinternet.ohchr.org/_layouts/treatybodyexternal/Download.aspx?symbolno=CRPD%2FC%2FDEU%2FCO%2F1&Lang=en| author2-link = Convention on the Rights of Persons with Disabilities| conference = | access-date = July 19, 2015| archive-date = July 22, 2015| archive-url = https://web.archive.org/web/20150722111450/http://tbinternet.ohchr.org/_layouts/treatybodyexternal/Download.aspx?symbolno=CRPD%2FC%2FDEU%2FCO%2F1&Lang=en| url-status = live}} and/or bodily autonomy.{{cite web |url=http://transactivists.org/2015/04/08/making-depathologization-a-matter-of-law-a-comment-from-gate-on-the-maltese-act-on-gender-identity-gender-expression-and-sex-characteristics/ |title=Making depathologization a matter of law. A comment from GATE on the Maltese Act on Gender Identity, Gender Expression and Sex Characteristics |last1=Cabral |first1=Mauro |work=GATE - Global Action for Trans Equality |author-link=Mauro Cabral |date=April 8, 2015 |publisher=Global Action for Trans Equality |access-date=2015-07-03 |archive-url=https://web.archive.org/web/20150704213308/http://transactivists.org/2015/04/08/making-depathologization-a-matter-of-law-a-comment-from-gate-on-the-maltese-act-on-gender-identity-gender-expression-and-sex-characteristics/ |archive-date=July 4, 2015 }}
• additionally, the best interests of the child may not be served by surgeries aimed at familial and social integration.

File:Small Ela Luk.jpg]]

{{further|Intersex human rights reports}}

In recent years, Intersex rights have been the subject of reports by several national and international institutions. These include the Swiss National Advisory Commission on Biomedical Ethics (2012), the UN special rapporteur on torture and other cruel, inhuman or degrading treatment or punishment (2013), and the Australian Senate (2013). In 2015 the Council of Europe, the United Nations Office of the United Nations High Commissioner for Human Rights and the World Health Organization also addressed the issue. In April 2015, Malta became the first country to outlaw coercive medical interventions. In the same year, the Council of Europe became the first institution to state that intersex people have the right not to undergo sex affirmation interventions.

For Intersex Awareness Day, October 26, UN experts including the Committee against Torture, the Committee on the Rights of the Child and the Committee on the Rights of Persons with Disabilities, along with the Council of Europe Commissioner for Human Rights, the Inter-American Commission on Human Rights and United Nations Special Rapporteurs called for an urgent end to human rights violations against intersex persons, including in medical settings. The experts also called for the investigation of alleged human rights abuses, the ability to file claims for compensation, and the implementation of anti-discrimination measures:{{Citation| last = Office of the High Commissioner for Human Rights| author-link = Office of the United Nations High Commissioner for Human Rights| title = End violence and harmful medical practices on intersex children and adults, UN and regional experts urge| date = October 24, 2016| url = http://www.ohchr.org/EN/NewsEvents/Pages/DisplayNews.aspx?NewsID=20739&LangID=E| access-date = July 28, 2017| archive-date = November 21, 2016| archive-url = https://web.archive.org/web/20161121185256/http://ohchr.org/EN/NewsEvents/Pages/DisplayNews.aspx?NewsID=20739&LangID=E| url-status = live}}

{{blockquote|In countries around the world, intersex infants, children and adolescents are subjected to medically unnecessary surgeries, hormonal treatments and other procedures in an attempt to forcibly change their appearance to be in line with societal expectations about female and male bodies. When, as is frequently the case, these procedures are performed without the full, free and informed consent of the person concerned, they amount to violations of fundamental human rights...

States must, as a matter of urgency, prohibit medically unnecessary surgery and procedures on intersex children. They must uphold the autonomy of intersex adults and children and their rights to health, to physical and mental integrity, to live free from violence and harmful practices and to be free from torture and ill-treatment. Intersex children and their parents should be provided with support and counselling, including from peers.}}

In 2017, the human rights non-governmental organizations Amnesty International and Human Rights Watch{{Cite book| isbn = 978-1-62313-502-7| last1 = Human Rights Watch| author1-link = Human Rights Watch| last2 = interACT| author2-link = Interact Advocates for Intersex Youth| title = I Want to Be Like Nature Made Me| date = July 2017| publisher = Human Rights Watch| url = https://www.hrw.org/report/2017/07/25/i-want-be-nature-made-me/medically-unnecessary-surgeries-intersex-children-us| access-date = 2017-07-28| archive-date = 2017-10-05| archive-url = https://web.archive.org/web/20171005133541/https://www.hrw.org/report/2017/07/25/i-want-be-nature-made-me/medically-unnecessary-surgeries-intersex-children-us| url-status = live}}{{Cite journal| last = Stewart| first = Philippa| title = Interview: Intersex Babies Don't Need 'Fixing'| journal = Human Rights Watch| access-date = 2017-07-25| date = 2017-07-25| url = https://www.hrw.org/news/2017/07/25/interview-intersex-babies-dont-need-fixing| archive-date = 2017-08-03| archive-url = https://web.archive.org/web/20170803222257/https://www.hrw.org/news/2017/07/25/interview-intersex-babies-dont-need-fixing| url-status = live}}{{Cite web| last = Human Rights Watch| title = US: Harmful Surgery on Intersex Children| work = Human Rights Watch| access-date = 2017-07-25| date = 2017-07-25| url = https://www.hrw.org/news/2017/07/25/us-harmful-surgery-intersex-children| archive-date = 2019-04-26| archive-url = https://web.archive.org/web/20190426140812/https://www.hrw.org/news/2017/07/25/us-harmful-surgery-intersex-children| url-status = live}} published major reports on the rights of children with intersex conditions.

{{main|Intersex rights in Colombia}}

Although not many cases of children with intersex conditions are available, a case taken to the Constitutional Court of Colombia led to changes in their treatment.{{cite journal|last=Curtis|first=Skyler|title=Reproductive Organs and Differences of Sex Development: The Constitutional Issues Created by the Surgical Treatment of Intersex Children|journal=McGeorge Law Review|year=2010–2011|volume=42|page=863|url=http://heinonline.org/HOL/Page?handle=hein.journals/mcglr42&div=66&g_sent=1&collection=journals|access-date=15 November 2012|archive-date=18 December 2014|archive-url=https://web.archive.org/web/20141218001531/http://heinonline.org/HOL/Page?handle=hein.journals%2Fmcglr42&div=66&g_sent=1&collection=journals|url-status=live}} The case restricted the power of doctors and parents to decide surgical procedures on children's ambiguous genitalia after the age of five, while continuing to permit interventions on younger children. Due to the decision of the Constitutional Court of Colombia on Case 1 Part 1 (SU-337 of 1999), doctors are obliged to inform parents on all the aspects of the intersex child. Parents can only consent to surgery if they have received accurate information, and cannot give consent after the child reaches the age of five. By then the child will have, supposedly, realized their gender identity.{{cite web|title=Corte Constitucional de Colombia: Sentencia T-1025/02|url=http://www.corteconstitucional.gov.co/relatoria/2002/t-1025-02.htm|access-date=2 December 2012|archive-date=20 February 2013|archive-url=https://web.archive.org/web/20130220193844/http://www.corteconstitucional.gov.co/relatoria/2002/t-1025-02.htm|url-status=live}} The court case led to the setting of legal guidelines for doctors' surgical practice on intersex children.

{{main|Intersex rights in Malta}}

In April 2015, Malta became the first country to outlaw non-consensual medical interventions in a Gender Identity Gender Expression and Sex Characteristics Act. The Act recognizes a right to bodily integrity and physical autonomy, explicitly prohibiting modifications to children's sex characteristics for social factors:

{{blockquote|14. (1) It shall be unlawful for medical practitioners or other professionals to conduct any sex assignment treatment and/or surgical intervention on the sex characteristics of a minor which treatment and/or intervention can be deferred until the person to be treated can provide informed consent: Provided that such sex assignment treatment and/or surgical intervention on the sex characteristics of the minor shall be conducted if the minor gives informed consent through the person exercising parental authority or the tutor of the minor.

(2) In exceptional circumstances treatment may be effected once agreement is reached between the Interdisciplinary Team and the persons exercising parental authority or tutor of the minor who is still unable to provide consent: Provided that medical intervention which is driven by social factors without the consent of the minor, will be in violation of this Act.}}

The Act was widely welcomed by civil society organizations.{{Cite web| publisher = OII Europe| title = OII-Europe applauds Malta's Gender Identity, Gender Expression and Sex Characteristics Act. This is a landmark case for intersex rights within European law reform| date = April 1, 2015| url = http://oiieurope.org/press-release-oii-europe-applauds-maltas-gender-identity-gender-expression-and-sex-characteristics-act/| access-date = 2015-07-03| archive-date = 2015-05-22| archive-url = https://web.archive.org/web/20150522051313/http://oiieurope.org/press-release-oii-europe-applauds-maltas-gender-identity-gender-expression-and-sex-characteristics-act/| url-status = live}}{{cite web |url=https://oii.org.au/28592/we-celebrate-maltese-protections-for-intersex-people/ |title=We celebrate Maltese protections for intersex people |last1=Carpenter |first1=Morgan |author-link=Morgan Carpenter |date=April 2, 2015 |publisher=Organisation Intersex International Australia |access-date=2015-07-03 |archive-date=2015-07-04 |archive-url=https://web.archive.org/web/20150704224253/https://oii.org.au/28592/we-celebrate-maltese-protections-for-intersex-people/ |url-status=live }}

{{main|Intersex rights in Chile}}

In November 2023, through Circular No. 15 of the Ministry of Health, unnecessary and non-consensual surgeries, procedures or medical treatments on intersex newborns, children and adolescents are prohibited.{{cite web |title=Circular No. 15/2023 |url=https://diprece.minsal.cl/wp-content/uploads/2023/11/Circular-15-Instruye-a-equipos-de-salud-a-adoptar-todas-las-medidas-necesarias-para-asegurar-el-interes-superior-de-ninos-ninas-y-adolescentes-con-variaciones-de-las-caracteristicas-sexuales.pdf |website=diprece.minsal.cl |access-date=8 December 2023 |language=es |date=7 November 2023}}

In January 2016, the Ministry of Health of Chile ordered through Circular No. 18 the suspension of unnecessary normalization treatments for intersex children, including irreversible surgery, until they reach an age when they can make decisions on their own.{{cite web |url=https://www.outrightinternational.org/content/chilean-government-stops-normalization-intersex-children | title = Chilean Government Stops the 'Normalization' of Intersex Children | work = OutRight Action International | date = January 14, 2016 | access-date = February 2, 2016 | archive-date = April 18, 2019 | archive-url = https://web.archive.org/web/20190418033702/https://outrightinternational.org/content/chilean-government-stops-normalization-intersex-children | url-status = live }}{{cite web|title=Chilean Ministry of Health issues instructions stopping "normalising" interventions on intersex children|url=https://oii.org.au/30250/chilean-ministry-stops-normalising/|website=Organisation Intersex International Australia|access-date=3 January 2017|date=11 January 2016|archive-date=10 March 2017|archive-url=https://web.archive.org/web/20170310022403/https://oii.org.au/30250/chilean-ministry-stops-normalising/|url-status=live}} The regulations were superseded in August 2016 by Circular No. 07.{{Cite web| last1 = Inter| first1 = Laura| last2 = Aoi| first2 = Hana| title = Circular 7 de 2016: Un paso atrás en la lucha por los Derechos Humanos de las personas intersexuales en Chile. Por Laura Inter y Hana Aoi| work = Brújula Intersexual| access-date = 2017-07-09| date = June 15, 2017| url = https://brujulaintersexual.wordpress.com/2017/06/15/circular-7-2016-un-paso-atras/| archive-date = 2017-07-30| archive-url = https://web.archive.org/web/20170730060752/https://brujulaintersexual.wordpress.com/2017/06/15/circular-7-2016-un-paso-atras/| url-status = live}}{{Cite web| last = Godoy| first = Camilo| title = ¿Cómo nace la Circular 7 del Ministerio de Salud de Chile? Por Camilo Godoy| work = Brújula Intersexual| access-date = 2017-07-09| date = June 18, 2017| url = https://brujulaintersexual.wordpress.com/2017/06/17/como-nace-la-circular-7-chile/| archive-url = https://web.archive.org/web/20170730060244/https://brujulaintersexual.wordpress.com/2017/06/17/como-nace-la-circular-7-chile/| archive-date = 2017-07-30}}{{Cite web| last1 = Inter| first1 = Laura| last2 = Aoi| first2 = Hana| title = Circular 7 De 2016: Un Paso Atrás En La Lucha Por Los Derechos Humanos De Las Personas Intersexuales En Chile| work = Brújula Intersexual| date = June 2017| url = https://brujulaintersexual.files.wordpress.com/2017/06/circular-7-laura-y-hana11.pdf| access-date = 2017-07-28| archive-date = 2017-07-30| archive-url = https://web.archive.org/web/20170730060541/https://brujulaintersexual.files.wordpress.com/2017/06/circular-7-laura-y-hana11.pdf| url-status = live}} Circulars 18/2015 and 07/2016 were annulled by Circular 15/2023.

On 22 April 2019 the Madras High Court (Madurai Bench) passed a landmark judgment{{cite web|url=https://www.livelaw.in/news-updates/transwoman-regarded-as-bride-madras-hc-bans-sex-re-assignment-surgeries-intersex-children-144467|title="Transwoman A 'Bride' Under Hindu Marriage Act": Madras HC; Also Bans Sex Re-Assignment Surgeries On Intersex Children [Read Judgment]|date=23 April 2019 |access-date=2019-04-24|archive-date=2019-07-12|archive-url=https://web.archive.org/web/20190712083504/https://www.livelaw.in/news-updates/transwoman-regarded-as-bride-madras-hc-bans-sex-re-assignment-surgeries-intersex-children-144467|url-status=live}} and issued direction to ban Sex-Selective Surgeries on Intersex Infants based on the works of Gopi Shankar Madurai. On August 13, 2019 the Government of Tamil Nadu, India has issued a Government Order to ban non-necessary surgeries on the sex characteristics of babies and children in the Indian state of Tamil Nadu with 77.8 Million people, this regulation is exempted in the case of life-threatening situations.{{cite web |date=29 August 2019 |title=Indian State Bans Unnecessary Surgery on Intersex Children - Human Rights Watch |url=https://www.hrw.org/news/2019/08/29/indian-state-bans-unnecessary-surgery-intersex-children |url-status=live |archive-url=https://web.archive.org/web/20210120075631/https://www.hrw.org/news/2019/08/29/indian-state-bans-unnecessary-surgery-intersex-children |archive-date=2021-01-20 |access-date=2019-08-30}}{{cite web |date=23 April 2019 |title="Ban sex reassignment surgeries on intersex infants Madras High Court tells Tamil Nadu Govt" - The News Minute |url=https://www.thenewsminute.com/article/ban-sex-reassignment-surgeries-intersex-infants-madras-hc-tells-tn-govt-100565 |url-status=live |archive-url=https://web.archive.org/web/20190423135759/https://www.thenewsminute.com/article/ban-sex-reassignment-surgeries-intersex-infants-madras-hc-tells-tn-govt-100565 |archive-date=2019-04-23 |access-date=2019-04-24}}{{cite news |date=24 April 2019 |title=Ruling on intersex infants: Madurai activist comes in for praise by High Court |url=https://timesofindia.indiatimes.com/city/madurai/ruling-on-intersex-infants-madurai-activist-comes-in-for-praise-by-hc/articleshow/69016201.cms |url-status=live |archive-url=https://web.archive.org/web/20190509070231/https://timesofindia.indiatimes.com/city/madurai/ruling-on-intersex-infants-madurai-activist-comes-in-for-praise-by-hc/articleshow/69016201.cms |archive-date=2019-05-09 |access-date=2019-04-24 |website=The Times of India}}{{cite web |date=29 April 2019 |title=Indian Court Decides In Favor of Informed Consent Rights for Intersex People - Human Rights Watch |url=https://www.hrw.org/news/2019/04/29/indian-court-decides-favor-informed-consent-rights-intersex-people |url-status=live |archive-url=https://web.archive.org/web/20210119181838/https://www.hrw.org/news/2019/04/29/indian-court-decides-favor-informed-consent-rights-intersex-people |archive-date=2021-01-19 |access-date=2019-07-15}}

{{main|Intersex rights in Germany}}

A law that provides for a general ban on operations in children and adolescents with 'variants of gender development' ('Varianten der Geschlechtsentwicklung') was passed in the German parliament on March 25, 2021.{{cite web |url=https://www.bundestag.de/dokumente/textarchiv/2021/kw12-de-geschlechterentwicklung-kinder-830122 |title=Schutz von Kindern mit Varianten der Geschlechtsentwicklung |website=Deutscher Bundestag |language=German |access-date=April 29, 2021 |archive-date=May 11, 2021 |archive-url=https://web.archive.org/web/20210511220342/https://www.bundestag.de/dokumente/textarchiv/2021/kw12-de-geschlechterentwicklung-kinder-830122 |url-status=live }}{{cite web |url=http://dipbt.bundestag.de/extrakt/ba/WP19/2677/267726.html |title=Gesetz zum Schutz von Kindern mit Varianten der Geschlechtsentwicklung |language=German |website=Deutscher Bundestag |access-date=April 29, 2021 |archive-date=April 27, 2021 |archive-url=https://web.archive.org/web/20210427223406/http://dipbt.bundestag.de/extrakt/ba/WP19/2677/267726.html |url-status=live }} According to a report in the Deutsches Ärzteblatt, the law is intended to strengthen the self-determined decision-making of children and adolescents and avoid possible damage to their health. Surgical changes to gender characteristics should only take place - even with the consent of the parents - if the operation cannot be postponed until age 14. The Federal Chamber of Psychotherapists requires the mandatory participation of a counsellor with experience on intersex in an assessment before a possible intervention.{{cite web |first=Petra |last=Bühring |url=https://www.aerzteblatt.de/archiv/217721/Intersexuelle-Kinder-Recht-zur-Selbstbestimmung |title=Intersexuelle Kinder: Recht zur Selbstbestimmung |date=February 20, 2021 |language=German |website=aerzteblatt.de |access-date=April 29, 2021 |archive-date=March 9, 2022 |archive-url=https://web.archive.org/web/20220309212304/https://www.aerzteblatt.de/archiv/217721/Intersexuelle-Kinder-Recht-zur-Selbstbestimmung |url-status=live }} While supportive of progress,{{Cite web | publisher = OII Europe | url = https://oiieurope.org/a-good-first-step-germany-adopts-law-banning-igm/ | title = A good first step: Germany adopts law banning IGM. But there is still room for improvement | date = March 30, 2021 | access-date = April 4, 2021 | archive-date = March 31, 2021 | archive-url = https://web.archive.org/web/20210331214856/https://oiieurope.org/a-good-first-step-germany-adopts-law-banning-igm/ | url-status = live }} the law that was finally passed was also criticized by the Organisation Intersex International (OII) Germany, OII Europe, and Intergeschlechtliche Menschen, because of the existence of exceptions.{{cite web |url=https://oiigermany.org/wp-content/uploads/2020/11/Stellungnahme-OII-Germany-Nov-2020_.pdf |title=Stellungnahme IVIM - OII Germany zum Gesetzentwurf der Bundesregierung "Entwurf eines Gesetzes zum Schutz von Kindern mit Varianten der Geschlechtsentwicklung" |date=September 23, 2020 |language=German |access-date=April 29, 2021 |archive-date=August 11, 2021 |archive-url=https://web.archive.org/web/20210811130235/https://oiigermany.org/wp-content/uploads/2020/11/Stellungnahme-OII-Germany-Nov-2020_.pdf |url-status=live }}{{cite web |url=https://oiigermany.org/wp-content/uploads/2021/03/Presseerkla%CC%88rung-Internationale-Vereinigung-Intergeschlechtlicher-Menschen_3_2021.pdf |title=Presseerklärung Internationale Vereinigung Intergeschlechtlicher Menschen |website=OII Germany |language=German |date=March 26, 2021 |access-date=April 29, 2021 |archive-date=May 8, 2021 |archive-url=https://web.archive.org/web/20210508105832/https://oiigermany.org/wp-content/uploads/2021/03/Presseerkla%CC%88rung-Internationale-Vereinigung-Intergeschlechtlicher-Menschen_3_2021.pdf |url-status=live }}

{{further|Genetic diagnosis of intersex}}

Preimplantation genetic diagnosis (PGD or PIGD) refers to genetic testing of embryos prior to implantation (as a form of embryo profiling), and sometimes even of oocytes prior to fertilization. PGD is considered in a similar fashion to prenatal diagnosis. When used to screen for a specific genetic condition, the method makes it highly likely that the baby will be free of the condition under consideration. PGD thus is an adjunct to assisted reproductive technology, and requires in vitro fertilization (IVF) to obtain oocytes or embryos for evaluation. The technology allows discrimination against those with intersex traits.

Georgiann Davis argues that such discrimination fails to recognize that many people with intersex traits lead full and happy lives.{{Cite journal| doi = 10.1080/15265161.2013.828119| issn = 1526-5161| volume = 13| issue = 10| pages = 51–53| last = Davis| first = Georgiann| author-link=Georgiann Davis|title = The Social Costs of Preempting Intersex Traits| journal = The American Journal of Bioethics| date = October 2013| pmid=24024811| s2cid = 7331095}} Morgan Carpenter highlights the appearance of several intersex variations in a list by the UK Human Fertilisation and Embryology Authority of "serious" "genetic conditions" that may be de-selected, including 5 alpha reductase deficiency and androgen insensitivity syndrome, traits evident in elite women athletes and "the world's first openly intersex mayor".{{Cite web |last=Carpenter |first=Morgan |author-link=Morgan Carpenter |title=Morgan Carpenter at LGBTI Human Rights in the Commonwealth conference |location=Glasgow |date=July 18, 2014 |access-date=April 29, 2021 |url=http://oii.org.au/27467/lgbti-human-rights-in-the-commonwealth/ |archive-url=https://web.archive.org/web/20140912102123/http://oii.org.au/27467/lgbti-human-rights-in-the-commonwealth/ |archive-date=September 12, 2014}} Organisation Intersex International Australia has called for the Australian National Health and Medical Research Council to prohibit such interventions, noting a "close entanglement of intersex status, gender identity and sexual orientation in social understandings of sex and gender norms, and in medical and medical sociology literature".{{Cite report| publisher = Organisation Intersex International Australia| last1 = Carpenter| first1 = Morgan| author2-link = Organisation Intersex International Australia| last2 = Organisation Intersex International Australia| title = Submission on the Review of Part B of the Ethical Guidelines for the Use of Assisted Reproductive Technology in Clinical Practice and Research, 2007| location = Sydney| date = April 30, 2014| url = http://oii.org.au/25621/submission-ethics-genetic-selection-intersex-traits/| access-date = September 13, 2015| archive-date = October 6, 2014| archive-url = https://web.archive.org/web/20141006114348/http://oii.org.au/25621/submission-ethics-genetic-selection-intersex-traits/| url-status = live}}

In 2015, the Council of Europe published an Issue Paper on Human rights and intersex people, remarking:

{{blockquote|Intersex people's right to life can be violated in discriminatory "sex selection" and "preimplantation genetic diagnosis, other forms of testing, and selection for particular characteristics". Such de-selection or selective abortions are incompatible with ethics and human rights standards due to the discrimination perpetrated against intersex people on the basis of their sex characteristics.}}

[[File:Inclusion of sex characteristics in anti-discrimination law.svg|thumb|right|452px|

{{legend|#002255|Explicit protection on grounds of sex characteristics (Bosnia and Herzegovina, Finland, Greece, Serbia, Malta, Portugal, Norway, Iceland, the Netherlands, Montenegro)}}

{{legend|#0066FF|Explicit protection on grounds of intersex status (Australia, Jersey)}}

{{legend|#9FCFFF|Explicit protection on grounds of intersex within attribute of sex (South Africa, Germany)}}

{{legend|#e3e3e3|No explicit protection on grounds}}]]

{{main|Discrimination against intersex people}}

A handful of jurisdictions so far provide explicit protection from discrimination for intersex people. South Africa was the first country to explicitly add intersex to legislation, as part of the attribute of "sex". Australia was the first country to add an independent attribute, of "intersex status".{{cite web | url = http://www.comlaw.gov.au/Details/C2013A00098 | title = Sex Discrimination Amendment (Sexual Orientation, Gender Identity and Intersex Status) Act 2013, No. 98, 2013, C2013A00098 | work = ComLaw | date = 2013 | access-date = 2015-07-19 | archive-date = 2014-10-06 | archive-url = https://web.archive.org/web/20141006122244/http://www.comlaw.gov.au/Details/C2013A00098 | url-status = live }} Malta was the first to adopt a broader framework of "sex characteristics, through legislation that also ended modifications to the sex characteristics of minors undertaken for social and cultural reasons. Bosnia-Herzegovina listed as "sex characteristics"{{cite web | url = http://www.lezbelib.com/europe-news/lgbti-people-are-now-better-protected-in-bosnia-and-herzegovina | title = LGBTI people are now better protected in Bosnia and Herzegovina | access-date = 2016-08-02 | archive-date = 2016-08-26 | archive-url = https://web.archive.org/web/20160826022235/http://www.lezbelib.com/europe-news/lgbti-people-are-now-better-protected-in-bosnia-and-herzegovina | url-status = live }} Greece prohibits discrimination and hate crimes based on "sex characteristics", since 24 December 2015.{{cite web | url = http://www.efsyn.gr/arthro/proti-fora-isoi-apenanti-ston-nomo | script-title = el:Πρώτη φορά, ίσοι απέναντι στον νόμο | date = 2015-12-23 | language = el | access-date = 2016-03-14 | archive-date = 2017-10-25 | archive-url = https://web.archive.org/web/20171025203410/http://www.efsyn.gr/arthro/proti-fora-isoi-apenanti-ston-nomo | url-status = live | work = Η Εφημερίδα των Συντακτών }} Since 2021, Serbia also prohibits discrimination based on "sex characteristics". Since 2022, Chile bans discrimination based on "sex characteristics" under Law 21,430.

An Australian survey of 272 persons born with atypical sex characteristics, published in 2016, found that 18% of respondents (compared to an Australian average of 2%) failed to complete secondary school, with early school leaving coincident with pubertal medical interventions, bullying and other factors.{{Cite journal| doi = 10.1080/14681811.2016.1149808| issn = 1468-1811 | pages = 602–618| last = Jones| first = Tiffany| title = The needs of students with intersex variations| journal = Sex Education| volume = 16 | issue = 6 | date = March 11, 2016 | s2cid = 74173324 }}

A 2015 Australian survey of people born with atypical sex characteristics found high levels of poverty, in addition to very high levels of early school leaving, and higher than average rates of disability.{{Cite book| publisher = Open Book Publishers| isbn = 978-1-78374-208-0| last1 = Jones| first1 = Tiffany| last2 = Hart| first2 = Bonnie| last3 = Carpenter| first3 = Morgan| last4 = Ansara| first4 = Gavi| last5 = Leonard| first5 = William| last6 = Lucke| first6 = Jayne| title = Intersex: Stories and Statistics from Australia| location = Cambridge, UK| access-date = 2016-02-02| date = February 2016| url = http://oii.org.au/wp-content/uploads/key/Intersex-Stories-Statistics-Australia.pdf | archive-url = https://web.archive.org/web/20160914152729/http://oii.org.au/wp-content/uploads/key/Intersex-Stories-Statistics-Australia.pdf| archive-date = 2016-09-14}} An Employers guide to intersex inclusion published by Pride in Diversity and Organisation Intersex International Australia also discloses cases of discrimination in employment.{{Cite book| publisher = Pride in Diversity and Organisation Intersex International Australia| isbn = 978-0-646-92905-7| last1 = Carpenter| first1 = Morgan| last2 = Hough| first2 = Dawn| author1-link = Morgan Carpenter| title = Employers' Guide to Intersex Inclusion| location = Sydney, Australia| date = 2014| url = http://oii.org.au/employer| access-date = 2016-05-30| archive-date = 2016-04-25| archive-url = https://web.archive.org/web/20160425044934/https://oii.org.au/employer/| url-status = dead}}

Discrimination protection intersects with involuntary and coercive medical treatment. Maltese protections on grounds of sex characteristics provides explicit protection against unnecessary and harmful modifications to the sex characteristics of children.

In May 2016, the United States Department of Health and Human Services issued a statement explaining Section 1557 of the Affordable Care Act stating that the Act prohibits "discrimination on the basis of intersex traits or atypical sex characteristics" in publicly funded healthcare, as part of a prohibition of discrimination "on the basis of sex".{{cite web| last = interACT| title = Federal Government Bans Discrimination Against Intersex People in Health Care| work = interactadvocates| date = 23 May 2016| access-date = 2016-05-27| url = http://interactadvocates.org/federal-government-bans-discrimination-against-intersex-people-in-health-care/| archive-date = 2016-05-28| archive-url = https://web.archive.org/web/20160528104341/http://interactadvocates.org/federal-government-bans-discrimination-against-intersex-people-in-health-care/| url-status = live}}

{{main|Sex verification in sports}}

In 2013, it was disclosed in a medical journal that four unnamed elite female athletes from developing countries were subjected to gonadectomies (sterilization) and partial clitoridectomies (female genital mutilation) after testosterone testing revealed that they had an intersex condition. Testosterone testing was introduced in the wake of the Caster Semenya case, of a South African runner subjected to testing due to her appearance and vigor.{{Cite journal| doi = 10.1210/jc.2012-3893| pmid = 23633205 | issn = 0021-972X | volume = 98| issue = 6| pages = –1055–E1059| last1 = Fénichel| first1 = Patrick| last2 = Paris| first2 = Françoise| last3 = Philibert| first3 = Pascal| last4 = Hiéronimus| first4 = Sylvie| last5 = Gaspari| first5 = Laura| last6 = Kurzenne| first6 = Jean-Yves| last7 = Chevallier| first7 = Patrick| last8 = Bermon| first8 = Stéphane| last9 = Chevalier| first9 = Nicolas| last10 = Sultan| first10 = Charles| title = Molecular Diagnosis of 5α-Reductase Deficiency in 4 Elite Young Female Athletes Through Hormonal Screening for Hyperandrogenism| journal = The Journal of Clinical Endocrinology & Metabolism| date = June 2013| doi-access = free}}{{Cite journal| doi = 10.1136/bmj.g2926| issn = 1756-1833| volume = 348| issue = apr28 9| pages = –2926–g2926| last1 = Jordan-Young| first1 = R. M.| last2 = Sonksen| first2 = P. H.| last3 = Karkazis| first3 = K.| author-link1= Rebecca Jordan-Young | author-link3= Katrina Karkazis |title = Sex, health, and athletes| journal = BMJ| date = April 2014 | pmid=24776640| s2cid = 2198650}}{{cite news|url=http://news.bbc.co.uk/sport1/hi/athletics/8210471.stm|title=Semenya told to take gender test|work=BBC Sport|date=19 August 2009|access-date=19 August 2009|archive-date=5 September 2017|archive-url=https://web.archive.org/web/20170905133852/http://news.bbc.co.uk/sport1/hi/athletics/8210471.stm|url-status=live}}{{cite news | title = A Lab is Set to Test the Gender of Some Female Athletes. | work = New York Times | date = 30 July 2008 | url = https://www.nytimes.com/2008/07/30/sports/olympics/30gender.html | access-date = 22 February 2017 | archive-date = 6 May 2021 | archive-url = https://web.archive.org/web/20210506162401/https://www.nytimes.com/2008/07/30/sports/olympics/30gender.html | url-status = live }} There is no evidence that innate hyperandrogenism in elite women athletes confers an advantage in sport.{{Cite journal| doi = 10.1210/jc.2014-1391| pmid = 25137421 | issn = 0021-972X | pages = –2014–1391| last1 = Bermon| first1 = Stéphane| last2 = Garnier| first2 = Pierre Yves| last3 = Lindén Hirschberg| first3 = Angelica| last4 = Robinson| first4 = Neil| last5 = Giraud| first5 = Sylvain| last6 = Nicoli| first6 = Raul| last7 = Baume| first7 = Norbert| last8 = Saugy| first8 = Martial| last9 = Fénichel| first9 = Patrick| last10 = Bruce| first10 = Stephen J.| last11 = Henry| first11 = Hugues| last12 = Dollé| first12 = Gabriel| last13 = Ritzen| first13 = Martin| title = Serum Androgen Levels in Elite Female Athletes| journal = The Journal of Clinical Endocrinology & Metabolism| date = August 2014 | volume=99| issue = 11 | doi-access = free}}{{cite news|last1=Branch|first1=John|title=Dutee Chand, Female Sprinter With High Testosterone Level, Wins Right to Compete|url=https://www.nytimes.com/2015/07/28/sports/international/dutee-chand-female-sprinter-with-high-male-hormone-level-wins-right-to-compete.html|access-date=22 May 2016|work=The New York Times|date=27 July 2016|archive-date=14 August 2016|archive-url=https://web.archive.org/web/20160814221355/http://www.nytimes.com/2015/07/28/sports/international/dutee-chand-female-sprinter-with-high-male-hormone-level-wins-right-to-compete.html|url-status=live}} While Australia protects intersex persons from discrimination, the Act contains an exemption in sport.

File:Utrechtpride-intersexboat.jpg

Compensation claims have been made in a limited number of legal cases.

{{main|Christiane Völling|Intersex rights in Germany}}

In Germany in 2011, Christiane Völling was successful in a case against her medical treatment. The surgeon was ordered to pay €100,000 in compensatory damages{{cite web |url=http://zwischengeschlecht.org/pages/Hermaphrodite-wins-damage-claim |title=Christiane Völling: Hermaphrodite wins damage claim over removal of reproductive organs |last1=Zwischengeschlecht |date=August 12, 2009 |access-date=2015-07-20 |author1-link=Zwischengeschlecht |archive-date=2015-07-05 |archive-url=https://web.archive.org/web/20150705201148/http://zwischengeschlecht.org/pages/Hermaphrodite-wins-damage-claim |url-status=live }} after a legal battle that began in 2007, thirty years after the removal of her reproductive organs.{{Cite web| title = German Gender-Assignment Case Has Intersexuals Hopeful| publisher = Deutsche Welle| date = 12 December 2007| work = DW.COM| access-date = 2015-12-21| url = http://www.dw.com/en/german-gender-assignment-case-has-intersexuals-hopeful/a-3000902| archive-date = 2015-12-22| archive-url = https://web.archive.org/web/20151222145816/http://www.dw.com/en/german-gender-assignment-case-has-intersexuals-hopeful/a-3000902| url-status = live}}{{Cite web| title = Christiane Völling| publisher = German Ethics Council| date = August 2010| access-date = 2015-12-21| url = http://diskurs.ethikrat.org/christiane-volling/| archive-url = https://web.archive.org/web/20160304060821/http://diskurs.ethikrat.org/christiane-volling/| archive-date = 2016-03-04}}

{{further|Intersex rights in Chile}}

On August 12, 2005, the mother of a child, Benjamín, filed a lawsuit against the Maule Health Service after the child's male gonads and reproductive system were removed without informing the parents of the nature of the surgery. The child had been raised as a girl. The claim for compensatory damages was initiated in the Fourth Court of Letters of Talca, and ended up in the Supreme Court of Chile. On November 14, 2012, the Court sentenced the Maule Health Service for "lack of service" and to pay compensation of 100 million pesos for moral and psychological damages caused to Benjamín, and another 5 million for each of the parents.{{cite web|title=Condenan al H. de Talca por error al determinar sexo de bebé|url=http://diario.latercera.com/2012/11/24/01/contenido/pais/31-123780-9-condenan-al-h-de-talca--por-error-al-determinar-sexo-de-bebe.shtml|archive-url=https://web.archive.org/web/20121124010101/http://diario.latercera.com/2012/11/24/01/contenido/pais/31%2D123780%2D9%2Dcondenan%2Dal%2Dh%2Dde%2Dtalca%2D%2Dpor%2Derror%2Dal%2Ddeterminar%2Dsexo%2Dde%2Dbebe.shtml|website=diario.latercera.com|access-date=15 February 2017|archive-date=24 November 2012 |language=es}}{{cite web|last=García|first=Gabriela|title=Identidad forzada|url=http://www.paula.cl/reportajes-y-entrevistas/reportajes/identidad-forzada/|website=www.paula.cl|language=es|date=2013-06-20|access-date=2017-02-15|archive-date=2017-02-15|archive-url=https://web.archive.org/web/20170215212801/http://www.paula.cl/reportajes-y-entrevistas/reportajes/identidad-forzada/|url-status=live}}

{{further|Intersex rights in the United States}}

In the United States the M.C. v. Aaronson case, advanced by interACT with the Southern Poverty Law Center, was brought before the courts in 2013.{{cite web |url=http://www.splcenter.org/get-informed/news/groundbreaking-splc-lawsuit-accuses-south-carolina-doctors-and-hospitals-of-unnece |title=Groundbreaking SLPC Lawsuit Accuses South Carolina Doctors and Hospitals of Unnecessary Surgery on Infant |last1=Southern Poverty Law Center |date=May 14, 2013 |access-date=2015-07-20 |author1-link=Southern Poverty Law Center |archive-date=2015-07-13 |archive-url=https://web.archive.org/web/20150713101437/http://www.splcenter.org/get-informed/news/groundbreaking-splc-lawsuit-accuses-south-carolina-doctors-and-hospitals-of-unnece |url-status=live }}{{cite web |url=http://nursingclio.org/2013/05/17/do-no-harm-intersex-surgeries-and-the-limits-of-certainty/ |title=Do No Harm: Intersex Surgeries and the Limits of Certainty |last1=Reis |first1=Elizabeth |date=May 17, 2013 |website=Nursing Clio |access-date=2015-07-20 |archive-date=2018-12-03 |archive-url=https://web.archive.org/web/20181203055735/https://nursingclio.org/2013/05/17/do-no-harm-intersex-surgeries-and-the-limits-of-certainty/ |url-status=live }}{{cite web |url=https://www.theatlantic.com/health/archive/2013/05/when-to-do-surgery-on-a-child-with-both-genitalia/275884/ |title=When to Do Surgery on a Child With 'Both' Genitalia |last1=Dreger |first1=Alice |date=May 16, 2013 |website=The Atlantic |access-date=2015-07-20 |archive-date=2019-04-28 |archive-url=https://web.archive.org/web/20190428013307/https://www.theatlantic.com/health/archive/2013/05/when-to-do-surgery-on-a-child-with-both-genitalia/275884/ |url-status=live }} In 2015, the Court of Appeals for the Fourth Circuit dismissed the case, stating that, "it did not “mean to diminish the severe harm that M.C. claims to have suffered” but that a reasonable official in 2006 did not have fair warning from then-existing precedent that performing sex assignment surgery on sixteen-month-old M.C. violated a clearly established constitutional right."{{cite web | url = http://blogs.harvard.edu/billofhealth/2015/03/05/m-c-v-aaronson-update/ | title = M.C. v. Aaronson | first = Emily | last = Largent | work = Petrie-Flom Center, Harvard Law | date = March 5, 2015 | access-date = February 18, 2017 | archive-date = February 18, 2017 | archive-url = https://web.archive.org/web/20170218235654/http://blogs.harvard.edu/billofhealth/2015/03/05/m-c-v-aaronson-update/ | url-status = live }}{{Cite web| last = interACT| author-link = Interact Advocates for Intersex Youth| title = Update on M.C.'s Case – The Road to Justice can be Long, but there is more than one path for M.C.| access-date = 2017-02-18| date = January 27, 2015| url = http://interactadvocates.org/update-on-the-m-c-case-the-road-to-justice-can-be-long/| archive-url = https://web.archive.org/web/20170219013202/http://interactadvocates.org/update-on-the-m-c-case-the-road-to-justice-can-be-long/| archive-date = 2017-02-19}} In July 2017, it was reported that the case had been settled out of court by the Medical University of South Carolina for $440,000, without admission of liability.{{Cite web| last = Ghorayshi| first = Azeen| title = A Landmark Lawsuit About An Intersex Baby's Genital Surgery Just Settled For $440,000| work = BuzzFeed| access-date = 2017-07-27| date = July 27, 2017| url = https://www.buzzfeed.com/azeenghorayshi/intersex-surgery-lawsuit-settles| archive-date = 2017-07-27| archive-url = https://web.archive.org/web/20170727175528/https://www.buzzfeed.com/azeenghorayshi/intersex-surgery-lawsuit-settles| url-status = live}}

{{further|Intersex rights in Germany}}

In 2015, Michaela Raab filed suit against doctors in Nuremberg, Germany, for failing to properly advise her. Doctors stated that they "were only acting according to the norms of the time - which sought to protect patients against the psychosocial effects of learning the full truth about their chromosomes."{{Cite web| last = The Local| title = Intersex person sues clinic for unnecessary op| date = February 27, 2015| access-date = 2015-12-21| url = http://www.thelocal.de/20150227/intersex-person-sues-doctors-for-unwanted-op| archive-date = 2015-12-14| archive-url = https://web.archive.org/web/20151214092025/http://www.thelocal.de/20150227/intersex-person-sues-doctors-for-unwanted-op| url-status = live}} On 17 December 2015, the Nuremberg State Court ruled that the University of Erlangen-Nuremberg Clinic pay damages and compensation.{{Cite web| last = Zwischengeschlecht| title = Nuremberg Hermaphrodite Lawsuit: Michaela "Micha" Raab Wins Damages and Compensation for Intersex Genital Mutilations!| access-date = 2015-12-21| date = December 17, 2015| url = http://stop.genitalmutilation.org/post/Nuremberg-Hermaphrodite-Lawsuit-Damages-and-Compensation-for-Intersex-Genital-Mutilations| archive-date = 2016-05-11| archive-url = https://archive.today/20160511101133/http://stop.genitalmutilation.org/post/Nuremberg-Hermaphrodite-Lawsuit-Damages-and-Compensation-for-Intersex-Genital-Mutilations| url-status = live}}

File:Licence to Lie.jpg treatment standards in 1963]]

With the rise of modern medical science in Western societies, many intersex people with ambiguous external genitalia have had their genitalia surgically modified to resemble either female or male genitals. Surgeons pinpointed the birth of intersex babies as a "social emergency".{{cite journal|last1=Coran|first1=Arnold G.|last2=Polley|first2=Theodore Z.|title=Surgical management of ambiguous genitalia in the infant and child|journal=Journal of Pediatric Surgery|date=July 1991|volume=26|issue=7|pages=812–820|doi=10.1016/0022-3468(91)90146-K|pmid=1895191|citeseerx=10.1.1.628.4867}} A secrecy-based model was also adopted, in the belief that this was necessary to ensure “normal” physical and psychosocial development.{{cite web| last = Holmes| first = Morgan| author-link = Morgan Holmes| title = Is Growing up in Silence Better Than Growing up Different?| work = Intersex Society of North America| url = http://www.isna.org/node/743| access-date = 2015-07-21| archive-date = 2016-03-05| archive-url = https://web.archive.org/web/20160305055336/http://www.isna.org/node/743| url-status = live}}{{cite web| last = Intersex Society of North America| title = What's wrong with the way intersex has traditionally been treated?| url = http://www.isna.org/faq/concealment#fn2| access-date = 2015-07-21| archive-date = 2014-06-26| archive-url = https://web.archive.org/web/20140626004731/http://www.isna.org/faq/concealment#fn2| url-status = live}} Disclosure also included telling people that they would never meet anyone else with the same condition. Access to medical records has also historically been challenging. Yet the ability to provide free, informed consent depends on the availability of information.

The Council of Europe and World Health Organization{{Cite book| publisher = World Health Organization| isbn = 9789241564984| last = World Health Organization| title = Sexual health, human rights and the law| location = Geneva| date = 2015}} acknowledge the necessity for improvements in information provision, including access to medical records.

Some intersex organizations claim that secrecy-based models have been perpetuated by a shift in clinical language to disorders of sex development. Morgan Carpenter of Organisation Intersex International Australia quotes the work of Miranda Fricker on "hermeneutical injustice" where, despite new legal protections from discrimination on grounds of intersex status, "someone with lived experience is unable to even make sense of their own social experiences" due to the deployment of clinical language and "no words to name the experience".{{Cite conference| publisher = Organisation Intersex International Australia| last = Carpenter| first = Morgan| title = Intersex and ageing| date = February 3, 2015| url = https://oii.org.au/28385/intersex-and-ageing/| conference = | access-date = July 21, 2015| archive-date = April 13, 2015| archive-url = https://web.archive.org/web/20150413004051/https://oii.org.au/28385/intersex-and-ageing/| url-status = live}}

{{main|Legal recognition of intersex people}}

According to the Asia Pacific Forum of National Human Rights Institutions, few countries have provided for the legal recognition of intersex people. The Forum states that the legal recognition of intersex people is:

• firstly about access to the same rights as other men and women, when assigned male or female;
• secondly it is about access to administrative corrections to legal documents when an original sex assignment is not appropriate; and
• thirdly, while opt in schemes may help some individuals, legal recognition is not about the creation of a third sex or gender classification for intersex people as a population, but instead is about enabling an opt-in scheme for any individual who seeks it.

In some jurisdictions, access to any form of identification document can be an issue.

Like all individuals, some intersex individuals may be raised as a particular sex (male or female) but then identify with another later in life, while most do not.{{cite book |last=Money |first=John |author-link = John Money |author2=Ehrhardt, Anke A. |title=Man & Woman Boy & Girl. Differentiation and dimorphism of gender identity from conception to maturity |year=1972 |publisher=The Johns Hopkins University Press |location=US |isbn=978-0-8018-1405-1 |url-access=registration |url=https://archive.org/details/manwomanboygirl00mone }}{{cite book |last=Domurat Dreger |first=Alice |title=Hermaphrodites and the Medical Invention of Sex |year=2001 |publisher=Harvard University Press |location=US |isbn=978-0-674-00189-3 }}{{cite book |last=Marañón |first=Gregorio |title=Los estados intersexuales en la especie humana |year=1929 |publisher=Morata |location=Madrid }} Like non-intersex people, some intersex individuals may not identify themselves as either exclusively female or exclusively male. A 2012 clinical review suggests that between 8.5-20% of persons with intersex conditions may experience gender dysphoria,{{cite journal | author = Furtado P. S.| year = 2012 | title = Gender dysphoria associated with disorders of sex development | journal = Nat. Rev. Urol. | volume = 9 | issue = 11| pages = 620–627 | doi = 10.1038/nrurol.2012.182 |display-authors=etal | pmid=23045263| s2cid = 22294512 }} while sociological research in Australia, a country with a third 'X' sex classification, shows that 19% of people born with atypical sex characteristics selected an "X" or "other" option, while 52% are women, 23% men and 6% unsure.{{Citation| last = Organisation Intersex International Australia| title = Demographics| date = July 28, 2016| url = https://oii.org.au/demographics/| access-date = 2016-09-30| archive-date = 2016-10-01| archive-url = https://web.archive.org/web/20161001215740/https://oii.org.au/demographics/| url-status = live}}

Depending on the jurisdiction, access to any birth certificate may be an issue,{{Cite news|url=https://www.reuters.com/article/us-kenya-intersex-idUSKCN0JJ1M120141205|title=Kenya takes step toward recognizing intersex people in landmark ruling|website=Reuters|date=2014-12-05|access-date=2021-07-05|archive-date=2015-09-24|archive-url=https://web.archive.org/web/20150924211232/http://www.reuters.com/article/2014/12/05/us-kenya-intersex-idUSKCN0JJ1M120141205|url-status=live}} including a birth certificate with a sex marker.{{cite web | url = http://www.advocate.com/commentary/2013/11/06/op-ed-germany's-third-gender-law-fails-equality | first = Hida | last = Viloria | work = The Advocate | title = Op-ed: Germany's Third-Gender Law Fails on Equality | date = November 6, 2013 | access-date = March 9, 2022 | archive-date = March 9, 2022 | archive-url = https://web.archive.org/web/20220309212250/https://www.advocate.com/commentary/2013/11/06/op-ed-germany%E2%80%99s-third-gender-law-fails-equality | url-status = live }}

In 2014, in the case of Baby 'A' (Suing through her Mother E.A) & another v Attorney General & 6 others [2014], a Kenyan court ordered the Kenyan government to issue a birth certificate to a five-year-old child born in 2009 with ambiguous genitalia.{{cite news|last=Migiro|first=Katy|url=https://www.reuters.com/article/us-kenya-intersex-idUSKCN0JJ1M120141205|title=Kenya takes step toward recognizing intersex people in landmark ruling|work=Reuters|access-date=2021-07-05|archive-date=2015-09-24|archive-url=https://web.archive.org/web/20150924211232/http://www.reuters.com/article/2014/12/05/us-kenya-intersex-idUSKCN0JJ1M120141205|url-status=live}} In Kenya a birth certificate is necessary for attending school, getting a national identity document, and voting. Many intersex persons in Uganda are understood to be stateless due to historical difficulties in obtaining identification documents, despite a birth registration law that permits intersex minors to change assignment.{{Citation| last = Support Initiative for Persons with Congenital Disorders| title = Baseline Survey on Intersex Realities in East Africa - Specific Focus on Uganda, Kenya and Rwanda| date = 2016}}

The Asia Pacific Forum of National Human Rights Institutions states that:

{{blockquote|Recognition before the law means having legal personhood and the legal protections that flow from that. For intersex people, this is neither primarily nor solely about amending birth registrations or other official documents. Firstly, it is about intersex people who have been issued a male or a female birth certificate being able to enjoy the same legal rights as other men and women.{{Cite book| publisher = Asia Pacific Forum of National Human Rights Institutions| isbn = 978-0-9942513-7-4| last = Asia Pacific Forum of National Human Rights Institutions| title = Promoting and Protecting Human Rights in relation to Sexual Orientation, Gender Identity and Sex Characteristics| date = June 2016| url = http://www.asiapacificforum.net/resources/manual-sogi-and-sex-charactersitics/| access-date = 2016-08-29| archive-date = 2017-01-15| archive-url = https://web.archive.org/web/20170115144950/http://www.asiapacificforum.net/resources/manual-sogi-and-sex-charactersitics/| url-status = live}}}}

Access to a birth certificate with a correct sex marker may be an issue for people who do not identify with their sex assigned at birth, or it may only be available accompanied by surgical requirements.

The passports and identification documents of Australia and some other nationalities have adopted "X" as a valid third category besides "M" (male) and "F" (female), at least since 2003.{{cite journal|first=Ingrid | last = Holme | title = Hearing People's Own Stories | journal = Science as Culture | volume = 17 | issue = 3 | doi = 10.1080/09505430802280784 | date = 2008| pages=341–344| s2cid = 143528047 }}{{cite web|url=http://www.passports.govt.nz/Transgender-applicants|title=New Zealand Passports - Information about Changing Sex / Gender Identity|access-date=6 October 2014|archive-date=23 September 2014|archive-url=https://web.archive.org/web/20140923055123/http://www.passports.govt.nz/Transgender-applicants|url-status=live}} In 2013, Germany became the first European nation to allow babies with characteristics of both sexes to be registered as indeterminate gender on birth certificates, amidst opposition and skepticism from intersex organisations who point out that the law appears to mandate exclusion from male or female categories.{{cite web | url = http://www.dw.de/third-sex-option-on-birth-certificates/a-17193869 | title = Third sex option on birth certificates | work = Deutsche Welle | date = 1 November 2013 | access-date = 19 July 2015 | archive-date = 10 October 2014 | archive-url = https://web.archive.org/web/20141010184218/http://www.dw.de/third-sex-option-on-birth-certificates/a-17193869 | url-status = live }}{{cite web | url = http://oiieurope.org/bluff-package-for-inter-leaving-sex-entry-open-is-not-an-option/ | title = Sham package for Intersex: Leaving sex entry open is not an option | work = OII Europe | date = 15 February 2013 | access-date = 19 July 2015 | archive-date = 29 August 2014 | archive-url = https://web.archive.org/web/20140829115843/http://oiieurope.org/bluff-package-for-inter-leaving-sex-entry-open-is-not-an-option/ | url-status = live }} The Council of Europe acknowledged this approach, and concerns about recognition of third and blank classifications in a 2015 Issue Paper, stating that these may lead to "forced outings" and "lead to an increase in pressure on parents of intersex children to decide in favour of one sex." The Issue Paper argues that "further reflection on non-binary legal identification is necessary":

Mauro Cabral, Global Action for Trans Equality (GATE) Co-Director, indicated that any recognition outside the “F”/”M” dichotomy needs to be adequately planned and executed with a human rights point of view, noting that: {{blockquote|“People tend to identify a third sex with freedom from the gender binary, but that is not necessarily the case. If only trans and/or intersex people can access that third category, or if they are compulsively assigned a third sex, then the gender binary gets stronger, not weaker”}}

{{further|Discrimination against intersex people|Legal recognition of intersex people}}

Read country-specific pages on intersex rights via the links on the country name, where available.

{{Update|the United States|date=January 2025}}

• Intersex Awareness Day
• Intersex people and military service
• Intersex human rights reports
• Intersex medical interventions
• Discrimination against intersex people
• Legal recognition of intersex people

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• {{Cite book| last = Regmi| first = Esan| author-link = Esan Regmi| title = Stories of Intersex People from Nepal| location = Kathmandu| url = https://oii.org.au/30476/stories-intersex-people-nepal/ | date = 2016}}
• {{Cite book| author1-link = Australian Senate | isbn = 978-1-74229-917-4 | last1 = Senate of Australia | last2 = Community Affairs References Committee| title = Involuntary or coerced sterilisation of intersex people in Australia| location = Canberra| date = 2013| url = http://www.aph.gov.au/Parliamentary_Business/Committees/Senate/Community_Affairs/Involuntary_Sterilisation/Sec_Report/index}}
• {{Cite book| pages = 91–104| editor1-last = Center for Human Rights & Humanitarian Law| editor2-last = Washington College of Law| last = Tamar-Mattis| first = Anne| author-link = Anne Tamar-Mattis| editor1-link = Center for Human Rights & Humanitarian Law| title = Torture in Healthcare Settings: Reflections on the Special Rapporteur on Torture's 2013 Thematic Report| chapter = Medical Treatment of People with Intersex Conditions as Torture and Cruel, Inhuman, or Degrading Treatment or Punishment| location = Washington, DC| date = 2014| chapter-url = http://antitorture.org/torture-in-healthcare-publication/| access-date = 2016-03-14| archive-date = 2016-03-14| archive-url = https://web.archive.org/web/20160314165812/http://antitorture.org/torture-in-healthcare-publication/| url-status = dead}}
• {{Cite web| last=United Nations Office of the High Commissioner for Human Rights | author-link = Office of the High Commissioner for Human Rights | title = Free & Equal Campaign Fact Sheet: Intersex| date = 2015| url = https://unfe.org/system/unfe-65-Intersex_Factsheet_ENGLISH.pdf }}
• {{cite web | url = http://www.ohchr.org/Documents/HRBodies/HRCouncil/RegularSession/Session22/A.HRC.22.53_English.pdf | last= UN Special Rapporteur on torture and other cruel, inhuman or degrading treatment or punishment | title = Report of the UN Special Rapporteur on Torture | work = Office of the UN High Commissioner for Human Rights | date = February 2013}}
• {{cite web |title=Intersex Awareness Day – Wednesday 26 October |url=https://www.ohchr.org/EN/NewsEvents/Pages/DisplayNews.aspx?NewsID=20739&LangID=E |publisher=Office of the United Nations High Commissioner for Human Rights |access-date=7 October 2018 |date=24 October 2016}}
• {{Cite book| isbn = 978-92-4-150732-5| last1 = World Health Organization| last2 = OHCHR| last3 = UN Women| last4 = UNAIDS| last5 = UNDP| last6 = UNFPA| last7 = UNICEF| title = Eliminating forced, coercive and otherwise involuntary sterilization, An interagency statement| date = 2014| url = http://apps.who.int/iris/bitstream/10665/112848/1/9789241507325_eng.pdf?ua=1|author1-link= World Health Organization | author2-link = Office of the High Commissioner for Human Rights}}
• {{Cite book| publisher = World Health Organization| isbn = 9789241564984| last = World Health Organization| title = Sexual health, human rights and the law| location = Geneva| date = 2015}}

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