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The Fundamental Rights Situation of Intersex People

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The Fundamental Rights Situation of Intersex People 04/2015 The fundamental rights situation of intersex people Most European societies recognise people as either male or female. However, this does not account for all variations in sex characteristics. As a result, intersex people experience fundamental rights violations ranging from discrimination to medical interventions without their consent. This paper examines the legal situation of intersex people from a fundamental rights perspective. It draws on evidence from the Agency’s updated legal analysis on homophobia, transphobia, and discrimination on grounds of sexual orientation and gender identity, which now includes a section on intersex issues. Key facts Key conclusions Many Member States legally require births Legal and medical professionals should be to be certified and registered as either male better informed of the fundamental rights or female. of intersex people, particularly children. In at least 21 Member States, sex Gender markers in identity documents and ‘normalising’ surgery is carried out on birth registries should be reviewed to better intersex children. protect intersex people. In 8 Member States, a legal representative Member States should avoid non- can consent to sex ‘normalising' medical consensual ‘sex-normalising’ medical interventions independently of the child’s treatments on intersex people. ability to decide. 18 Member States require patient consent provided the child has the ability to decide. Intersex discrimination is better covered by sex discrimination rather than discrimination on the basis of sexual orientation and/or gender identity as it concerns physical (sex) characteristics. 1 The fundamental rights situation of intersex people them to fall outside of this classification. It can Introduction also lead to grave violations of their rights to physical and psychological integrity as well as ‘Intersex’ is used in this paper as an umbrella other fundamental rights. term to denote a number of different variations in a person’s bodily characteristics that do not match strict medical definitions of male or female. These characteristics may be Background chromosomal, hormonal and/or anatomical and may be present to differing degrees. Many In the European Union intersex issues have variants of sex characteristics are immediately progressively emerged as relevant to detected at birth, or even before. Sometimes fundamental rights protection. However, they these variants become evident only at later are still largely treated as medical issues falling stages in life, often during puberty. While most outside the scope of public scrutiny. A number of intersex people are healthy, a very small developments at EU level in recent years have percentage may have medical conditions which contributed to a better understanding of the might be life-threatening, if not treated problems intersex people face. For example, in promptly. 2013, the ‘working definitions’ laid down by the Council of the European Union stated that traditional notions of maleness and femaleness Intersex is a collective term for many natural 2 are culturally established. The ‘Lunacek Report’ variations in sex characteristics. It is not a of the European Parliament, also adopted in medical condition. 2013, recommended that the European Commission, EU Member States and relevant Medically, some of these variants are grouped agencies address the current lack of knowledge, under ‘disorders of sexual development’. research and relevant legislation on the human 3 However, this is rejected by many, including rights of intersex people. activists and intersex people themselves, who perceive it to be stigmatising and pathologising.1 Member States have also raised the issue of It should also be noted that some intersex people intersex. For instance, in 2010, the Italian Committee on Bioethics published a report may not wish to identify as such. reinforcing the exclusively medical approach to intersex issues, reinstating sex binary as an Practices, such as issuing birth certificates and “indispensable element of personal identity”.4 medical treatments, can have an impact on the However, the Committee also stressed the fundamental rights of intersex people. For importance of acting in the best interest of the example, Article 1 of the Charter of Fundamental child, following a case-by-case approach, and Rights of the European Union, protects human avoiding surgical and medical intervention until dignity. Other Charter rights include: the right to the child is able to give informed consent. In integrity of the person (Article 3); respect for 2012, the German Ethics Council (Ethikrat) private and family life (Article 7); the right to published a comprehensive Opinion on intersex found a family (Article 9); and rights of the child, issues, providing a range of recommendations to including the right of children to express their safeguard the rights of intersex people.5 The views freely and to have their views taken into Opinion argues that legal systems presume a consideration on matters which concern them in strict sex binary that does not always occur in accordance with their age and maturity (Article nature. Thus, intersex issues should concern legal 24). Intersex people also benefit from the professionals and policy makers, and not only prohibition of discrimination under the Charter health and healthcare professionals. However, (Article 21). most organisations concerned with protecting the rights of intersex people in the EU support the When basic aspects of a person’s legal status recommendations developed by the Swiss (e.g. birth or death registration), social status National Advisory Commission on Biomedical (e.g. access to services) or health conditions are Ethics instead of those adopted in EU Member frequently defined by the so-called ‘sex binary’ States. The Swiss recommendations emphasise classification of being either ‘male’ or ‘female’ that, as a rule, sex assignment treatment should intersex people are often discriminated against. only be performed when the person concerned This is because their sex characteristics cause agrees. They also emphasise that intersex 2 FRA Focus 04/2015 children and their parents should be given policy. This is an area where the EU has exercised psychological counselling and support. The its competence in several specific domains which recommendations consider protecting the child’s touch on the protection of intersex people, such integrity as being essential.6 as employment, access to goods and services, and free movement. A study of intersex people published by the Netherlands Institute for Social research in 2014 Unequal treatment of intersex people has been found that virtually all the intersex people frequently addressed in EU policies and advocacy interviewed encountered problems in their social as part of discrimination on the ground of sexual situation. They talked about being ‘different’, orientation and/or gender identity. However, feeling lonely and experiencing shame and such treatment can better be addressed as embarrassment.7 The study called for further discrimination on the ground of sex, as it is linked research into their experiences. to the sex assigned to a person at birth and its direct consequences. For example, an intersex Intersex issues are increasingly emerging also person incorrectly assigned a female sex at birth, among the activities of civil society, including may be prevented from marrying a woman in lesbian, gay, bisexual and transgender those countries where civil marriage is not organisations. For example, ILGA-Europe started possible for same-sex couples. working on intersex issues in 2008.8 The Organisation Intersex International Europe (OII) It is also important to bear in mind that intersex has been established as a cooperation platform refers to the bodily characteristics of a person. for intersex organisations in several European There is no evidence linking specific sex countries.9 In Austria for instance, the characteristics with either gender identity or Homosexual Initiative Salzburg (Homosexuelle sexual orientation. Thus, intersex people might Initiative Salzburg, HOSI) assigned a be as likely as non-intersex people to self- representative for intersex issues (Intersex- identify as heterosexual, bisexual, homosexual, Beauftragte). Specific intersex NGOs have also trans, etc. However, regardless of the sexual been established, such as the Association of orientation or gender identity of intersex people, Intersex People Austria (Verein Intersexueller they should benefit from protection from Menschen Österreich), and the Intersex Platform discrimination on the ground of sex under Article Austria (Plattform Intersex Österreich) - an 21 of the EU’s Fundamental Rights Charter. independent network of NGOs, scientists and Regarding secondary EU law, it should be noted activists that aims to foster public discussion, and that the Lunacek Report has called on the offer advice and information.10 European Commission, together with relevant agencies to “issue guidelines specifying that transgender and intersex persons are covered under ‘sex’ in Directive 2006/54/EC [Gender Grounds for protection from Equality Directive (recast)]” (para. C. ii).17 discrimination So far, however, it appears that the directive has not been implemented in this way. FRA’s The Council of the European Union,11 and the research did not find sufficient legislation or case European Parliament12, as well as the Council of law to find out whether or not intersex people Europe,13 the UN High Commissioner
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