Print
See related documents
Resolution 2191 (2017)
Promoting the human rights of and eliminating discrimination against intersex people
1. Intersex people are born with biological
sex characteristics that do not fit societal norms or medical definitions
of what makes a person male or female. Sometimes a person’s intersex
status is detected at birth; sometimes it only becomes apparent
later in life, notably during puberty. Despite the wide variety
of situations concerned, the majority of intersex people are physically
healthy. Only a few suffer from medical conditions that put their
health at risk. Yet the situation of intersex people has for a long
time been treated as an essentially medical issue. The prevailing
medical view has been that intersex children’s bodies can and should
be made to conform to either a male or a female paradigm, often
through surgical and/or hormonal intervention; that this should
be done as early as possible; and that the children should then
be raised in the gender corresponding to the sex assigned to their
body.
2. The Parliamentary Assembly considers that this approach involves
serious breaches of physical integrity, in many cases concerning
very young children or infants who are unable to give consent and
whose gender identity is unknown. This is done despite the fact
that there is no evidence to support the long-term success of such
treatments, no immediate danger to health and no genuine therapeutic
purpose for the treatment, which is intended to avoid or minimise
(perceived) social problems rather than medical ones. It is often
followed by lifelong hormonal treatments and medical complications,
compounded by shame and secrecy.
3. Parents are often under pressure to make urgent, life-changing
decisions on behalf of their child, without having a full and genuine
understanding of the long-term consequences for the child of the
decisions made about their body during their infancy and early childhood.
4. Understanding of these issues is gradually increasing, but
concerted efforts are still needed to raise public awareness as
to the situation and rights of intersex people so as to ensure that
they are fully accepted in society, without stigmatisation or discrimination.
5. The Assembly emphasises that it is crucial to ensure that
the law does not create or perpetuate barriers to equality for intersex
people. This includes ensuring that intersex people who do not identify
as male or female have access to legal recognition of their gender
identity, and that where their gender has not been correctly recorded
at birth, the procedure for rectifying this is simple and based
on self-identification only, as set out in Assembly Resolution 2048 (2015) on
discrimination against transgender people in Europe. Anti-discrimination laws
may also need to be amended to ensure that the situation of intersex
people is effectively covered.
6. The Assembly considers that the above may raise important
issues under a number of provisions of the European Convention on
Human Rights (ETS No. 5), notably Articles 3 and 8.
7. In the light of the above, and bearing in mind the provisions
of the Convention for the Protection of Human Rights and Dignity
of the Human Being with regard to the Application of Biology and
Medicine: Convention on Human Rights and Biomedicine (ETS No. 164,
“Oviedo Convention”) and the relevant recommendations made in its Resolution 1952 (2013) on
children’s right to physical integrity, as well as those by the
Council of Europe Commissioner for Human Rights and numerous treaty
bodies of the United Nations, the Assembly calls on Council of Europe
member States to:
7.1. with regard
to effectively protecting children’s right to physical integrity
and bodily autonomy and to empowering intersex people as regards
these rights:
7.1.1. prohibit medically unnecessary sex-“normalising”
surgery, sterilisation and other treatments practised on intersex
children without their informed consent;
7.1.2. ensure that, except in cases where the life of the child
is at immediate risk, any treatment that seeks to alter the sex
characteristics of the child, including their gonads, genitals or
internal sex organs, is deferred until such time as the child is
able to participate in the decision, based on the right to self-determination
and on the principle of free and informed consent;
7.1.3. provide all intersex people with health care offered by
a specialised, multidisciplinary team taking a holistic and patient-centred
approach and comprising not only medical professionals but also
other relevant professionals such as psychologists, social workers
and ethicists, and based on guidelines developed together by intersex
organisations and the professionals concerned;
7.1.4. ensure that intersex people have effective access to health
care throughout their lives;
7.1.5. ensure that intersex people have full access to their
medical records;
7.1.6. provide comprehensive and up-to-date training on these
matters to all medical, psychological and other professionals concerned,
including conveying a clear message that intersex bodies are the
result of natural variations in sex development and do not as such
need to be modified;
7.2. with a view to assisting intersex people, their parents
and the people around them in dealing with the challenges posed, inter alia, by social attitudes
towards variations in sex characteristics:
7.2.1. ensure
that adequate psychosocial support mechanisms are available for
intersex people and their families throughout their lives;
7.2.2. support civil society organisations working to break the
silence around the situation of intersex people and to create an
environment in which intersex people feel safe to speak openly about
their experiences;
7.3. with regard to civil status and legal gender recognition:
7.3.1. ensure that laws and practices governing the registration
of births, in particular as regards the recording of a newborn’s
sex, duly respect the right to private life by allowing sufficient flexibility
to deal with the situation of intersex children without forcing
parents or medical professionals to reveal a child’s intersex status
unnecessarily;
7.3.2. simplify legal gender recognition procedures in line with
the recommendations adopted by the Assembly in Resolution 2048 (2015) and ensure
in particular that these procedures are quick, transparent and accessible
to all and based on self-determination;
7.3.3. ensure, wherever gender classifications are in use by
public authorities, that a range of options are available for all
people, including those intersex people who do not identify as either male
or female;
7.3.4. consider making the registration of sex on birth certificates
and other identity documents optional for everyone;
7.3.5. ensure that, in accordance with the right to respect for
private life, intersex people are not prevented from entering into
a civil partnership or marriage or from remaining in such a partnership
or marriage as a result of the legal recognition of their gender;
7.4. with regard to combating discrimination against intersex
people, ensure that anti-discrimination legislation effectively
applies to and protects intersex people, either by inserting sex
characteristics as a specific prohibited ground in all anti-discrimination
legislation, and/or by raising awareness among lawyers, police,
prosecutors, judges and all other relevant professionals, as well
as intersex people, of the possibility of dealing with discrimination
against them under the prohibited ground of sex, or as an “other”
(unspecified) ground where the list of prohibited grounds in relevant
national anti-discrimination provisions is non-exhaustive;
7.5. collect more data and carry out further research into
the situation and rights of intersex people, including into the
long-term impact of sex-“normalising” surgery, sterilisation and
other treatments practised on intersex people without their free
and informed consent, and in this context:
7.5.1. conduct
an inquiry into the harm caused by past invasive and/or irreversible
sex-“normalising” treatments practised on individuals without their
consent and consider granting compensation, possibly through a specific
fund, to individuals having suffered as a result of such treatment
carried out on them;
7.5.2. in order to build a complete picture of current practice,
keep a record of all interventions carried out on children’s sex
characteristics;
7.6. carry out campaigns to raise awareness among the professionals
concerned and among the general public as regards the situation
and rights of intersex people.
8. Finally, the Assembly invites national parliaments to work
actively, with the participation of intersex people and their representative
organisations, to raise public awareness about the situation of
intersex people in their country and to give effect to the recommendations
made above.