Children's Health Rights and Gender Issues

Total Page:16

File Type:pdf, Size:1020Kb

Children's Health Rights and Gender Issues Chapter 15 Children’s Health Rights and Gender Issues Melinda Jones 1 Introduction* Children’s health rights are located at the intersection between the fields of law, medicine and human rights. They are intended to guide the delivery of health services in a non- discriminatory manner that protects and promotes the dignity and personal autonomy of the child. These rights are extremely important for minority children, especially those with non- conforming gender characteristics who often have a difficult relationship with health and medical systems. These are children who are characterized by non-typical gender ex- pression or orientation (lesbian, gay and bisexual), those with gender identity issues (transgender) and those born with atypical sex characteristics (inter- sex), often grouped together as lgbti (lesbian, gay, bisexual, transgender and intersex) children.1 The very existence of these children challenges the cultural and social constructions of binary gender and what it means to be male or female; masculine or feminine. In this regard, lgbti children find themselves as outsiders living at the edge of the community. The provision of appropriate health rights (including the right to have the highest attainable standard of health) can bring these children in from the margins. The international community has repeatedly asserted that all people are entitled to be treated with dignity and respect and that this unques- tionably includes lgbti people. In 2006, a group of international human rights law experts drafted the Yogyakarta Principles on the Application of International Law in Relation to Sexual Orientation and Gender Identity2 * I would like to thank Dafni Samuni, Danielle Jones-Resnik and Morgan Carpenter for their contributions to this chapter. The views expressed are mine alone. Readers should feel free to comment on this chapter or contact me at [email protected]. 1 I include in this group all children who are gender non- conforming or who have non- mainstream gender orientation or identity. Not all of these children identify as lgbti, but I use this terminology as a shorthand to include, inter alia, children who may be gender fluid or asexual, or who identify as neither male nor female and may be thought of as third gender. 2 International Commission of Jurists (2007) Yogyakarta Principles – Principles on the appli- cation of international human rights law in relation to sexual orientation and gender identi- ty: www.icj.org/ yogyakarta- principles. See also D. Brown: Making Room for Sexual Orientation © Koninklijke Brill NV, Leiden, 2019 | DOI:10.1163/ 9789004327573_ 017 Children’s Health Rights and Gender Issues 383 now considered a seminal document in support of lgbti rights. Because of the ongoing and glaring violations of human rights experienced by mem- bers of the lgbti community, many human rights bodies have issued state- ments declaring that the rights of lgbti people are the same as all other people.3 lgbti children, like all children, are entitled to enjoy the protec- tion and benefits of human rights and require a safe environment where their rights are promoted in order to participate fully in society.4 That this has not been the experience of many lgbti children, should be a matter of concern to all. What is at stake, beyond the lived reality and rights of these children, are questions of key concern to the field of biomedical law. These are therapeutic and non- therapeutic medical intervention; the principle of necessity; the right to consent to medical treatment; and the legal requirement that that consent is informed consent. These issues will be discussed both with respect to the protection and the promotion of the rights of the child. This chapter will focus on three significant issues confronting lgbti chil- dren.5 The first is the violence which many lgbti children experience because and Gender Identity in International Human Rights Law: An Introduction to the Yogyakarta Principles, Michigan Journal of International Law 31 Summer 2010, no. 4, p. 821. 3 Office of the High Commissioner for Human Rights (2011) Discriminatory laws and practices and acts of violence against individuals based on their sexual orientation and gender identity, A/ HRC/ 19/ 41, par. 16, at: www.ohchr.org/ Documents/ HRBodies/ HRCouncil/ RegularSession/ Session19/ A- HRC- 19- 41_ en.pdf; Organization of American States (2012) Human rights, sex- ual orientation and gender identity, Resolution AG/ RES. 2653 (XLI- O/ 11), at: www.oas.org/ en/ iachr/ lgtbi/ docs/ GA%20Res%20%202721.pdf; Parliamentary Assembly of the Council of Europe (2010) Discrimination on the basis of sexual orientation and gender identity, Resolu- tion 1728, at: http:// assembly.coe.int/ Mainf.asp?link=/ Documents/ AdoptedText/ ta10/ ERES1728 .htm 4 The United Nations Convention on the Rights of the Child (1989) Treaty Series, 1577, 3 at http:// www.ohchr.org/ EN/ ProfessionalInterest/ Pages/ CRC.aspx; UN Committee on the Rights of the Child: Joint General Recommendation No. 31 of the Committee on the Elimination of Discrimination Against Women/ General Comment No. 18 of the Committee on the Rights of the Child On Harmful Practices CEDAW/ C/ GC/ 31- CRC/ C/ GC/ 18 https:// documents- dds- ny.un. org/ doc/ UNDOC/ GEN/ N14/ 627/ 78/ PDF/ N1462778.pdf?OpenElement; UN Committee on the Rights of the Child: General Comment No. 15: on the right of the child to the enjoyment of the highest attainable standard of health (Art. 24) CRC/ C/ GC/ 13, 17 April 2013, at.http:// tbinternet.ohchr.org/ _ layouts/ treatybodyexternal/ Download.aspx?symbolno= CRC%2fC%2fG- C%2f15&Lang=en 5 Although much discussion about lgbti rights focuses on the rights of adolescents, I have used the term ‘children’ as it is used in Convention on the Rights of the Child, to refer to all up until the age of 18. The age range is significant, because focusing on adolescents fails to account for medical interventions in the lives of intersex children, in particular, that occur during infancy and childhood..
Recommended publications
  • IHRA 20210628 Review
    28 June 2021 Review of Victorian government, community and related resources on intersex Morgan Carpenter, Intersex Human Rights Australia (IHRA) 1 Contents 1 Contents ........................................................................................................................... 2 2 About this review ............................................................................................................. 2 3 Summary oF key issues ..................................................................................................... 3 3.1 Key issues arising in the resources review ................................................................ 3 3.2 A note on changing nomenclature ........................................................................... 4 4 Victorian government ....................................................................................................... 5 4.1 Bettersafercare.vic.gov.au ........................................................................................ 5 4.2 Health.vic.gov.au ...................................................................................................... 8 4.3 Victorian public service ........................................................................................... 10 5 Community and support organisations .......................................................................... 10 5.1 Australian X & Y Spectrum Support (AXYS) ............................................................. 10 5.2 Congenital Adrenal Hyperplasia Support Group Australia
    [Show full text]
  • Intersex Human Rights Australia May 2018
    Intersex Human Rights Australia May 2018 7 May 2018 Submission to the Australian Law Reform Commission on the Review of the Family Law System – Issues Paper 1 Introduction We thank the Australian Law Reform Commission for the opportunity to make a submission on the Review of the Family Law System—Issues Paper. Intersex Human Rights Australia (IHRA) is a national intersex-led organisation that promotes the human rights (including the bodily autonomy) of people born with intersex variations. Formerly known as Organisation Intersex International (OII) Australia, IHRA is a not-for-profit company, with Public Benevolent Institution (charitable) status: http://ihra.org.au. This submission is endorsed by: The Androgen Insensitivity Syndrome Support Group Australia (AISSGA), a peer support, information and advocacy group by and for people affected by androgen insensitivity syndrome (AIS) and/or related intersex variations and variations of sex characteristics, and their families: http://aissga.org.au Disabled People’s Organisations Australia (DPO Australia) is a national coalition of Disabled People’s Organisations, which are run by and for people with disability and grounded in a normative human rights framework: http://www.dpoa.org.au The National LGBTI Health Alliance is the national peak health organisation in Australia for organisations and individuals that provide health-related programs, services and research focused on lesbian, gay, bisexual, transgender, and intersex people (LGBTI) and other sexuality, gender, and bodily diverse people and communities: http://lgbtihealth.org.au People with Disability Australia (PWDA) is a national disability rights and advocacy organisation, and member of DPO Australia. PWDA’s primary membership is made up of people with disability and organisations primarily constituted by people with disability.
    [Show full text]
  • Intersex and Transgender Student Support
    https://ashm.org.au/training/kirby-seminar/ These slides are for educational use only. They may not be published, posted online, or used in commercial presentations without prior permission from the presenter. Morgan Carpenter Co-executive director at Intersex Human Rights Australia (formerly OIIAU) ihra.org.au M.Bioethics (Sydney); PhD candidate in bioethics at Sydney Health Ethics, The University of Sydney sydney.edu.au/medicine/sydney-health-ethics/ Justice of the Peace in NSW. Home page: morgancarpenter.com 2 “The ALLY@UNSW network are trained staff and students that aims to ensure that UNSW is a safe and welcoming place for all students and staff who identify as LGBTIQ.” UNSW. 2019. ‘LGBTIQ Support for Students & Staff | UNSW Current Students’. March 18. https://student.unsw.edu.au/ally 3 “Gender affirmation and transition support “Intersex and transgender student support “Transgender students who seek support before, during or affirming transition may choose to speak to an Educational Support Advisor. Educational support advisors can assist with referrals to services both on and off campus as well as liaise regarding administrative issues within the such names and identity. Educational support advisors can assist you to plan your transition.” UNSW. 2018. ‘Gender Affirmation and Transition Support | UNSW Current Students’. July 17. https://student.unsw.edu.au/ally/gender 4 “The performance’s leading character, Carmen, is the fictional love- child of Leon Trotsky and Frida Kahlo, so naturally she has plenty of stories to relay. Viewers are presented with a bounty of visual delights… Carmen’s costume highlights her sexuality with a giant sparkling gem adorning her crotch, the lighting expertly sets the mood with hues of blue and pink… “As an intersex person, Carmen, herself is ‘other’.
    [Show full text]
  • The Road to Hell. Intersex People, Sexual Health and Human Rights
    1 The Road to Hell. Intersex People, Sexual Health and Human Rights. Keynote lecture by Mauro Cabral Grinspan at the 24th Congress of the World Association for Sexual Health and XII Congreso Nacional de Educación Sexual y Sexología. Building Bridges in Sexual Health and Rights.October 12- 15, World Trade Center, Ciudad de México, Mexico. I aM not a sexologist. I aM an historian and, as Many other historians, I aM obsessed with tiMe. TiMe, I have to tell you, it’s a quite fascinating subject. SometiMes it Makes things look different just because one thing caMe before another; other times, it Makes things to look the saMe even when separated by days, years or even decades. Let’s consider, for example, this Congress. In its Program there is a session called “The John Money Lecture”1. It was an honorific session; doubly honorific, in fact. The lecture honors John Money, and it honors the invited speaker by asking her to lecture about her area of expertise, but in John Money’s honor. It was delivered yesterday. Today is another day, we are in a completely different lecture, and I am a completely different speaker. This lecture is not a John Money’s lecture, except that, well, it is a John Money’s lecture. It can’t be anything else but a John Money’s lecture. Originally, My presentation was going to be focused on the sexual health and human rights issues faced by intersex people -that is to say, those people whose inborn sex characteristics vary from both Male and feMale standards.
    [Show full text]
  • Gender Perspectives on Torture: Law and Practice
    Gender Perspectives on Torture: Law and Practice CENTER FOR HUMAN RIGHTS & HUMANITARIAN LAW Anti-Torture Initiative Gender Perspectives on Torture: Law and Practice CENTER FOR HUMAN RIGHTS & HUMANITARIAN LAW Anti-Torture Initiative ii GENDER PERSPECTIVES ON TORTURE: Law and Practice Table of Contents � v Acknowledgements vii Preface: Macarena Sáez xi Introduction: Juan E. Méndez xv Foreword: Dubravka Šimonović 1 I. Gender-Based Violence: State Responsibility 3 The Vital Voices Justice Institute: Helping States Combat Gender-Based Violence Gigi Scoles and Anupama Selvam 19 Reparations for Sexual and Other Gender-Based Violence Carla Ferstman 33 How Non-State Torture is Gendered and Invisibilized: Canada’s Non-Compliance with the Committee Against Torture's Recommendations Jackie Jones, Jeanne Sarson, and Linda MacDonald 57 The Importance of Investigating Torture Against Women and Girls by Non-State Actors: Applicable Legal Standards from International Human Rights Law Teresa Fernández Paredes 87 II. Gender and Sexuality as the Basis for Specific Harms 89 Murdered in the Name of “Honor” Aisha K. Gill 105 Female Genital Mutilation as a Form of Torture and Other Cruel, Inhuman, or Degrading Treatment or Punishment": Intersections with the Migration Context Els Leye and Ino Kehrer 123 Pregnancy and Virginity Testing in Educational Settings and the Torture and Other Ill-Treatment Framework Esther Major 139 Forced Contraception as a Means of Torture Christie J. Edwards 161 The Humanisation of Women: A Work in Progress Purna Sen 183 Gendering the Lens: Critical Reflections on Gender, Hospitality and Torture Mauro Cabral Grinspan and Morgan Carpenter iii iv GENDER PERSPECTIVES ON TORTURE: Law and Practice 197 III.
    [Show full text]
  • Inclusion Guide to Respecting People with Intersex Variations
    INCLUSION GUIDE TO RESPECTING PEOPLE WITH INTERSEX VARIATIONS WHO ARE INTERSEX PEOPLE? Intersex people have innate variations of sex characteristics that differ from medical and social norms for female or male bodies. Intersex is an umbrella term for a diverse range of different traits that can be determined prenatally, at birth, during puberty and at other times. These traits include androgen insensitivity, congenital adrenal hyperplasia, 17-beta hydroxysteroid dehydrogenase 3 deficiency, and many more. Because their bodies are perceived as different, intersex people are at risk of stigmatisation, violence and harmful practices, including forced or coercive medical interventions intended to make their bodies more typically female or male. USEFUL TERMS Sex characteristics: physical features relating Disorders of sex development: a pejorative term to sex, including genitalia and other sexual and for intersex traits introduced following an invite- reproductive anatomy, chromosomes, hormones, only clinical workshop in 2005. Some individuals and secondary physical features emerging from prefer the ameliorative term ‘differences of sex puberty.1 development’. Sex: legal or social status initially based on sex Endosex: a word meaning “non-intersex”. This can characteristics observed at birth. In some cases, be helpful in acknowledging that intersex persons infants with intersex variations may undergo a old enough to freely express an identity may be series of examinations and tests to establish sex. In heterosexual and may identify with sex assigned at such cases, attempts will be made to determine the birth (commonly termed cisgender). infant’s intersex variation and likely future gender identity. Normative ideas about how children’s bodies should look play a significant role in sex assignment.2 Many – perhaps most – intersex traits only become evident after sex assignment.
    [Show full text]
  • Intersex Variations, Human Rights, and the International Classification
    HHr Health and Human Rights Journal Intersex Variations, Human Rights, and the HHR_final_logo_alone.indd 1 10/19/15 10:53 AM International Classification of Diseases morgan carpenter Abstract Over time, the World Health Organization (WHO) has reviewed and removed pathologizing classifications and codes associated with sexual and gender minorities from the International Classification of Diseases (ICD). However, classifications associated with intersex variations, congenital variations in sex characteristics or differences of sex development, remain pathologized. The ICD-11 introduces additional and pathologizing normative language to describe these as “disorders of sex development.” Current materials in the ICD-11 Foundation also specify, or are associated with, unnecessary medical procedures that fail to meet human rights norms documented by the WHO itself and Treaty Monitoring Bodies. This includes codes that require genitoplasties and gonadectomies associated with gender assignment, where either masculinizing or feminizing surgery is specified depending upon technical and heteronormative expectations for surgical outcomes. Such interventions lack evidence. Human rights defenders and institutions regard these interventions as harmful practices and violations of rights to bodily integrity, non-discrimination, equality before the law, privacy, and freedom from torture, ill- treatment, and experimentation. WHO should modify ICD-11 codes by introducing neutral terminology and by ensuring that all relevant codes do not specify practices that violate human rights. Morgan Carpenter is a senior advisor at GATE, a co-executive director of Intersex Human Rights Australia, and a graduate and PhD candidate in bioethics at Sydney Health Ethics in the Faculty of Medicine and Health, University of Sydney, Australia. This article was produced in the context of the GATE initiative on the process of revision and reform of the International Classification of Diseases.
    [Show full text]
  • Protecting the Human Rights of People Born with Variations in Sex Characteristics in the Context of Medical Interventions
    Protecting the Human Rights of People Born with Variations in Sex Characteristics in the context of Medical Interventions CONSULTATION PAPER July 2018 13 January 2017 ABN 47 996 232 602 Level 3, 175 Pitt Street, Sydney NSW 2000 GPO Box 5218, Sydney NSW 2001 General enquiries 1300 369 711 Complaints info line 1300 656 419 TTY 1800 620 241 Australian Human Rights Commission Protecting the Human Rights of People Born with Variations in Sex Characteristics in the context of Medical Interventions Table of contents 1 Introduction ................................................................................................................... 3 2 About the project .......................................................................................................... 3 2.1 Background ............................................................................................................... 3 2.2 Why the Australian Human Rights Commission? ................................................ 5 2.3 Ethics approval ......................................................................................................... 5 3 Terminology ................................................................................................................... 6 4 Relevance of human rights .......................................................................................... 8 4.1 Overview .................................................................................................................... 8 5 International developments ........................................................................................
    [Show full text]
  • Masculinity As an Identity and As a Cluster of Traits
    SOCIETY REGISTER 2021 / 5(1): 147-158 ISSN 2544–5502 DOI: 10.14746/sr.2021.5.1.08 MASCULINITY AS AN IDENTITY AND AS A CLUSTER OF TRAITS RENATA ZIEMINSKA1 1 University of Szczecin, Department of Philosophy and Cognitive Science, ul. Krakowska 71, 71-017 Szczecin, Poland. ORCID: 0000-0002-4403-0987, Email: [email protected] ABSTRACT: The paper presents the concept of masculinity within the non-binary and multilayered model of gender/sex traits. Within that model, masculinity is not a sim- ple idea, but rather is fragmented into many traits in diverse clusters. The experience of transgender men and men with intersex traits suggests that self-determined male gender identity is a mega trait that is sufficient for being a man. However, masculinity is not only psychological, as the content of the psychological feeling of being a man refers to social norms about how men should be and behave. And male coded traits are described as traits that frequently occur within the group of people identifying as men. Therefore, I claim that there are two interdependent ideas in the concept of masculinity: the self-determined male gender identity (first-person perspective) and a cluster of traits coded as male (third-person perspective). Within non-binary model the interplay between the two interdependent ideas allows to include borderline mas- culinities. KEYWORDS: spectrum of masculinity, borderline masculinities, male gender identity, non-binary model of gender/sex he aim of the paper is to present the concept of masculinity within the non-binary Tand multilayered model of gender/sex traits (Ziemińska 2018; 2021).
    [Show full text]
  • The Inherent Harms of Regulating Women's Testosterone in Sport
    Bioethical Inquiry https://doi.org/10.1007/s11673-018-9876-3 SYMPOSIUM: SEX, GENDER, AND THE BODY Impossible BChoices^: The Inherent Harms of Regulating Women’s Testosterone in Sport Katrina Karkazis & Morgan Carpenter Received: 24 May 2018 /Accepted: 11 July 2018 # Journal of Bioethical Inquiry Pty Ltd. 2018 Abstract In April 2018, the International Association of Keywords Bioethics .Sports .Intersex .Disordersofsex Athletics Federations (IAAF) released new regulations development . Hyperandrogenism . Testosterone placing a ceiling on women athletes’ natural testosterone levels to Bensure fair and meaningful competition.^ The regulations revise previous ones with the same intent. They require women with higher natural levels of testos- On April 23, 2018 the International Association of terone and androgen sensitivity who compete in a set of Athletics Federations (IAAF), the governing body for Brestricted^ events to lower their testosterone levels to track and field, released new regulations for participa- ’ below a designated threshold. If they do not lower their tion in the female category placing a ceiling on women s testosterone, women may compete in the male category, natural testosterone levels. The testosterone regulations in an intersex category, at the national level, or in unre- are but the latest in a series of regulations that have ’ stricted events. Women may also challenge the regula- governed women s eligibility in sport for decades, and tion, whether or not they have lowered their testosterone, that have been criticized as both discriminatory against B ^ or quit sport. Irrespective of IAAF’s stated aims, the women and a form of sex testing (for example, options forced by the new regulations are impossible Ritchie 2003;Heggie2010;Karkazisetal.2012).
    [Show full text]
  • LGBTIQ+ INCLUSIVE PRACTICE TOOLKIT for COMMUNITY LEGAL CENTRES Index
    LGBTIQ LGBTIQ+ INCLUSIVE PRACTICE TOOLKIT FOR COMMUNITY LEGAL CENTRES Index Introduction and acknowledgements 2 Why is inclusive practice important? 4 Understanding LGBTIQ+ basics 5 Being an inclusive service provider 9 Being an inclusive employer 15 APPENDIX 1 – Organisational Audit Tool 19 APPENDIX 2 – Template Policies 24 APPENDIX 3 – Model Transition Leave Clause 59 1 Introduction Since the first Community Legal Centre (CLC) was set up in Australia in the early 1970s, CLCs have been committed to pushing for positive systemic social change and providing free legal services to the communities who need it most. In the last decade, there has been a significant cultural shift in the way LGBTIQ+ communities and society more broadly understands and communicates about gender identity, sexual orientation and variations of physical sex characteristics (often described as intersex). There have also been significant legal victories in the past two years including marriage equality, the end to forced trans divorce, the re: Kelvin trans stage 2 hormone treatment case (which has made it easier for younger trans and gender diverse people to access gender-affirming healthcare), and the national movement towards birth certificate law reform, including the recent changes to the law in Tasmania. But there is still a long way to go. LGBTIQ+ communities continue to experience greater stigma and discrimination than many other communities in Australia, and the ongoing public debates around issues such as the Safe Schools programs, religious exemptions to anti-discrimination legislation and the rights of trans and gender diverse people to change their primary identity documents and access gender-affirming healthcare has an ongoing detrimental impact on the mental health and emotional wellbeing of LGBTIQ+ communities.
    [Show full text]
  • Comment on the Definition of Sexual Orientation and Gender Identity Submitted to the Drafting Committee, Yogyakarta Principles
    Comment on the Definition of Sexual Orientation and Gender Identity Submitted to The Drafting Committee, Yogyakarta Principles on the Application of International Human Rights Law to Sexual Orientation and Gender Identity Submitted by Andrew Park, Director, International Programs The Williams Institute on the Study of Sexual Orientation and Gender Identity February 17, 2017 I am pleased to submit to you this comment in response to the January 5, 2017 call for comments regarding a review of the Yogyakarta Principles on the Application of International Human Rights Law to Sexual Orientation and Gender Identity (the Principles). This comment recommends a modification of the definition of Sexual Orientation and Gender Identity.1 The definition of sexual orientation and gender identity in the Yogyakarta Principles serves the purpose of identifying the characteristics by which people can be classified. Human rights violations can occur when governments and non-state actors unjustly treat people differently based on such characteristics, or where governments and non-state actors do not adequately take such characteristics into account when responding to the needs of individuals. These definitions should be assessed in light of the purpose of the Yogyakarta Principles, which is to establish “a consistent understanding of how the comprehensive regime of international human rights law”2 is applied to issues of sexual orientation and gender identity. A. Currently, the principles define sexual orientation and gender identity as follows: Sexual orientation is understood to refer to each person’s capacity for profound emotional, affectional and sexual attraction to, and intimate and sexual relations with, individuals of a different gender or the same gender or more than one gender.
    [Show full text]