Medicine:Intersex human rights

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Short description: Human rights for intersex people
Participants at the third International Intersex Forum, Malta, in December 2013

Intersex people are born with sex characteristics, such as chromosomes, gonads, or genitals, that, according to the UN Office of the High Commissioner for Human Rights, "do not fit typical binary notions of male or female bodies."[1]

Intersex persons often face stigmatisation and discrimination from birth, particularly when an intersex variation is visible. In some countries 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.[2][3][4]

Intersex infants and children, such as those with ambiguous outer genitalia, may be surgically and/or hormonally altered to fit perceived more socially acceptable sex characteristics. However, this is considered controversial, with no firm evidence of good outcomes.[5] Such treatments may involve sterilization. Adults, including elite female athletes, have also been subjects of such treatment.[6][7] These issues are recognized as human rights abuses, with statements from UN agencies,[8][9] the Australian parliament,[10] and German and Swiss ethics institutions.[11] Intersex organizations have also issued joint statements over several years, including the Malta declaration by the third International Intersex Forum.

Implementation of human rights protections in legislation and regulation has progressed more slowly. In 2011, Christiane Völling won the first successful case brought against a surgeon for non-consensual surgical intervention.[12] In 2015, the Council of Europe recognized for the first time a right for intersex persons to not undergo sex assignment treatment.[13] In April 2015, Malta became the first country to outlaw nonconsensual medical interventions to modify sex anatomy, including that of intersex people.[14][15]

Other human rights and legal issues include the right to life, protection from discrimination, standing to file in law and compensation, access to information, and legal recognition.[13][16] Few countries so far protect intersex people from discrimination.[13][16]


Intersex and human rights

ILGA conference 2018, group photo to mark Intersex Awareness Day

Research indicates a growing consensus that diverse intersex bodies are normal—if relatively rare—forms of human biology,[17] 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,[18][19] found that intersex people are discriminated against worldwide:

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.[13]

Relationship between 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.[20]

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".[21] 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.[22]

Physical integrity and bodily autonomy

  Legal prohibition of non-consensual medical interventions
  Regulatory suspension of non-consensual medical interventions
  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.[2][3] Abandonments and infanticides have been reported in Uganda,[2] Kenya,[23] south Asia,[24] and China.[4] 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.[23]

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.[18] 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.[4]

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

  • the right to life.[13]
  • the right to privacy, including a right to personal autonomy or self-determination regarding medical treatment.[10][11]
  • prohibitions against torture and other cruel, inhuman and degrading treatment.[8][10]
  • a right to physical integrity[25] and/or bodily autonomy.[15][26]
  • additionally, the best interests of the child may not be served by surgeries aimed at familial and social integration.[11]

Human rights reports

Hong Kong intersex activist Small Luk

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),[11] the UN special rapporteur on torture and other cruel, inhuman or degrading treatment or punishment (2013),[8] and the Australian Senate (2013).[10] 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.[14][15] 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.[13]

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:[27]

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.[27]

In 2017, the human rights non-governmental organizations Amnesty International[28][29] and Human Rights Watch[30][31][32] published major reports on the rights of children with intersex conditions.

Constitutional Court of 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.[33] 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.[34] The court case led to the setting of legal guidelines for doctors' surgical practice on intersex children.

Maltese legislation

In April 2015, Malta became the first country to outlaw non-consensual medical interventions in a Gender Identity Gender Expression and Sex Characteristics Act.[14][15] The Act recognizes a right to bodily integrity and physical autonomy, explicitly prohibiting modifications to children's sex characteristics for social factors:

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.[35]

The Act was widely welcomed by civil society organizations.[26][36][37]

Chilean regulations

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.[38]

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.[39][40] The regulations were superseded in August 2016 by Circular No. 07.[41][42][43] Circulars 18/2015 and 07/2016 were annulled by Circular 15/2023.

Indian State of Tamil Nadu

On 22 April 2019 the Madras High Court (Madurai Bench) passed a landmark judgment[44] 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.[45][46][47][48]

Legal protections in Germany 2021

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.[49][50] 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.[51] While supportive of progress,[52] 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.[53][54][55]

Right to life

Further information: Medicine: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.[56] 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".[57] 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".[58]

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

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.[13]

Protection from discrimination

  Explicit protection on grounds of sex characteristics (Bosnia and Herzegovina, Finland, Greece, Serbia, Malta, Portugal, Norway, Iceland, the Netherlands)
  Explicit protection on grounds of intersex status (Australia, Jersey)
  Explicit protection on grounds of intersex within attribute of sex (South Africa, Germany)
  No explicit protection on grounds

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".[59] Australia was the first country to add an independent attribute, of "intersex status".[60] 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.[26] Bosnia-Herzegovina listed as "sex characteristics"[61][62] Greece prohibits discrimination and hate crimes based on "sex characteristics", since 24 December 2015.[63][64] Since 2021, Serbia also prohibits discrimination based on "sex characteristics".[65] Since 2022, Chile bans discrimination based on "sex characteristics" under Law 21,430.[66]

Education

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.[67]

Employment

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.[68] An Employers guide to intersex inclusion published by Pride in Diversity and Organisation Intersex International Australia also discloses cases of discrimination in employment.[69]

Healthcare

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.[15][26]

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".[70]

Sport

Main page: Biology: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.[71][72] 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.[71][72][73][74] There is no evidence that innate hyperandrogenism in elite women athletes confers an advantage in sport.[75][76] While Australia protects intersex persons from discrimination, the Act contains an exemption in sport.

Remedies and compensation claims

Intersex activists on a boat at Utrecht Canal Pride on June 16, 2018

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

Christiane Völling case, 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[77][78] after a legal battle that began in 2007, thirty years after the removal of her reproductive organs.[12][79]

Benjamín-Maricarmen case, 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.[80][81]

M.C. v. Aaronson case, US

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.[82][83][84] 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."[85][86] 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.[87]

Michaela Raab case, 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."[78] On 17 December 2015, the Nuremberg State Court ruled that the University of Erlangen-Nuremberg Clinic pay damages and compensation.[88]

Access to information

"They should never be told ... "[89] Licence to Lie - Androgen insensitivity syndrome 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".[90] A secrecy-based model was also adopted, in the belief that this was necessary to ensure “normal” physical and psychosocial development.[11][91][92] Disclosure also included telling people that they would never meet anyone else with the same condition.[10] Access to medical records has also historically been challenging.[13] Yet the ability to provide free, informed consent depends on the availability of information.

The Council of Europe[13] and World Health Organization[93] 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".[94]

Legal recognition

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.[16]

In some jurisdictions, access to any form of identification document can be an issue.[95]

Gender identities

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.[96][97][98] 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,[99] 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.[68][100]

Access to identification documents

Depending on the jurisdiction, access to any birth certificate may be an issue,[95] including a birth certificate with a sex marker.[101]

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.[102] In Kenya a birth certificate is necessary for attending school, getting a national identity document, and voting.[102] 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.[103]

Access to the same rights as other men and women

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

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.[16]

Binary categories

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,[13] or it may only be available accompanied by surgical requirements.[16]

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.[104][105] 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.[106][107] 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."[13] 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:

“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”[13]

Intersex rights by jurisdiction

Read country-specific pages on intersex rights via the links on the country name, where available. <section begin="bycountry" />

Africa

Country/jurisdiction Physical integrity and bodily autonomy Anti-discrimination protection Access to identification documents Access to same rights as other men and women Changing M/F identification documents Third gender or sex classifications Ending official classification by sex or gender Sex and gender distinctions Assign infants and children to male or female
Kenya Kenya Since 2022Yes[108][109] No Yes[95] Since 2022Yes[110]
South Africa South Africa No[111][112] Yes[59] Yes Yes[113] Yes Subject to medical and social reports
Uganda Uganda No[114][115] No Yes[116]

Americas

Country/jurisdiction Physical integrity and bodily autonomy Anti-discrimination protection Access to identification documents Access to same rights as other men and women Changing M/F identification documents Third gender or sex classifications Ending official classification by sex or gender Sex and gender distinctions Assign infants and children to male or female
Argentina Argentina No Yes Self-determination[117] Yes Since July 2021, gender X became available and implemented[118]
Canada Canada No[119] No Yes Yes Self-determination Yes
Chile Chile Yes[120][121] Yes[66][122][123] Yes Yes Self-determination[124] Yes[124]
Colombia Colombia No No, but restricted in children aged over 5. No Yes Self-determination
Mexico Mexico No[125][126][127] No[126] Yes Since May 2023, a gender X option formally became available on Passports within Mexico - alongside male and female options.[128][129]
United States United States No[130] Partial, in healthcare[131] No Laws on female genital mutilation not enforced[130] Yes/No Opt in only for Washington D.C., California, New York City, Ohio (with a court order only), New Mexico,[132] Nevada,[133] Oregon, Utah (with a court order only),[134] Washington State, New Jersey,[135] and Colorado.[136][137][138][139] In October 2021, the very first US Passport with a gender X was issued by a court order for an individual. From April-11-2022, gender X becomes officially available and recognised for any validly issued US Passport holder.[140][141][142]
Uruguay Uruguay Yes[143][144] Yes Self-determination Yes[145]

Asia

Country/jurisdiction Physical integrity and bodily autonomy Anti-discrimination protection Access to identification documents Access to same rights as other men and women Changing M/F identification documents Third gender or sex classifications Ending official classification by sex or gender Sex and gender distinctions Assign infants and children to male or female
Bangladesh Bangladesh No No Emblem-question.svg[146][citation needed] Yes[146][citation needed]
China China No[147][148]
India India Yes[45][46][47][48][149] Yes[45] Yes[45] Yes[45] Yes[150] Yes[150]
Japan Japan No No Warning Requires surgery[16]
Nepal Nepal No No Yes[151]Emblem-question.svg[152] Yes[151]
Pakistan Pakistan No Yes[153] Yes Self-determination[153] Yes[153]
South Korea South Korea No No Yes[citation needed]
Thailand Thailand No No Warning Requires surgery[16]
Vietnam Vietnam No No Warning Requires surgery[16]

Europe

Country/jurisdiction Physical integrity and bodily autonomy Anti-discrimination protection Access to identification documents Access to same rights as other men and women Changing M/F identification documents Third gender or sex classifications Ending official classification by sex or gender Sex and gender distinctions Assign infants and children to male or female
Albania Albania Yes[154] Yes[155]
Austria Austria Yes[156]
Bosnia and Herzegovina Bosnia and Herzegovina No Yes[61]
Belgium Belgium Emblem-question.svg Emblem-question.svg Emblem-question.svg Yes Self-determination[157][158] Emblem-question.svg
Denmark Denmark No[28][29] No Yes Self-determination[159] No
Finland Finland No Emblem-question.svg Emblem-question.svg No
France France No Emblem-question.svg Emblem-question.svg No
Germany Germany Yes with exceptions[53][160][161] No Emblem-question.svg Emblem-question.svg Yes[162]
Greece Greece No Yes[63]
Iceland Iceland No Yes[163][164][165] Emblem-question.svg Emblem-question.svg Yes Self-determination[163][164][165] Yes[163][164][165]
Republic of Ireland Ireland No Yes Self-determination[159] No
Jersey Jersey No Yes[166]
Luxembourg Luxembourg Emblem-question.svg Emblem-question.svg Emblem-question.svg Yes[167] Emblem-question.svg
Malta Malta Yes Legislated[citation needed] Yes[35] Yes Yes Yes Self-determination[159] Yes[168]
Montenegro Montenegro No Yes[169] No No No No No No No
Netherlands Netherlands Yes Emblem-question.svg Emblem-question.svg Emblem-question.svg Emblem-question.svg
Norway Norway No[170] Emblem-question.svg Emblem-question.svg Yes Self-determination[171][172][173] Emblem-question.svg
Portugal Portugal No Legislated[174][175] Yes Yes Yes Yes Self-determination[174][175] Yes
Serbia Serbia No Yes[65]
Switzerland Switzerland No[11][176][177][178] No Yes Self-determination[179] No
United Kingdom United Kingdom No No Requires diagnosis of gender dysphoria[180] No

Oceania

Country/jurisdiction Physical integrity and bodily autonomy Anti-discrimination protection Access to identification documents Access to same rights as other men and women Changing M/F identification documents Third gender or sex classifications Ending official classification by sex or gender Sex and gender distinctions Assign infants and children to male or female
Australia Australia Yes At federal level[181] No Exemptions regarding sport and female genital mutilation[181] Yes Policies vary depending on jurisdiction[182] Warning Requires sexual reassignment surgery and permission from at least 2 medical practitioners within both NSW and QLD only. Appropriate clinical treatment (or just 1 doctors permission) within WA, SA, NT and the ACT. "Self-determination" within TAS and VIC.[183] Yes (Passports) Yes Opt in at federal level, state/territory policies vary[182][184]
New Zealand New Zealand No No Exemptions regarding female genital mutilation[16] Yes From July 2023, by self-determination[185] Yes (Passports) Warning (Third birth certificate may be used if determined at birth[186])

<section end="bycountry" />

See also

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

Notes

  1. ↑ "Free & Equal Campaign Fact Sheet: Intersex". United Nations Office of the High Commissioner for Human Rights. 2015. https://unfe.org/system/unfe-65-Intersex_Factsheet_ENGLISH.pdf. 
  2. ↑ 2.0 2.1 2.2 Civil Society Coalition on Human Rights and Constitutional Law; Human Rights Awareness and Promotion Forum; Rainbow Health Foundation; Sexual Minorities Uganda; Support Initiative for Persons with Congenital Disorders (2014). "Uganda Report of Violations based on Sex Determination, Gender Identity, and Sexual Orientation". http://www.hrapf.org/publications/research-papers/uganda-report-violations-based-sex-determination-gender-identity-and. 
  3. ↑ 3.0 3.1 Grady, Helen; Soy, Anne (May 4, 2017). "The midwife who saved intersex babies". BBC World Service, Kenya. https://www.bbc.com/news/world-africa-39780214. 
  4. ↑ 4.0 4.1 4.2 Beyond the Boundary - Knowing and Concerns Intersex (October 2015). "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". http://tbinternet.ohchr.org/_layouts/treatybodyexternal/Download.aspx?symbolno=INT%2fCAT%2fCSS%2fHKG%2f22156&Lang=en. 
  5. ↑ "Submission 88 to the Australian Senate inquiry on the involuntary or coerced sterilisation of people with disabilities in Australia". Australasian Paediatric Endocrine Group (APEG). 27 June 2013. http://www.aph.gov.au/DocumentStore.ashx?id=aafe43f3-c6a2-4525-ad16-15e4210ee0ac&subId=16191. 
  6. ↑ Rebecca Jordan-Young; Peter Sonksen; Katrina Karkazis (2014). "Sex, health, and athletes". BMJ 348: g2926. doi:10.1136/bmj.g2926. PMID 24776640. http://www.bmj.com/content/348/bmj.g2926. Retrieved 2015-07-19. 
  7. ↑ Macur, Juliet (6 October 2014). "Fighting for the Body She Was Born With". The New York Times. https://www.nytimes.com/2014/10/07/sports/sprinter-dutee-chand-fights-ban-over-her-testosterone-level.html. 
  8. ↑ 8.0 8.1 8.2 "Report of the UN Special Rapporteur on Torture". Office of the UN High Commissioner for Human Rights. February 2013. http://www.ohchr.org/Documents/HRBodies/HRCouncil/RegularSession/Session22/A.HRC.22.53_English.pdf. 
  9. ↑ "Eliminating forced, coercive and otherwise involuntary sterilization, An interagency statement". World Health Organization. May 2014. https://www.who.int/reproductivehealth/publications/gender_rights/eliminating-forced-sterilization/en/. 
  10. ↑ 10.0 10.1 10.2 10.3 10.4 Cite error: Invalid <ref> tag; no text was provided for refs named SenateOnSterilisation
  11. ↑ 11.0 11.1 11.2 11.3 11.4 11.5 Swiss National Advisory Commission on Biomedical Ethics NEK-CNE (November 2012). On the management of differences of sex development. Ethical issues relating to "intersexuality".Opinion No. 20/2012. Berne. http://www.nek-cne.ch/fileadmin/nek-cne-dateien/Themen/Stellungnahmen/en/NEK_Intersexualitaet_En.pdf. Retrieved 2015-07-19. 
  12. ↑ 12.0 12.1 "German Gender-Assignment Case Has Intersexuals Hopeful". DW.COM. Deutsche Welle. 12 December 2007. http://www.dw.com/en/german-gender-assignment-case-has-intersexuals-hopeful/a-3000902. 
  13. ↑ 13.00 13.01 13.02 13.03 13.04 13.05 13.06 13.07 13.08 13.09 13.10 13.11 Council of Europe; Commissioner for Human Rights (April 2015), Human rights and intersex people, Issue Paper, https://wcd.coe.int/ViewDoc.jsp?Ref=CommDH/IssuePaper(2015)1&Language=lanEnglish&Ver=original, retrieved 2022-03-09 
  14. ↑ 14.0 14.1 14.2 "Surgery and Sterilization Scrapped in Malta's Benchmark LGBTI Law". The New York Times. Reuters. 1 April 2015. https://www.nytimes.com/reuters/2015/04/01/world/europe/01reuters-gay-rights-malta.html. 
  15. ↑ 15.0 15.1 15.2 15.3 15.4 "Malta passes law outlawing forced surgical intervention on intersex minors". Star Observer. 2 April 2015. http://www.starobserver.com.au/news/international-news-news/malta-passes-law-outlawing-forced-surgical-intervention-on-intersex-minors/134800. 
  16. ↑ 16.0 16.1 16.2 16.3 16.4 16.5 16.6 16.7 16.8 Asia Pacific Forum of National Human Rights Institutions (June 2016). Promoting and Protecting Human Rights in relation to Sexual Orientation, Gender Identity and Sex Characteristics. Asia Pacific Forum of National Human Rights Institutions. ISBN 978-0-9942513-7-4. http://www.asiapacificforum.net/resources/manual-sogi-and-sex-charactersitics/. Retrieved 2016-08-29. 
  17. ↑ Zderic, Stephen (2002). 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"]. New York, NY [u.a.]: Kluwer Acad. / Plenum Publ.. ISBN 978-0306467592. 
  18. ↑ 18.0 18.1 Ghattas, Dan Christian; Heinrich Böll Foundation (September 2013). "Human Rights Between the Sexes". http://www.boell.de/sites/default/files/endf_human_rights_between_the_sexes.pdf. 
  19. ↑ "A preliminary study on the life situations of inter* individuals". OII Europe. 4 November 2013. http://oiieurope.org/a-preliminary-study-on-the-life-situations-of-inter-individuals/. 
  20. ↑ "Submission: list of issues for Australia's Convention Against Torture review". Organisation Intersex International Australia. June 28, 2016. https://oii.org.au/30546/loi-cat-review/. 
  21. ↑ ""Intersex legislation" that allows the daily mutilations to continue = PINKWASHING of IGM practices". Zwischengeschlecht. August 28, 2016. http://stop.genitalmutilation.org/post/Intersex-politics-that-ignore-the-daily-mutilations-PINKWASHING-OF-IGM-PRACTICES. 
  22. ↑ "TRANSCRIPTION > UK Questioned over Intersex Genital Mutilations by UN Committee on the Rights of the Child - Gov Non-Answer + Denial". Zwischengeschlecht. May 26, 2016. http://stop.genitalmutilation.org/post/UK-Questioned-over-Intersex-Genital-Mutilations-by-UN-Committee-on-the-Rights-of-the-Child. 
  23. ↑ 23.0 23.1 Odero, Joseph (December 23, 2015). "Intersex in Kenya: Held captive, beaten, hacked. Dead.". 76 CRIMES. http://76crimes.com/2015/12/23/intersex-in-kenya-held-captive-beaten-hacked-dead/. 
  24. ↑ Warne, Garry L.; Raza, Jamal (September 2008). "Disorders of sex development (DSDs), their presentation and management in different cultures". Reviews in Endocrine and Metabolic Disorders 9 (3): 227–236. doi:10.1007/s11154-008-9084-2. ISSN 1389-9155. PMID 18633712. 
  25. ↑ United Nations; Committee on the Rights of Persons with Diabilities (April 17, 2015). "Concluding observations on the initial report of Germany (advance unedited version)". Geneva: United Nations. http://tbinternet.ohchr.org/_layouts/treatybodyexternal/Download.aspx?symbolno=CRPD%2FC%2FDEU%2FCO%2F1&Lang=en. Retrieved July 19, 2015. 
  26. ↑ 26.0 26.1 26.2 26.3 Cabral, Mauro (April 8, 2015). "Making depathologization a matter of law. A comment from GATE on the Maltese Act on Gender Identity, Gender Expression and Sex Characteristics". Global Action for Trans Equality. 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/. 
  27. ↑ 27.0 27.1 Office of the High Commissioner for Human Rights (October 24, 2016), End violence and harmful medical practices on intersex children and adults, UN and regional experts urge, http://www.ohchr.org/EN/NewsEvents/Pages/DisplayNews.aspx?NewsID=20739&LangID=E, retrieved July 28, 2017 
  28. ↑ 28.0 28.1 Amnesty International (2017). First, Do No Harm. https://www.amnesty.org/en/documents/eur01/6086/2017/en/. Retrieved 2017-05-15. 
  29. ↑ 29.0 29.1 Amnesty International (2017). "First, Do No Harm: ensuring the rights of children born intersex.". https://www.amnesty.org/en/latest/campaigns/2017/05/intersex-rights/. 
  30. ↑ Human Rights Watch; interACT (July 2017). I Want to Be Like Nature Made Me. Human Rights Watch. ISBN 978-1-62313-502-7. https://www.hrw.org/report/2017/07/25/i-want-be-nature-made-me/medically-unnecessary-surgeries-intersex-children-us. Retrieved 2017-07-28. 
  31. ↑ Stewart, Philippa (2017-07-25). "Interview: Intersex Babies Don't Need 'Fixing'". Human Rights Watch. https://www.hrw.org/news/2017/07/25/interview-intersex-babies-dont-need-fixing. Retrieved 2017-07-25. 
  32. ↑ Human Rights Watch (2017-07-25). "US: Harmful Surgery on Intersex Children". Human Rights Watch. https://www.hrw.org/news/2017/07/25/us-harmful-surgery-intersex-children. 
  33. ↑ Curtis, Skyler (2010–2011). "Reproductive Organs and Differences of Sex Development: The Constitutional Issues Created by the Surgical Treatment of Intersex Children". McGeorge Law Review 42: 863. http://heinonline.org/HOL/Page?handle=hein.journals/mcglr42&div=66&g_sent=1&collection=journals. Retrieved 15 November 2012. 
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  35. ↑ 35.0 35.1 Malta (April 2015), Gender Identity, Gender Expression and Sex Characteristics Act: Final version, http://justiceservices.gov.mt/DownloadDocument.aspx?app=lp&itemid=26805&l=1, retrieved 2015-07-19 
  36. ↑ "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". OII Europe. April 1, 2015. http://oiieurope.org/press-release-oii-europe-applauds-maltas-gender-identity-gender-expression-and-sex-characteristics-act/. 
  37. ↑ Carpenter, Morgan (April 2, 2015). "We celebrate Maltese protections for intersex people". Organisation Intersex International Australia. https://oii.org.au/28592/we-celebrate-maltese-protections-for-intersex-people/. 
  38. ↑ "Circular No. 15/2023" (in es). 7 November 2023. 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. 
  39. ↑ "Chilean Government Stops the 'Normalization' of Intersex Children". OutRight Action International. January 14, 2016. https://www.outrightinternational.org/content/chilean-government-stops-normalization-intersex-children. 
  40. ↑ "Chilean Ministry of Health issues instructions stopping "normalising" interventions on intersex children". 11 January 2016. https://oii.org.au/30250/chilean-ministry-stops-normalising/. 
  41. ↑ Inter, Laura; Aoi, Hana (June 15, 2017). "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". Brújula Intersexual. https://brujulaintersexual.wordpress.com/2017/06/15/circular-7-2016-un-paso-atras/. 
  42. ↑ Godoy, Camilo (June 18, 2017). "¿Cómo nace la Circular 7 del Ministerio de Salud de Chile? Por Camilo Godoy". Brújula Intersexual. https://brujulaintersexual.wordpress.com/2017/06/17/como-nace-la-circular-7-chile/. 
  43. ↑ Inter, Laura; Aoi, Hana (June 2017). "Circular 7 De 2016: Un Paso Atrás En La Lucha Por Los Derechos Humanos De Las Personas Intersexuales En Chile". Brújula Intersexual. https://brujulaintersexual.files.wordpress.com/2017/06/circular-7-laura-y-hana11.pdf. 
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  119. ↑ Criminal Code (R.S.C., 1985, c. C-46), 2019-05-23, https://laws-lois.justice.gc.ca/eng/acts/c-46/section-268.html, retrieved 2019-06-01 
  120. ↑ "Circular 15". https://www.movilh.cl/wp-content/uploads/2023/11/Circular-No-15-Intersex.pdf. 
  121. ↑ "Complementa circular 18 que instruye sobre ciertos aspectos de la atencion de salud a niños y niñas intersex". Ministerio de Salud. 23 August 2016. http://normativas.minsal.cl/CIRCULARES/CIRCULAR_7_16_SP.pdf. 
  122. ↑ "Proyectos de Ley Sistema de garantías de los derechos de la niñez" (in es-LA). Cámara de Diputados de Chile. https://www.camara.cl/pley/pley_detalle.aspx?prmID=10729&prmBoletin=10315-18. 
  123. ↑ "Comisión de la Cámara aprueba que niñas y niños trans tengan derecho a desarrollar su identidad de género" (in es-LA). http://www.movilh.cl/comision-de-la-camara-aprueba-que-ninas-y-ninos-trans-tengan-derecho-a-desarrollar-su-identidad-de-genero/. 
  124. ↑ 124.0 124.1 "Datos Registrales con Enfoque de Género" (in es). July 2017. http://www.registrocivil.cl/transparencia/DatoInteresCiudadano/Datos_Registrales_por_Genero_2017_1.pdf. 
  125. ↑ Inter, Laura (2015). "Finding My Compass". Narrative Inquiry in Bioethics 5 (2): 95–98. doi:10.1353/nib.2015.0039. PMID 26300133. 
  126. ↑ 126.0 126.1 Inter, Laura (October 2016). "The situation of the intersex community in Mexico". Intersex Day. http://intersexday.org/en/situation-mexico/. 
  127. ↑ Baruch, Ricardo (October 13, 2016), Sí, hay personas intersexuales en México, Animal Politico, http://www.animalpolitico.com/blogueros-blog-invitado/2016/10/13/las-personas-intersexuales-mexico/, retrieved May 15, 2017 
  128. ↑ Sprayregen, Molly (May 27, 2023). "Mexico adds nonbinary option to passports in "great leap" for the "dignity of people"". https://www.lgbtqnation.com/2023/05/mexico-adds-nonbinary-option-to-passports-in-great-leap-for-the-dignity-of-people/. 
  129. ↑ Balevic, Katie. "Mexico introduced a non-binary passport, allowing people to write their gender as 'x' instead of male or female". https://www.businessinsider.com/mexico-introduces-non-binary-passport-allowing-gender-written-x-2023-5. 
  130. ↑ 130.0 130.1 interACT (June 2016). "Recommendations from interACT: Advocates for Intersex Youth regarding the List of Issues for the United States for the 59th Session of the Committee Against Torture". http://tbinternet.ohchr.org/Treaties/CAT/Shared%20Documents/USA/INT_CAT_ICS_USA_24552_E.pdf. Retrieved 2017-05-15. 
  131. ↑ interACT (2016). "Federal Government Bans Discrimination Against Intersex People in Health Care". http://interactadvocates.org/federal-government-bans-discrimination-against-intersex-people-in-health-care/. 
  132. ↑ "New Laws Take Effect in New Mexico". June 14, 2019. https://www.kob.com/new-mexico-news/new-laws-take-effect-in-new-mexico/5389614/. 
  133. ↑ "ID Documents Center - Nevada". https://transequality.org/documents/state/nevada. 
  134. ↑ Stevens, Taylor (October 8, 2018). "Utahn Becomes One of the First in the State to Receive Nonbinary 'X' Markers on Birth Certificate and Driver License". https://www.sltrib.com/news/politics/2018/10/08/male-female-x-utahn/. 
  135. ↑ Gunz, Rafaella (January 6, 2019). "New Jersey to Introduce Gender-neutral Birth Certificates in February". https://www.gaystarnews.com/article/new-jersey-introduce-gender-neutral-birth-certificates-february-2019/. 
  136. ↑ "Birth Certificates". https://www.colorado.gov/pacific/cdphe/birth-certificates. 
  137. ↑ "California Senate Bill "SB-179 Gender identity: female, male, or nonbinary" to enact the Gender Recognition Act, to authorize the change of gender on the new birth certificate to be female, male, or nonbinary.". January 24, 2017. https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201720180SB179. 
  138. ↑ O'Hara, Mary Emily (September 26, 2016). "Californian Becomes Second US Citizen Granted 'Non-Binary' Gender Status". https://www.nbcnews.com/feature/nbc-out/californian-becomes-second-us-citizen-granted-non-binary-gender-status-n654611. 
  139. ↑ O'Hara, Mary Emily (December 29, 2016). "Nation's First Known Intersex Birth Certificate Issued in NYC". https://www.nbcnews.com/feature/nbc-out/nation-s-first-known-intersex-birth-certificate-issued-nyc-n701186. 
  140. ↑ "Selecting your Gender Marker". https://travel.state.gov/content/travel/en/passports/need-passport/selecting-your-gender-marker.html. 
  141. ↑ Migdon, Brooke (2022-04-04). "Nearly 17K Americans may request gender 'X' passport this year" (in en-US). https://thehill.com/changing-america/respect/diversity-inclusion/3258443-nearly-17000-americans-may-request-gender-x-passport-this-year/. 
  142. ↑ "US issues its first passport with X gender designation to reflect 'lived reality'" (in en). 2021-10-27. https://www.theguardian.com/world/2021/oct/27/us-passport-x-gender-designation-first. 
  143. ↑ "Ley N° 19580 de violencia hacia las mujeres basada en género" (in es). https://www.impo.com.uy/bases/leyes/19580-2017. 
  144. ↑ "Prohíben las operaciones de definición de sexo en la niñez" (in es-UY). 14 January 2018. https://www.elpais.com.uy/informacion/prohiben-operaciones-definicion-sexo-ninez.html. 
  145. ↑ "Ley Integral Para Personas Trans". Uruguay Ministry for Social Development. http://www.mides.gub.uy/innovaportal/file/77785/1/proyecto-de-ley-integral-para-personas-trans.pdf. 
  146. ↑ 146.0 146.1 UK Home Office (December 2016). "Bangladesh: Sexual orientation and gender identity". UK Home Office Country Policy and Information Note. https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/580345/Bangladesh_-_CPIN_Sexual_orientation_and_gender_identity_-_December_2016.pdf. Retrieved 25 May 2017. 
  147. ↑ United Nations; Committee against Torture (2015). "Concluding observations on the fifth periodic report of China". Geneva: United Nations. http://tbinternet.ohchr.org/_layouts/treatybodyexternal/Download.aspx?symbolno=CAT%2fC%2fCHN%2fCO%2f5&Lang=en. 
  148. ↑ United Nations; Committee against Torture (2015). "Concluding observations on the fifth periodic report of China with respect to the Hong Kong Special Administrative Region". Geneva: United Nations. http://tbinternet.ohchr.org/_layouts/treatybodyexternal/Download.aspx?symbolno=CAT%2fC%2fCHN-HKG%2fCO%2f5&Lang=en. 
  149. ↑ Karthikeyan, Ragamalika (February 3, 2017). "Activists say surgical 'correction' of intersex babies at birth wrong, govt doesn't listen". The News Minute. http://www.thenewsminute.com/article/activists-say-surgical-correction-intersex-babies-birth-wrong-govt-doesnt-listen-56739. 
  150. ↑ 150.0 150.1 Supreme Court of India 2014. "Supreme Court recognises the right to determine and express one's gender; grants legal status to 'third gender'". http://supremecourtofindia.nic.in/outtoday/wc40012.pdf. 
  151. ↑ 151.0 151.1 "Sunil Babu Pant and Others/ v. Nepal Government and Others, Supreme Court of Nepal". National Judicial Academy Law Journal. April 2007. http://icj.wpengine.netdna-cdn.com/wp-content/uploads/2012/07/Sunil-Babu-Pant-and-Others-v.-Nepal-Government-and-Others-Supreme-Court-of-Nepal.pdf. Retrieved 4 May 2016. 
  152. ↑ Regmi, Esan (2016). Stories of Intersex People from Nepal. Kathmandu. https://oii.org.au/30476/stories-intersex-people-nepal/. Retrieved 2017-05-15. 
  153. ↑ 153.0 153.1 153.2 "Transgender Persons (Protection of Rights) Act, 2018". http://www.na.gov.pk/uploads/documents/1528787262_286.pdf. 
  154. ↑ "Albania approves protocol to stop medical intervention on intersex babies". 27 June 2020. https://exit.al/en/2020/06/27/albania-approves-protocol-to-stop-medical-intervention-on-intersex-babies/. 
  155. ↑ "Albania Amends Its Law for Protection From Discrimination: HIV Status and Sex Characteristics Are Now Protected Grounds". https://www.lgbti-era.org/news/albania-amends-its-law-protection-discrimination-hiv-status-and-sex-characteristics-are-now. 
  156. ↑ "Der Österreichische Verfassungsgerichtshof - Intersex persons have the right to adequate designation in the civil register". https://www.vfgh.gv.at/medien/Civil_register_-_Intersex_persons.en.php. 
  157. ↑ "– Belgium – New Gender Recognition Law with obstacles". https://tgeu.org/belgium-new-gender-recognition-law-with-obstacles/. 
  158. ↑ "New Belgian Gender Recognition Act: shouldn't self-determination also include non-binary people?". https://iacl-aidc-blog.org/2018/03/20/new-belgian-gender-recognition-act-shouldnt-self-determination-also-include-non-binary-people/. 
  159. ↑ 159.0 159.1 159.2 McDonald, Henry; Others (July 16, 2015). "Ireland passes law allowing trans people to choose their legal gender". The Guardian. https://www.theguardian.com/world/2015/jul/16/ireland-transgender-law-gender-recognition-bill-passed. 
  160. ↑ "Stellungnahme IVIM - OII Germany zum Gesetzentwurf der Bundesregierung "Entwurf eines Gesetzes zum Schutz von Kindern mit Varianten der Geschlechtsentwicklung"" (in German). September 23, 2020. https://oiigermany.org/wp-content/uploads/2020/11/Stellungnahme-OII-Germany-Nov-2020_.pdf. 
  161. ↑ "Presseerklärung Internationale Vereinigung Intergeschlechtlicher Menschen". March 26, 2021. https://oiigermany.org/wp-content/uploads/2021/03/Presseerkla%CC%88rung-Internationale-Vereinigung-Intergeschlechtlicher-Menschen_3_2021.pdf. 
  162. ↑ "Bundesverfassungsgericht - Press - Civil status law must allow a third gender option". http://www.bundesverfassungsgericht.de/SharedDocs/Pressemitteilungen/EN/2017/bvg17-095.html. 
  163. ↑ 163.0 163.1 163.2 Fisher, Owl (June 21, 2019). "On Trans Issues, Iceland has just put Britain to Shame". https://www.theguardian.com/commentisfree/2019/jun/21/trans-issues-britain-iceland-law-intersex-rights. 
  164. ↑ 164.0 164.1 164.2 "Gender Autonomy Act Applauded". June 21, 2019. https://icelandmonitor.mbl.is/news/politics_and_society/2019/06/21/gender_autonomy_act_applauded/. 
  165. ↑ 165.0 165.1 165.2 "Iceland Passes Major Gender Identity Law: "The Fight Is Far From Over"". June 19, 2019. https://grapevine.is/news/2019/06/19/iceland-passes-major-gender-identity-law-the-fight-is-far-from-over/. 
  166. ↑ "Discrimination (Sex and Related Characteristics) (Jersey) Regulations 2015". 2015. https://www.jerseylaw.je/Law/display.aspx?url=lawsinforce%5chtm%5cROFiles%5cR%26OYear2015%2fR%26O-061-2015.htm. 
  167. ↑ "Luxembourg makes status change for transgender people easier". 26 July 2018. https://luxtimes.lu/luxembourg/34530-luxembourg-makes-status-change-for-transgender-people-easier. 
  168. ↑ Dalli, Miriam (3 February 2015). "Male, Female or X: the new gender options on identification documents". Malta Today. http://www.maltatoday.com.mt/news/national/49185/male_female_or_x_the_new_gender_options_on_identification_documents. 
  169. ↑ "Zakon o zabrani diskriminacije | Crna Gora | Paragraf Lex". Article 19 ("Any discrimination, unequal treatment or unequal position of a person or group of persons on the basis of gender identity, sexual orientation and / or intersex characteristics is considered discrimination."). https://www.paragraf.me/propisi-crnegore/zakon-o-zabrani-diskriminacije.html. 
  170. ↑ "Norway". https://rainbow-europe.org/#8652/0/0. 
  171. ↑ "Norway becomes fourth country in Europe to introduce model of self-determination - ILGA-Europe". https://www.ilga-europe.org/resources/news/latest-news/norway-introduces-self-determination. 
  172. ↑ "Norway becomes fourth country in the world to allow trans people to determine their own gender". 6 June 2016. https://www.gaystarnews.com/article/norway-becomes-fourth-country-world-allow-trans-people-determine-gender/#gs.1sGX2OA. 
  173. ↑ "Norway: Historic breakthrough for transgender rights". 18 March 2016. https://www.amnesty.org/en/latest/news/2016/03/norway-historic-breakthrough-for-transgender-rights/. 
  174. ↑ 174.0 174.1 "Portugal parliament approves new gender change law". Agence France-Presse. July 13, 2018. http://news.abs-cbn.com/overseas/07/13/18/portugal-parliament-approves-new-gender-change-law. 
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  176. ↑ Zwischengeschlecht.org (March 2014). "Intersex Genital Mutilations Human Rights Violations Of Children With Variations Of Sex Anatomy: NGO Report to the 2nd, 3rd and 4th Periodic Report of Switzerland on the Convention on the Rights of the Child (CRC)". Zurich. http://intersex.shadowreport.org/public/2014-CRC-Swiss-NGO-Zwischengeschlecht-Intersex-IGM_v2.pdf. 
  177. ↑ United Nations; Committee on the Rights of Child (February 26, 2015). "Concluding observations on the combined second to fourth periodic reports of Switzerland". Geneva. http://tbinternet.ohchr.org/_layouts/treatybodyexternal/Download.aspx?symbolno=CRC%2fC%2fCHE%2fCO%2f2-4&Lang=en. 
  178. ↑ United Nations; Committee on the Rights of Child (September 7, 2015). "Concluding observations on the seventh periodic report of Switzerland". Geneva. https://www.bj.admin.ch/dam/data/bj/staat/menschenrechte/antifolterkonvention/cat-ber-7-schlussfolgerungen-e.pdf. 
  179. ↑ "Switzerland to allow simple gender identity change next year" (in en-US). 27 December 2021. https://www.jurist.org/news/2021/12/switzerland-to-allow-simple-gender-identity-change-next-year/. 
  180. ↑ Payton, Naith (July 23, 2015). "Comment: Why the UK's gender recognition laws desperately need updating". The Pink Paper. http://www.pinknews.co.uk/2015/07/23/comment-why-the-uks-gender-recognition-laws-desperately-need-updating/. 
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  182. ↑ 182.0 182.1 "On intersex birth registrations". OII Australia. 13 November 2009. http://oii.org.au/4856/on-birth-registrations/. 
  183. ↑ "Now That Same-Sex Marriage Is Legal, States Must Abolish Transgender "Forced Divorce" Laws". 10 January 2018. https://www.buzzfeed.com/lanesainty/australian-states-have-one-year-to-repeal-transgender. 
  184. ↑ "Australian Government Guidelines on the Recognition of Sex and Gender, 30 May 2013". http://www.ag.gov.au/Publications/Pages/AustralianGovernmentGuidelinesontheRecognitionofSexandGender.aspx. 
  185. ↑ "New Zealand passes law allowing citizens to self-identify sex on birth certificates" (in en-US). 9 December 2021. https://www.jurist.org/news/2021/12/new-zealand-passes-law-allowing-citizens-to-self-identify-sex-on-birth-certificate/. 
  186. ↑ Department of Internal Affairs. "General information regarding Declarations of Family Court as to sex to be shown on birth certificates". http://www.dia.govt.nz/diawebsite.nsf/Files/GeninfoDeclarationsofFamilyCourt/$file/GeninfoDeclarationsofFamilyCourt.pdf. 

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