Raising our voices during the International Intersex Awareness Day

‘Intersex’ is a blanket term that refers to various innate bodily sex characteristics. Intersex personsare individuals born with so-called “ambiguous sex characteristics” ‘that do not meet medical and social norms for female or male bodies’. Although intersex persons make up 1.7% of the global population, across societies sex characteristics are predominantly defined according to a male-female binary standard. When an individual’s sex characteristics fall outside of this ‘normal’, they are considered to be ‘deviant’– and as such, subject to medical “correction” and social stigma.

Who decides what are ‘normal’ sex characteristics, and what are the consequences for those that do not fit within this ‘standard’? Why does it seem that society is determined to place the infant in a pink or blue box at all costs, even when life has shown us that there are more than 40 variations in sex characteristics? This is the core of the problem! 

We must fight for the rights of intersex persons and put an end to the harm they currently experience. Many individuals born with intersex characteristics are perfectly healthy. Nevertheless, many intersex persons are subjected to surgery and other medical interventions at early stages of life. These gender-normalising surgeries and medical interventions, which include hormonal treatments, are defended solely for the sake of society’s prioritisation of a binary concept of sex. Yet if most intersex persons are healthy, why does society insist on “fixing” them? Why can’t we respect the physical integrity of every human being?

In order to respect an intersex person’s human rights, international binding conventions such asConvention of the Rights of the Child,Convention on the Elimination of All Forms of Discrimination against Women urge societies to wait until the individual is old enough and able to participate in the decision-making process concerning potential medical interventions to the body.

Each of us has the right to identify our own sex and gender. I call upon all of us to break from the silent majority, to raise our voices to defend the rights of intersex persons.

Personally, I increase the visibility of the rights of persons with variations in sex characteristics through myresearch on the effectiveness of the Universal Periodic Review to promote the rights of intersex persons. Launched in 2008 and nested under theUnited Nations Human Rights Council, theUniversal Periodic Review (UPR)brings together the 193 UN Members States to assess their human rights records against the benchmark of theUniversal Declaration of Human Rights (1948) and its core human rights treaties. TheUPR is organised in four and a half year-cycles, and to date it has generated more than 84,000 UPR recommendations addressed to the States under Review by their peers.

As new rights emerge and support grows for expanding the concept of ‘gender’ beyond the binary categories of women and men, our interpretation of human rights should also apply to persons of diverse sexual orientations and gender identities (SOGI). Nonetheless, the rights of intersex persons are still not recognised, respected, protected and realised across regions and within societies. The first time that the UPR recommendations referenced “intersex” was in 2011, when the United States of America addressed Nepal – Nepal supported the received recommendation.

Today around 650 recommendations address the rights of intersex persons. However, my new study questions whether the UPR addresses these rights effectively. In my latest paper I examine the UPR recommendations up until October 2021, with a specific focus on intersex children and adults and a critical approach to the terminology used in this regard. My goal is to identify which UPR-recommendations that promote the rights of intersex persons are more likely to be accepted by the State under Review.

Based on my review, I find that among many SOGI-related recommendations, only a limited number explicitly address the rights of intersex persons. Often, the abbreviation ‘LGBTI’ is used to describe all persons that face SOGI-related concerns. The use of this abbreviation collapses the distinctions between each group represented by the term ‘LGBTI’, and the ways in which they face unique discriminations and challenges. As such, the use of ‘LGBTI’ to describe intersex individuals renders their specific needs and rights less visible. My analysis also demonstrates how the acceptance of UPR-recommendations by the State under Review differs according to the content. The rights of intersex persons are more often approached from a legal perspective rather than from a medical perspective, and related UPR-recommendations are more likely to be accepted when drafted in general terms, allowing each country to implement the recommendations in a contextualised way, rather than in more detailed terms, indicating the specific actions to take.

The findings of my study suggest that there is potential for the UPR to act as an enabling environment for progressive countries to enhance the rights of intersex persons universally. However, UPR recommendations that address the rights of intersex persons in specific legal terms do not appear to sufficiently enhance the rights of intersex persons in the near future, since these recommendations are more likely to be rejected by the State under Review.

Therefore, I propose that future UPR recommendations should adopt an intersectional approach to evaluate and address the rights of intersex persons. I conclude by suggesting that in order for UPR recommendations to be effective, the rights of intersex persons should be explicitly addressed as a separate topic – rather than as one of many groups obscured under the umbrella of ‘LGBTI’ persons – in order to increase their visibility and recognition of the unique challenges and discriminations that intersex persons face.

#IntersexAwarenessDay 

^{1. Alice Dreger, ‘Twenty Years of Working toward Intersex Rights’, Bioethics in Action (Cambridge University Press 2018), 55}

^{2. OHCHR, ‘Background Note on Human Rights Violations against Intersex People’, 2.} 

^{3. OHCHR, ‘Free & Equal Campaign Fact Sheet: Intersex’ (2015), 1.}

^{4. Morgan Carpenter, ‘The human rights of intersex people : addressing harmful practices and rhetoric of change’ Reproductive Health Matters’ 2016, 24(47), 74.}

^{5. Saskia Ravesloot, ‘The Universal Periodic Review beyond the binary - Advancing the rights of persons with variations in sex characteristics’ Papers of 8th international conference on gender & women studies 2021.}

^{6. UPR Recommendation 106.5 ‘Enact legislation to ensure members of the lesbian, gay bisexual, transgender and intersex (LGBTI) community citizenship rights, consistent with the equal rights enumerated in the Nepali Supreme Court’s 2008 decision’.}