Intersex rights: UNHRC adopts first of its kind resolution

Intersex rights are an integral part of the broader human rights conversation, focusing on the rights and dignity of intersex individuals. Read here to learn more about the issues of intersex rights.

Intersex people are born with physical sex characteristics (such as genitalia, gonads, hormone levels, or chromosomes) that do not fit typical binary notions of male or female bodies.

The intersex rights movement seeks to address and correct a range of issues and injustices that intersex people face, including medical practices, legal recognition, discrimination, and lack of awareness.

Intersex persons

Intersex persons are born with a wide range of natural variations in their sex characteristics that don’t fit the typical definition of male or female, including sexual anatomy, reproductive organs or chromosome patterns.

• Experts estimate that up to 1.7 per cent of the population is born with intersex traits.
• Intersex people may have any gender identity or sexual orientation.
• For example, an intersex person (sex characteristics), may identify as a man (gender identity) and as heterosexual (sexual orientation).
• Intersex is a term that encompasses a wide range of natural bodily variations that do not fit typical binary notions of male or female bodies.
• These variations can appear in chromosomes, genitalia, gonadal tissues (ovaries and testes), hormone levels, and secondary sex characteristics.
• It’s important to understand that intersex conditions are part of the natural diversity of human bodies, and individuals with these variations may have unique health considerations and personal identities.

Types of intersex conditions

The conditions can be categorised commonly as below:

• 46, XX intersex: Female chromosomes and ovaries but external genitals appear male. This can be caused by exposure to excess male hormones before birth.
• 46, XY intersex: Male chromosomes but external genitals are incompletely formed, ambiguous or female. Testes may be normal, malformed, or absent. Testosterone issues and other foetal development variations may cause it.
• Sex chromosome intersex: This can involve a range of chromosomal variations that affect sex development. They don’t cause a discrepancy between internal and external genitalia but possible problems with sex hormone levels and overall sexual development.

Here are some of the more commonly recognized types of intersex conditions:

Androgen Insensitivity Syndrome (AIS)

• AIS is a condition in which a person is genetically male (with XY chromosomes) but the body’s cells are unable to respond to androgens (male hormones).
• This can result in a person with AIS developing physical traits that are typical of females, despite having XY chromosomes.
• There are two types: Complete Androgen Insensitivity Syndrome (CAIS) results in a body that appears typically female, while Partial Androgen Insensitivity Syndrome (PAIS) can result in a wide range of genital ambiguity.

Congenital Adrenal Hyperplasia (CAH)

• CAH refers to a group of genetic conditions that affect the adrenal glands, which produce hormones.
• People with CAH lack the enzymes needed to make certain hormones, leading to a hormone imbalance.
• In individuals with XX chromosomes, this can result in masculinization of the external genitalia, leading to ambiguity at birth.

5-alpha Reductase Deficiency

• This is a condition that affects individuals with XY chromosomes, where the body cannot effectively convert testosterone into dihydrotestosterone (DHT), a hormone important for the development of male external genitalia.
• As a result, individuals may be born with genitalia that appear female or ambiguous.
• At puberty, when testosterone levels increase, secondary male characteristics (such as increased muscle mass, deepening of the voice, etc.) may develop.

Klinefelter Syndrome (XXY)

• Klinefelter Syndrome occurs when a male has an extra X chromosome (making the chromosome pattern XXY).
• This can lead to a spectrum of physical traits and developmental differences, including reduced fertility, less facial and body hair, and sometimes breast development.

Turner Syndrome (XO)

• Turner Syndrome affects individuals with one complete X chromosome rather than two (XO instead of XX or XY).
• This condition typically affects females and can result in short stature, infertility, heart defects, and certain learning disabilities.

Ovotesticular Disorder of Sex Development (DSD)

• This condition, formerly known as true hermaphroditism, is characterized by the presence of both ovarian and testicular tissue in the same individual.
• The external genitalia can vary greatly, from typically male to typically female and anything in between.

Mosaicism and Chimerism

• These conditions involve individuals having two or more different sets of DNA within their cells, which can lead to variations in physical development, including sexual characteristics.
• Mosaicism occurs when the differences in DNA arise from a single fertilized egg, while chimerism occurs due to the merging of two fertilized eggs in the womb.

Also Read: Chromosome and Chromosomal Disorders in Humans

Key Issues related to Intersex Rights

• Medical Autonomy and Ethical Treatment: One of the central issues is the practice of unnecessary medical surgeries and interventions on intersex infants and children.
• These procedures are often performed to make their bodies conform to societal norms of male and female bodies without the consent of the individual.
• Advocates argue for the right to bodily integrity and autonomy, suggesting that non-consensual cosmetic surgeries should be postponed until the individual can make an informed decision.
• Legal Recognition: Intersex people often face challenges in obtaining legal identification documents that reflect their gender identity or physical appearance.
• The movement advocates for easier processes to change legal gender markers and for the inclusion of non-binary, third-gender, or X markers on identification documents for those who wish to use them.
• Awareness and Education: There’s a significant lack of awareness and understanding about intersex issues among the general public and even within the medical community.
• Intersex rights advocates call for comprehensive education and training on intersex variations, emphasizing the diversity of human bodies and the importance of respecting each individual’s rights and dignity.
• Protection from Discrimination: Like other marginalized groups, intersex individuals often face discrimination in various areas of life, including healthcare, employment, education, and social services.
• Advocating for explicit protections against discrimination based on sex characteristics or intersex status is crucial.
• Support and Resources: The intersex community needs access to support and resources, including mental health services, peer support groups, and accurate information about their bodies and rights. Advocates work to establish and fund these support mechanisms.

Progress for intersex rights

It’s estimated that up to 1.7 per cent of the population is born with intersex traits, according to UN data.

• Working with civil society and intersex rights defenders, UN Human Rights has led several initiatives to promote the visibility and rights of intersex people and issued a Technical Note in 2023 for States and other stakeholders on UN recommendations on the rights of intersex people and good practices in their implementation.
• The intersex rights movement has made significant strides in recent years. Some countries and regions have enacted laws and guidelines to protect intersex individuals, especially concerning non-consensual medical procedures.
• Awareness has increased through the advocacy work of intersex individuals and organizations, as well as through inclusive education policies in some places.
• Legal recognition of non-binary or third genders in identification documents has been achieved in several jurisdictions, benefiting some intersex individuals.

Why in the news?

In a landmark vote, the Human Rights Council on April 4, 2024, adopted a resolution calling on Member States to enhance efforts to combat discrimination, violence and harmful practices against intersex people, the first of its kind for the United Nations.

• The resolution also calls on Member States to address the root causes, such as stereotypes, spread of misconceptions and inaccurate information, stigma and taboo, and to work to fulfil the enjoyment of the highest attainable standard of physical and mental health for persons with innate variations in sex characteristics.
• Twenty-four countries voted in favour, twenty-three abstained and none voted against the resolution, which was spearheaded by Finland, South Africa, Chile and Australia.

Challenges

Despite progress, many challenges remain.

• Legal, medical, and social recognition and understanding of intersex people’s rights vary widely around the world.
• In many places, there is still a significant lack of legal protections, and non-consensual medical interventions continue.
• Social stigma and discrimination persist, impacting the mental and physical health of intersex individuals.

Human rights abuses against intersex people include, but are not limited to:

• infanticide
• forced and coercive medical interventions
• discrimination in education, sports, employment and other services
• lack of access to justice and remedies, and legal recognition

Way forward

It’s crucial to approach discussions about intersex conditions with sensitivity and respect for the individuals who have these variations.

• Each person’s experience is unique, and not everyone with an intersex condition will identify as part of the intersex community.
• Some may identify with the gender assigned to them at birth, while others may not.
• The most important aspect is to respect each individual’s self-identification, privacy, and right to make decisions about their own body and how they navigate the world.

To ensure the physical integrity of intersex persons, States should:

• Prohibit medically unnecessary surgery and procedures on the sex characteristics of intersex children.
• Ensure that human rights violations against intersex people are investigated and alleged perpetrators prosecuted.
• Ensure that intersex people and their families receive adequate counselling and support, including from peers.
• Ensure that intersex people and organizations are consulted and participate in the development of research, legislation and policies that impact their rights.
• Provide health care personnel with training on the health needs and human rights of intersex people and the appropriate advice and care to give to parents and intersex children, being respectful of the intersex person’s autonomy, physical integrity and sex characteristics

Conclusion

Intersex rights are a crucial aspect of human rights, advocating for the dignity, autonomy, and recognition of intersex individuals.

Through education, legal reforms, and shifts in medical practices, the movement aims to protect intersex people from discrimination and unnecessary medical procedures, ensuring their right to live freely and authentically.

Continuing to push for these changes is essential for creating a more inclusive and respectful society for everyone, regardless of their sex characteristics.

Also read:

• LGBTQIA+ Community
• Transgender Rights
• Gender Justice

-Article by Swathi Satish