After birth, as children, adolescents and adults, intersex people face violations of their physical integrity, including medical interventions without personal, prior, persistent and fully informed consent. This can cause psychological trauma as well as severe physical impairments, ranging from painful scar-tissue or lack of sensation to osteoporosis and urethral issues.

Medicalisation and stigmatisation of intersex people results in significant trauma and mental health concerns. It is important to ensure that non-pathologising psycho-social and peer support should be available to intersex people as required throughout their life, as well as to parents and/or care providers.

“Disorder of Sex Development (DSD)” is a medical umbrella term, which was introduced in 2006 by a Clinician Consensus Statement. Together with new categories of “syndromes”, it replaced the older medical terms. Some clinicians use DSD to stand for “differences of” or “diverse” sex development. However, in all its forms the term pathologises healthy variations of sex characteristics and refers to intersex sex characteristics as characteristics that are “deviant” from the norm of male and female bodies and thus need to be “disambiguated” or “fixed”. The term “DSD” does not align with human rights standards, and is only used in direct quotations or when referring to medical concepts that use the term.

National surveys as well as the UN shadow reports clearly show that intersex people lack protection of their right to health. In order to ensure intersex people’s enjoyment of their right to health, States should take measures to:

• • protect people with variations of sex characteristics from non-emergency, invasive and irreversible “normalising” surgeries and other medical practices without the intersex individual’s personal and fully informed consent

as well as establish:

• the right to obtain treatment, including preventive check-ups and needed medication, which are based on the individual’s physical needs and are not limited by the sex/gender marker in their official documents.

• the right to lifelong coverage of any medication needed as a result of surgical and/or other interventions on the sex characteristics of a person by national health insurance reimbursement systems.

• the right to access to coverage that is not limited by the sex/gender marker in the person’s official documents, for any treatments.

• the right to expert-sensitive and individually tailored psychological and psycho-social counselling and support for all concerned individuals and their families, from the time of self-referral or diagnosis for as long as necessary.

• the right of survivors of intersex genital mutilation (IGM) to access reparative treatments on the same coverage terms as those provided for survivors of female genital mutilation (FGM).

• the right of access to one’s own complete medical records, including for minors.

as well as taking measures to:

• include human rights-based information about the existence of intersex people and about intersex issues in all medical curricula and other curricula in the area of health.

• establish obligatory training for medical professionals, such as doctors, midwives, psychologists and other professionals working in the health sector (e.g. reception desk staff), in order to ensure that intersex individuals and their families have access to adequate healthcare and are protected from discrimination. The training should include information about the vulnerability and special needs of intersex people in medical settings.

• establish obligatory, human rights-based training about the existence of intersex people and about the specific needs of intersex seniors for professionals working in elderly care to ensure that intersex seniors have access to adequate and respectful support and care without discrimination.

• invest in funding intersex groups and organisations so that they can engage in projects offering trainings for medical professionals, midwives, psychologists and other professionals working in the field of physical and mental health.