28 October 2013


The Senate Community Affairs References Committee has released its report [PDF] on Involuntary or coerced sterilisation of intersex people in Australia.

The report notes that
On 20 September 2012, the Senate referred the involuntary or coerced sterilisation of people with disabilities in Australia to the Senate Community Affairs References Committee for inquiry and report. On 7 February 2013 the Senate amended the terms of reference of the inquiry to add the following matter:
2. Current practices and policies relating to the involuntary or coerced sterilisation of intersex people, including: (a) sexual health and reproductive issues; and (b) the impacts on intersex people.
The addition of this item reflected the growing awareness by both the committee and stakeholders of a significant overlap between issues faced by people with disability and by intersex people. The committee's desire to examine the issues more closely was also fostered by the work of the government and the Senate Legal and Constitutional Affairs committee on the Exposure Draft of Human Rights and Anti-Discrimination Bill 2012, and the subsequent Sex Discrimination Amendment (Sexual Orientation, Gender Identity and Intersex Status) Bill 2013.
On 17 July 2013 the Community Affairs committee tabled its first report, on involuntary or coerced sterilisation of people with disabilities in Australia. This second, and final, report addresses the term of reference concerning intersex people.
The report features 15 recommendations, as follows
R1   that governments and other organisations use the term 'intersex' and not use the term 'disorders of sexual development'.
R2  that health professionals and health organisations review their use of the term 'disorders of sexual development', seeking to confine it to appropriate clinical contexts, and should use the terms 'intersex' or 'differences of sexual development' where it is intended to encompass genetic or phenotypic variations that do not necessarily require medical intervention in order to prevent harm to physical health.
R3  that all medical treatment of intersex people take place under guidelines that ensure treatment is managed by multidisciplinary teams within a human rights framework. The guidelines should favour deferral of normalising treatment until the person can give fully informed consent, and seek to minimise surgical intervention on infants undertaken for primarily psychosocial reasons.
R4  that the Commonwealth government provide funding to ensure that multidisciplinary teams are established for intersex medical care that have dedicated coordination, record-keeping and research support capacity, and comprehensive membership from the various medical and non-medical specialisms. All intersex people should have access to a multidisciplinary team.
R5  In light of the complex and contentious nature of the medical treatment of intersex people who are unable to make decisions for their own treatment, the committee recommends that oversight of these decisions is required.
R6  that all proposed intersex medical interventions for children and adults without the capacity to consent require authorisation from a civil and administrative tribunal or the Family Court.
R7  that the Standing Committee on Law and Justice consider the most expedient way to give all civil and administrative tribunals in all States and Territories concurrent jurisdiction with the Family Court to determine authorisation for intersex medical interventions proposed for a child.
R8  that civil and administrative tribunals be adequately funded and resourced to consider every intersex medical intervention proposed for a child.
R9  that the special medical procedures advisory committee draft guidelines for the treatment of common intersex conditions based on medical management, ethical, human rights and legal principles. These guidelines should be reviewed on an annual basis.
R10  that complex intersex medical interventions be referred to the special medical procedures advisory committee for consideration and report to whichever body is considering the case.
R11  that the provision of information about intersex support groups to both parents/families and the patient be a mandatory part of the health care management of intersex cases.
R12  that intersex support groups be core funded to provide support and information to patients, parents, families and health professionals in all intersex cases.
R13  that the Commonwealth Government support the establishment of an intersex patient registry and directly fund research that includes a long-term prospective study of clinical outcomes for intersex patients.
R14   that the Commonwealth government investigate the appropriate regulation of the use of dexamethasone for prenatal treatment of CAH.
R15  that, effective immediately, the administration of dexamethasone for prenatal treatment of CAH only take place as part of research projects that have ethics approval and patient follow-up protocols.