Federal call for action, 2025

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On behalf of InterAction for Health and Human Rights, A/Prof Morgan Carpenter welcomes the new government:

“We congratulate the Albanese Labor government on its re-election, with the promise to reform and build, to leave no-one behind, and to promote fairness, equality and respect for one another. We’re grateful also for the re-election of key ministers, and we wish to acknowledge the vital work of A/Minister Ged Kearney and her team. We look forward to continuing to work with the government, to improve health and wellbeing outcomes for people with innate variations of sex characteristics, to build on key actions from the 47th Parliament of Australia, and to deepen engagement across portfolios.”

Our call for action includes work in 7 areas:

1. Bodily autonomy and bodily integrity

Children with innate variations of sex characteristics remain routinely subjected to early elective medical interventions to make their bodies appear and function in ways that are more typically female or male. These are often justified by gender stereotypes and are opposed by psychosocial professional bodies (4). Where they pre-empt individuals’ rights to personally consent to treatment, they are considered harmful practices by community and human rights institutions: in a 2021 report, the Australian Human Rights Commission called for legislative and regulatory reform to ensure freedom from harmful practices (5). The ACT has enacted first legislation to regulate such interventions (6). Victoria has also made a commitment to do the same (7).

The 2024 Australian Department of Health and Aged Care action plan on LGBTIQA+ health and wellbeing states that the government is “working towards” “Supporting LGBTIQA+ people to make their own decisions about their bodies” (8).

We hope that government will continue and deepen the work already started in the 10-year action plan on LGBTIQA+ health and wellbeing. We seek particularly to ensure that these values inform work to harmonise legislation, policy and service delivery across the country.

2. Healthcare access

Current MBS codes promote paediatric surgeries while limiting access to healthcare for adults who are able to personally consent (3). Individuals and families have poor access to knowledgeable services, particularly in regional and remote areas. Access to fertility treatments is also limited.

Less work has yet been done in this area. We need amendments to MBS codes to support access to healthcare as adults, and de-incentivise interventions on infants and children.

We look forward to more action across the health portfolio, in work to implement the 10-year action plan.

3. Community-controlled psychosocial support and healthcare

The ACT government has established a paediatric psychosocial support service in the Canberra hospital system to help children and families (9). A key goal is to ensure that children can grow to understand their bodies and freely develop and express their own values and preferences for treatment.

The national InterLink psychosocial support service provides professional and peer-led psychosocial support to individuals and families, including children and adults. It has precarious funding, yet it is a unique service promoting mental health in a stigmatised and misunderstood population.

We welcome an $450,000 federal investment in our InterLink program. This funding ensures its survival beyond June 2025, at 50% of prior capacity (with pilot funding). We seek additional resources to deliver a full range of services.

4. Government misinformation

People with innate variations of sex characteristics are a diverse population, impacted by more than 100 known genes affecting sex development (1). Even in jurisdictions in Australia where third sex/gender markers exist, the evidence available shows that they are not used by parents of children with innate variations, they are used by parents who are expressing particular values and preferences about how they want to raise their children. People with innate variations of sex characteristics can grow up to be women or men, in line with sex registered at birth, or can grow up to be gender diverse. We regard all outcomes as acceptable, seeking respect for our heterogeneity as a population (2,3).

In 2013, updated in 2015, national sex and gender recognition guidelines published by the Attorney General’s Department both recognised diversity in sex/gender markers in our population, but also (wrongly in our view) inserted the terms intersex and indeterminate into a definition of a non-binary gender category, “X” (10). Since this development, we have repeatedly and continuously asked government to change the definition of the third gender to remove references to intersex and indeterminate, perhaps by renaming it “non-binary” to reflect actual needs (for example 11,12).

The gender recognition guidelines are a significant source of misinformation on our population, and this impacts our ability to accurately be counted (for example, in the national census). The guidelines have been superseded but not displaced by better practice in the 2020 Australian Bureau of Statistics Standard on sex, gender, variations of sex characteristics and sexual orientation (13).

The government can build on work already done, by the ABS but also by the Attorney General’s Department.

5. Anti-discrimination legislation

Inappropriate identity and gender-based construction of intersex have limited the utility of legal protections on grounds of “intersex status” in the Sex Discrimination Act. At the same time, we can see increasing stigmatisation and demonisation of our population, indicating a need for meaningful protections (14).

All states and territories (with the exception of Western Australia) have implemented better practice protections on grounds of “sex characteristics”.

The government can build on a commitment made by Minister Tony Burke in 2022, implementing reforms to update protections on grounds of ‘intersex status’ to ‘sex characteristics’. The ACT government made this update in an omnibus justice bill. The former Queensland Labor government enacted a best practice attribute.

6. Education

Individuals with innate variations of sex characteristics, parents and prospective parents often lack accurate information about our bodies and even our existence. This can lead to an inability to effectively manage health and deal with a new diagnosis. Education can address stigma and improve health outcomes (5).

We seek reform in educational curricula at primary, secondary and tertiary levels< to provide accurate human rights-affirming information about innate variations of sex characteristics.

7. Redress

People who have experienced unnecessary early interventions not only suffer a loss of agency and autonomy, but can also experience a need for lifelong support and access to reparative treatments.

Redress could include support for access to ongoing healthcare and reparative treatments.

We seek redress for individuals subjected to elective life-altering medical interventions to modify sex characteristics without personal informed consent.

About these issues

We have raised these issues for consideration throughout the previous Parliament, and in previous elections. Our work on these issues and more is informed by the 2017 Darlington Statement, a community consensus statement by organisations and individuals in Australia and Aotearoa NZ. Read more:

References

  1. Délot EC, Vilain E. Towards improved genetic diagnosis of human differences of sex development. Nat Rev Genet. 2021;(22):588–602. https://doi.org/10.1038/s41576-021-00365-5
  2. InterAction for Health and Human Rights. Theory of Change [Internet]. 2023 Nov [cited 2024 Apr 10]. Available from: https://interaction.org.au/40737/theory-of-change/
  3. Carpenter M. From Harmful Practices and Instrumentalisation, towards Legislative Protections and Community-Owned Healthcare Services: The Context and Goals of the Intersex Movement in Australia. Social Sciences. 2024 Apr;13(4):191. https://doi.org/10.3390/socsci13040191
  4. Chief Minister, Treasury and Economic Development Directorate. Draft Legislation To Protect The Rights Of People With Variations In Sex Characteristics In Medical Settings Listening report on submissions received [Internet]. 2022 Aug [cited 2022 Sep 1]. Available from: https://www.cmtedd.act.gov.au/policystrategic/…
  5. Australian Human Rights Commission. Ensuring health and bodily integrity: towards a human rights approach for people born with variations in sex characteristics [Internet]. Sydney, Australia: Australian Human Rights Commission; 2021 [cited 2021 Oct 18]. Available from: https://humanrights.gov.au/intersex-report-2021
  6. ACT Health. Protecting the rights of people with variations in sex characteristics [Internet]. 2024 [cited 2024 Mar 9]. Available from: https://www.act.gov.au/health/…
  7. Department of Health. (i) Am Equal: Future directions for Victoria’s Intersex community [Internet]. 2021 Jul [cited 2021 Jul 12]. Available from: https://www2.health.vic.gov.au/about/publications/factsheets/i-am-equal
  8. Department of Health and Aged Care. National Action Plan for the Health and Wellbeing of LGBTIQA+ People 2025-2035 [Internet]. 2024 [cited 2024 Dec 12]. Available from: https://www.health.gov.au/resources/…
  9. Canberra Health Services. Variations in Sex Characteristics Psychosocial Service [Internet]. ACT Health; 2024 [cited 2024 Aug 13]. Available from: https://www.canberrahealthservices.act.gov.au/
    services-and-clinics/…
  10. Attorney General’s Department. Australian Government Guidelines on the Recognition of Sex and Gender (2015) [Internet]. 2015 [cited 2015 Nov 18]. Available from: http://www.ag.gov.au/Publications/…
  11. National LGBTI Health Alliance, A Gender Agenda, Organisation Intersex International Australia, Trans Formative, Transgender Victoria. RE: Commonwealth Attorney-General’s Department Review of the Australian Government Guidelines on the Recognition of Sex and Gender [Internet]. 2015 [cited 2015 Oct 12]. Available from: https://interaction.org.au/30043/joint-submission-federal-sexgender-guidelines/
  12. Intersex Human Rights Australia and Intersex Peer Support Australia. Call for action by the new government [Internet]. 2022 [cited 2023 Aug 25]. Available from: https://ihra.org.au/39860/call-for-action-2022/
  13. Australian Bureau of Statistics. Standard for Sex, Gender, Variations of Sex Characteristics and Sexual Orientation Variables, 2020 [Internet]. 2023 [cited 2023 Nov 16]. Available from: https://www.abs.gov.au/statistics/…
  14. Carpenter M. Is It Ever OK to Reclassify Someone Out of Their Birth-Observed Sex Without Personal Consent? How Do We Manage Competing Methods of Classifying Sex? The American Journal of Bioethics. 2024 Nov 1;24(11):18–20. https://doi.org/10.1080/15265161.2024.2399853