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Legal recognition of intersex people

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Intersex people are born with sex characteristics, such as chromosomes, gonads, or genitals that, according to the UN Office of the High Commissioner for Human Rights, "do not fit typical binary notions of male or female bodies".[1]

According to the Asia Pacific Forum of National Human Rights Institutions, few countries have provided for the legal recognition of intersex people. The Asia Pacific Forum states that the legal recognition of intersex people is firstly about access to the same rights as other men and women, when assigned male or female; secondly it is about access to administrative corrections to legal documents when an original sex assignment is not appropriate; and thirdly it is not about the creation of a third sex or gender classification for intersex people as a population but it is, instead, about self determination.[2]

The Asia Pacific Forum, Council of Europe,[3] and Third International Intersex Forum call for non-binary gender classifications to be available on a voluntary, opt-in basis.[2] The Council of Europe has called for greater consideration of the implications of new sex classifications on intersex people,[3] while the Third International Intersex Forum called for the long term removal of sex or gender from official identification documents.[2]

In some countries, legal recognition may be limited, access to any form of birth certificate may be difficult,[4] while some other countries recognise that intersex people may have non-binary gender identities.[2] Sociological research in Australia, a country with a non-binary gender marker, has shown that 19% of people born with atypical sex characteristics may prefer that option.[5]

History

Edward Coke, The First Part of the Institutes of the Lawes of England (1st ed, 1628, title page) - 20131124
Main article: Intersex in history

In European societies, Roman law, post-classical Canon law, and later Common law, referred to a person's sex as male, female or hermaphrodite, with legal rights as male or female depending on the characteristics that appeared most dominant. Under Roman law, a hermaphrodite had to be classed as either male or female.[6] The 12th-century Decretum Gratiani states that "Whether an hermaphrodite may witness a testament, depends on which sex prevails".[7][8][9] The foundation of common law, the 16th Century Institutes of the Lawes of England described how a hermaphrodite could inherit "either as male or female, according to that kind of sexe which doth prevaile."[10][11] Single cases have been described in Canon law and other legal cases over the centuries.

Intersex scholar Morgan Holmes states that much early anthropological material on non-European cultures described gender systems with more than two categories as "primitive", but also that subsequent analysis of third sexes and genders is simplistic or romanticized:[12]

much of the existing work on cultural systems that incorporate a 'third sex' portray simplistic visions in which societies with more than two sex/gender categories are cast as superior to those that divide the world into just two. I argue that to understand whether a system is more or less oppressive than another we have to understand how it treats its various members, not only its 'thirds'... recognition of third sexes and third genders is not equal to valuing the presence of those who were neither male nor female, and often hinges on the explicit devaluation of women[12]

In recent years, civil society organization and human rights institutions have raised issues relating to legal recognition.

Intersex rights

Main article: Intersex human rights

Research indicates a growing consensus that diverse intersex bodies are normal—if relatively rare—forms of human biology,[13] and human rights institutions are placing increasing scrutiny on medical practices and issues of discrimination against intersex people. A 2013 first international pilot study. Human Rights between the Sexes, by Dan Christian Ghattas,[14][15] found that intersex people are discriminated against worldwide: "Intersex individuals are considered individuals with a «disorder» in all areas in which Western medicine prevails. They are more or less obviously treated as sick or «abnormal», depending on the respective society."[14]

In 2015, an Issue Paper on Human rights and intersex people by the Council of Europe highlighted several areas of concern, including legal recognition:

  • unnecessary "normalising" treatment of intersex persons, and unnecessary pathologisation of variations in sex characteristics.
  • unnecessary medicalisation is said to also impact a right to life.
  • inclusion in equal treatment and hate crime law; facilitating access to justice and reparations.
  • access to information, medical records, peer and other counselling and support.
  • legal recognition, including respect for self-determination in gender recognition, through expeditious access to official documents.[3]

According to the Asia Pacific Forum of National Human Rights Institutions, few countries have provided for the legal recognition of intersex people. The Asia Pacific Forum states that the legal recognition of intersex people is firstly about access to the same rights as other men and women, when assigned male or female; secondly it is about access to administrative corrections to legal documents when an original sex assignment is not appropriate; and thirdly, while opt in schemes may help some individuals, legal recognition is not about the creation of a third sex or gender classification for intersex people as a population.[2]

Gender identities

Like all individuals, some intersex individuals may be raised as a particular sex (male or female) but then identify with another later in life, while most do not.[16][17][18] A 2012 clinical review suggests that between 8.5-20% of persons with intersex conditions may experience gender dysphoria, distress or discomfort as a result of the sex and gender they were assigned at birth.[19]

Like non-intersex people, some intersex individuals may not identify themselves as either exclusively female or exclusively male. Sociological research in Australia, a country with a third 'X' sex classification, shows that 19% of people born with atypical sex characteristics selected an "X" or "other" option, while 52% are women, 23% men, and 6% unsure.[5][20] At birth, 52% of persons in the study were assigned female, and 41% were assigned male.[5]

Research has also shown gender identities of intersex individuals to be independent of sexual orientation.[21]

Intersex advocate Morgan Carpenter states that intersex should not be reduced to a gender identity issue; "intersex as identity is polymorphic, but asserts the dignity of stigmatised embodiment."[22] Dan Christian Ghattas states that "People who do not have an intersex body and want to use ‘intersex’ to describe their gender identity, should be aware of the fact that, unfortunately, they are actually making intersex human rights violations less visible."[23]

Access to identification documents

Currently, depending on the jurisdiction, access to any birth certificate may be an issue,[4] including a birth certificate with a sex marker.[24] For example, in 2014 a Kenyan court ordered its government to issue a birth certificate to a five-year-old child born with ambiguous genitalia, necessary to allow the child to attend school and obtain a national identity document.[4]

Access to the same rights as other men and women

The Asia Pacific Forum of National Human Rights Institutions states that:

Recognition before the law means having legal personhood and the legal protections that flow from that. For intersex people, this is neither primarily nor solely about amending birth registrations or other official documents. Firstly, it is about intersex people who have been issued a male or a female birth certificate being able to enjoy the same legal rights as other men and women[2]

Accessing the same rights as other men and women supposes the elimination of stigma and discrimination on grounds of sex characteristics, and rights to physical integrity and freedom from torture and ill-treatment.

The Asia Pacific Forum also highlights access to sport and concerns with sex verification policies.[2] Sex testing began at the 1966 European Athletics Championships in response to suspicion that several of the best women athletes from the Soviet Union and Eastern Europe were actually men.[25] At the Olympics, testing was introduced in 1968. Initially, sex verification took the form of physical examinations. It subsequently evolved into chromosome testing, and later testosterone testing. Reports have shown how elite women athletes with intersex conditions have been humiliated, excluded, and suffered human rights violations as a result of sex verification testing.[26][27][28] Such cases have included female genital mutilation and sterilization.[28]

Changing identification documents

Access to a birth certificate with a correct sex marker may be an issue for people who do not identify with their sex assigned at birth,[3] or it may only be available accompanied by surgical requirements.[2]

Some countries such as Argentina, Malta, Denmark and Ireland permit changes to sex classifications via simple administrative methods.[29] Some countries, such as Vietnam, Thailand and many European countries only permit changes to sex classifications following surgeries.[2] Other countries do not permit intersex people to change sex assignment at all or, such as the United Kingdom, only by declaring that they are transgender and obtaining a diagnosis of gender dysphoria.[30]

Third sex or gender classifications

The passports and identification documents of Australia and some other nationalities have adopted "X" as a valid third category besides "M" (male) and "F" (female), at least since 2003.[31][32] In 2013, Germany became the first European nation to allow babies with characteristics of both sexes to be registered as indeterminate gender on birth certificates, amidst opposition and skepticism from intersex organisations who point out that the law appears to mandate exclusion from male or female categories.[33][34][35][36][37]

The intersex movement supports voluntary and opt-in non-binary and multiple sex classifications, described in the statement of the Third International Intersex Forum. The Open Society Foundations published a report, License to Be Yourself in May 2014, documenting "some of the world's most progressive and rights-based laws and policies" enabling changes to gender markers on official documents.[38] The report comments on the recognition of third classifications, stating:

From a rights-based perspective, third sex / gender options should be voluntary... Those identifying as a third sex / gender should have the same rights as those identifying as male or female.[38]

The Council of Europe acknowledged concerns about recognition of third and blank classifications in a 2015 Issue Paper, stating that these may lead to "forced outings" and "lead to an increase in pressure on parents of intersex children to decide in favour of one sex."[3] The Issue Paper argues that "further reflection on non-binary legal identification is necessary":

Mauro Cabral, Global Action for Trans Equality (GATE) Co-Director, indicated that any recognition outside the “F”/”M” dichotomy needs to be adequately planned and executed with a human rights point of view, noting that: “People tend to identify a third sex with freedom from the gender binary, but that is not necessarily the case. If only trans and/or intersex people can access that third category, or if they are compulsively assigned a third sex, then the gender binary gets stronger, not weaker”[3]

The Asia Pacific Forum of National Human Rights Institutions recognised the right of individuals to non-binary or third sex classifications, but stated that, "creating a third, separate category for the registration of people born with an intersex trait ... would risk segregating and potentially stigmatising intersex people. It would also remove their right to determine their own sex or gender."[2]

Ending official classification by sex or gender

The statement of the Third International Intersex Forum calls for an end to official classification by sex or gender on identification documents. Dan Christian Ghattas states that, "providing the options for all parents to leave the sex/ gender entry open for their child would promote the equality of all sexes and genders".[23]

Morgan Carpenter states that, "the removal of sex and gender, like race and religion, from official documentation" is "a more universal, long-term policy goal".[22]

Sex and gender distinctions

Main article: Sex and gender distinction

Distinctions between sex and gender are lost in many official or legal documents,[39] and also online. In 2014, Facebook introduced dozens of options for users to specify their gender, including the option of intersex.[40]

Third International Intersex Forum

Participants at the third International Intersex Forum, Malta, in December 2013
Main article: International Intersex Forum

The Third International Intersex Forum, in Malta in 2013, called for infants and children to be assigned male or female, on the understanding that later identification may differ:

  • To register intersex children as females or males, with the awareness that, like all people, they may grow up to identify with a different sex or gender.
  • To ensure that sex or gender classifications are amendable through a simple administrative procedure at the request of the individuals concerned. All adults and capable minors should be able to choose between female (F), male (M), non-binary or multiple options. In the future, as with race or religion, sex or gender should not be a category on birth certificates or identification documents for anybody. (Third International Intersex Forum)[2]

Argentina

In 2012 the Argentine Congress passed the Ley de Género (Gender Law),[41] which allows any individuals over 18 to change the gender marker on their national ID on the basis of a written declaration only. In doing so, Argentina became the first country to adopt a gender recognition policy based entirely on individual autonomy, without any requirement for third party diagnosis, surgeries or obstacles of any type.

Australia

Australian federal guidelines enable intersex (and other) people to identify gender as male, female or X on all federal documents, including passports. Documentary evidence must be witnessed by a doctor or psychologist, but medical intervention is not required.[39] Alex MacFarlane received the first Australian passport with an 'X' sex descriptor, reported in January 2003.[31][42][43] Australian research has shown that 19% of people born with atypical sex characteristics selected an "X" or "other" classification, while 52% are women and 23% men and 6% unsure.[5][20]

Birth certificates are a State and Territory issue in Australia. Organisation Intersex International Australia asserts that identification changes are managed as an administrative correction, and that this process has enabled some adults to obtain birth certificates with an indeterminate or unspecified sex.[44]

Alex MacFarlane is believed to be the first person in Australia to obtain a birth certificate recording sex as indeterminate. The West Australian reported in January 2003 that the Department of Foreign Affairs and Trade "had decided to accommodate people whose birth certificates recorded their sex as indeterminate ... Alex is also believed to be the first Australian issued with a birth certificate acknowledging a gender other than male or female".[42] Councillor Tony Briffa JP, of the City of Hobsons Bay, Victoria, previously acknowledged as the world's first openly intersex mayor,[45][46] states on Tony's website that "my birth certificate is silent as to my sex".[47][48]

Australia protects intersex people from discrimination in a federal Sex Discrimination Act, but this facilitates exemptions in competitive sport.[49][50]

Australian laws and policies that prohibit female genital mutilation explicitly permit "normalizing" surgeries on intersex infants and girls.[51]

Finland

Since 2015, the Act on Equality between Women and Men includes "gender features of the body" within its definition of gender identity and gender expression, which are the prohibited grounds under the act, meaning that discrimination on these basics is prohibited.[23][52]

Germany

In November 2013, Germany became the first European country to allow "indeterminate" sex,[53] requiring this where a child may not be assigned male or female.[36] A report by the German Ethics Council stated that the law was passed because, "Many people who were subjected to a 'normalizing' operation in their childhood have later felt it to have been a mutilation and would never have agreed to it as adults." [53] The move is controversial with many intersex advocates in Germany and elsewhere suggesting that it might encourage surgical interventions.[24][53][54] The Council of Europe Issue Paper on intersex restates these concerns:

Human rights practitioners fear that the lack of freedom of choice regarding the entry in the gender marker field may now lead to an increase in stigmatisation and to “forced outings” of those children whose sex remains undetermined. This has raised the concern that the law may also lead to an increase in pressure on parents of intersex children to decide in favour of one sex.[3]

Jersey

Since 1 September 2015, Discrimination (Jersey) Law 2013 includes intersex status within its definition of sex. Sex is one of the prohibited grounds under the act, meaning that discrimination on this basis is prohibited.[55]

India

India does not have specific laws for Intersex people. For people who need to change gender, the case of National Legal Services Authority v. Union of India allows this by self determination.[56] Actions in 2015 by gender rights organization Srishti Madurai seek to include intersex people in legislation on gender recognition for transgender people.[57]

Multiple Indian athletes have been subjected to humiliation, discrimination and loss of work and medals following sex verification. Middle-distance runner Santhi Soundarajan, who won the silver medal in 800 m at the 2006 Asian Games in Doha, Qatar, was stripped of her medal[58] and later attempted suicide.[59][60] Track athlete Pinki Pramanik was accused by a female roommate of rape and later charged, gender tested and declared male, though she and other medical experts dispute these claims.[61] Such testing is controversial: Indian athlete Dutee Chand won a case against the IAAF in 2015, enabling women athletes with high testosterone levels to compete as women, on the basis that there is no clear evidence of performance benefits.[62] In 2016, sports clinicians Genel, Simpson and de la Chapelle stated, "One of the fundamental recommendations published almost 25 years ago ... that athletes born with a disorder of sex development and raised as females be allowed to compete as women remains appropriate".[63]

Ireland

On July 15, 2015, Ireland passed a bill that allows persons aged over 18 to change legal gender from male to female or female to male by self-determination, without requiring medical intervention.[64][65]

Kenya

In 2014, a Kenyan court ordered the Kenyan government to issue a birth certificate to a five-year-old child born with ambiguous genitalia.[4] In Kenya a birth certificate is necessary for attending school, getting a national identity document, and voting.[4]

Malta

In April 2015, Malta passed a Gender Identity Gender Expression and Sex Characteristics Act that protects intersex people from discrimination on grounds of "sex characteristics", and also recognizes a right to bodily integrity and physical autonomy.[66] At the same, Malta introduced new provisions allowing applicants to change their gender identity documents by a simple administrative method.[66][67][68] Malta also permits an "X" option.[69]

Nepal

A 2016 report on the status and histories on intersex people in Nepal reported that "Intersex people cannot amend the name or gender marker on birth certificates and have difficulties changing documents including citizenship and educational certificates and transcripts if wanted".[70]

New Zealand

Birth certificates are available at birth showing "indeterminate" sex if it is not possible to assign a sex. The New Zealand Department of Internal Affairs states, "A person's sex can be recorded as indeterminate at the time of birth if it cannot be ascertained that the person is either male or female, and there are a number of people so recorded."[71] New Zealand passports are available with an 'X' sex descriptor.[32] These were originally introduced for people transitioning gender[72]

Nevertheless, material presented by the Australasian Paediatric Endocrine Group to the Australian Senate in 2013 showed New Zealand to be a regional outlier in cases of congenital adrenal hyperplasia, with genital surgical interventions favoured on infant girls aged less than 6 months.[73]

New Zealand laws and policies that prohibit female genital mutilation explicitly permit "normalizing" surgeries on intersex infants and girls.[51]

South Africa

In South Africa, the Judicial Matters Amendment Act, 2005 (Act 22 of 2005) amended the Promotion of Equality and Prevention of Unfair Discrimination Act, 2000 (Act 4 of 2000) to include intersex within its definition of sex.[74]

Thailand

Intersex persons who need to change sex assignment are able to "‘correct’ their honorific titles if they have undergone surgery," following action by the country's National Human Rights Commission.[2]

United Kingdom

The United Kingdom does not permit intersex people to change sex classification, except by declaring that they are transgender and following transgender medical protocols and a diagnosis of gender dysphoria.[30]

United States

On September 26, 2016, intersex California resident Sara Kelly Keenan became the second person in the United States to legally change her gender to non-binary. Keenan, who uses she/her pronouns, identifies as intersex "both as my medical reality and as my gender identification... It never occurred to me that this was an option, because I thought the gender change laws were strictly for transgender people. I decided to try and use the same framework to have a third gender."[75]

Dana Zzyym, a U.S. non-binary intersex activist and Associate Director of OII-USA commenced a legal case against the U.S. State Department in 2015, seeking a gender-neutral passport.[76][77]

In May 2016, the United States Department of Health and Human Services issued a statement explaining Section 1557 of the Affordable Care Act stating that the Act prohibits "discrimination on the basis of intersex traits or atypical sex characteristics" in publicly-funded healthcare, as part of a prohibition of discrimination "on the basis of sex".[78][79]

Vietnam

Since a 2008 decree, intersex persons who wish to change sex assignment have been able to do so, subject to surgeries "at the earliest age". In 2017, a new law will come into effect enabling changes to sex assignment on the basis of "sex disability or their sex is not defined and requires medical intervention".[2]

See also

Notes

  1. ^ "Free & Equal Campaign Fact Sheet: Intersex" (PDF). United Nations Office of the High Commissioner for Human Rights. 2015. Retrieved 28 March 2016.
  2. ^ a b c d e f g h i j k l m Asia Pacific Forum of National Human Rights Institutions (June 2016). Promoting and Protecting Human Rights in relation to Sexual Orientation, Gender Identity and Sex Characteristics. Asia Pacific Forum of National Human Rights Institutions. ISBN 978-0-9942513-7-4.
  3. ^ a b c d e f g Council of Europe; Commissioner for Human Rights (April 2015), Human rights and intersex people, Issue Paper
  4. ^ a b c d e "Kenya takes step toward recognizing intersex people in landmark ruling". Reuters.
  5. ^ a b c d Jones, Tiffany; Hart, Bonnie; Carpenter, Morgan; Ansara, Gavi; Leonard, William; Lucke, Jayne (February 2016). Intersex: Stories and Statistics from Australia (PDF). Cambridge, UK: Open Book Publishers. ISBN 978-1-78374-208-0. Retrieved 2016-02-02.
  6. ^ Lynn E. Roller, "The Ideology of the Eunuch Priest," Gender & History 9.3 (1997), p. 558.
  7. ^ Decretum Gratiani, C. 4, q. 2 et 3, c. 3
  8. ^ "Decretum Gratiani (Kirchenrechtssammlung)". Bayerische StaatsBibliothek (Bavarian State Library). February 5, 2009.
  9. ^ Raming, Ida; Macy, Gary; Bernard J, Cook (2004). A History of Women and Ordination. Scarecrow Press. p. 113.
  10. ^ E Coke, The First Part of the Institutes of the Laws of England, Institutes 8.a. (1st Am. Ed. 1812) (16th European ed. 1812).
  11. ^ Greenberg, Julie (1999). "Defining Male and Female: Intersexuality and the Collision Between Law and Biology". Arizona Law Review. 41: 277–278.
  12. ^ a b Holmes, Morgan (July 2004). "Locating Third Sexes". Transformations Journal (8). ISSN 1444-3775. Retrieved 2014-12-28.
  13. ^ Zderic, Stephen (2002). Pediatric gender assignment : a critical reappraisal ; [proceedings from a conference ... in Dallas in the spring of 1999 which was entitled "pediatric gender assignment - a critical reappraisal"]. New York, NY [u.a.]: Kluwer Acad. / Plenum Publ. ISBN 0306467593.
  14. ^ a b Ghattas, Dan Christian; Heinrich Böll Foundation (September 2013). "Human Rights Between the Sexes" (PDF).
  15. ^ "A preliminary study on the life situations of inter* individuals". OII Europe. 4 November 2013.
  16. ^ Money, John; Ehrhardt, Anke A. (1972). Man & Woman Boy & Girl. Differentiation and dimorphism of gender identity from conception to maturity. USA: The Johns Hopkins University Press. ISBN 0-8018-1405-7.
  17. ^ Domurat Dreger, Alice (2001). Hermaphrodites and the Medical Invention of Sex. USA: Harvard University Press. ISBN 0-674-00189-3.
  18. ^ Marañón, Gregorio (1929). Los estados intersexuales en la especie humana. Madrid: Morata.
  19. ^ Furtado P. S.; et al. (2012). "Gender dysphoria associated with disorders of sex development". Nat. Rev. Urol. 9: 620–627. doi:10.1038/nrurol.2012.182.
  20. ^ a b Organisation Intersex International Australia (July 28, 2016), Demographics, retrieved 2016-09-30
  21. ^ Diamond, Milton (1997). "Sexual Identity and Sexual Orientation in Children with Traumatized or Ambiguous Genitalia". The Journal of Sex Research. 34 (2): 199–211. doi:10.1080/00224499709551885. JSTOR 3813570.
  22. ^ a b Carpenter, Morgan (May 2016). "The human rights of intersex people: addressing harmful practices and rhetoric of change". Reproductive Health Matters. 24 (47): 74–84. doi:10.1016/j.rhm.2016.06.003. ISSN 0968-8080. Retrieved 2016-10-01.
  23. ^ a b c Ghattas, Dan Christian; ILGA-Europe (2015). "Standing up for the human rights of intersex people – how can you help?" (PDF).
  24. ^ a b Viloria, Hida (November 6, 2013). "Op-ed: Germany's Third-Gender Law Fails on Equality". The Advocate.
  25. ^ R. Peel, "Eve’s Rib - Searching for the Biological Roots of Sex Differences", Crown Publishers, New York City, 1994, ISBN 0-517-59298-3[page needed]
  26. ^ Jordan-Young, R. M.; Sonksen, P. H.; Karkazis, K. (April 2014). "Sex, health, and athletes". BMJ. 348 (apr28 9): –2926–g2926. doi:10.1136/bmj.g2926. ISSN 1756-1833. Retrieved 2016-05-21.
  27. ^ Martínez-Patiño, Maria José (December 2005). "Personal Account: A woman Tried and Tested". The Lancet. 366: 366–538. doi:10.1016/s0140-6736(05)67841-5.
  28. ^ a b Pūras, Dainius; Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health (April 4, 2016), Sport and healthy lifestyles and the right to health. Report A/HRC/32/33, United Nations
  29. ^ McDonald, Henry; Others (July 16, 2015). "Ireland passes law allowing trans people to choose their legal gender". The Guardian. Retrieved 13 November 2015.
  30. ^ a b Payton, Naith (July 23, 2015). "Comment: Why the UK's gender recognition laws desperately need updating". The Pink Paper.
  31. ^ a b Holme, Ingrid (2008). "Hearing People's Own Stories". Science as Culture. doi:10.1080/09505430802280784. Retrieved 6 October 2014.
  32. ^ a b "New Zealand Passports - Information about Changing Sex / Gender Identity". Retrieved 6 October 2014.
  33. ^ "Third sex option on birth certificates". Deutsche Welle. 1 November 2013.
  34. ^ "Third Gender: A Step Toward Ending Intersex Discrimination". Der Spiegel. 22 August 2013.
  35. ^ "Intersex: Third Gender in Germany" (Spiegel, Huff Post, Guardian, ...): Silly Season Fantasies vs. Reality of Genital Mutilations". Zwischengeschlecht. 1 November 2013.
  36. ^ a b "Sham package for Intersex: Leaving sex entry open is not an option". OII Europe. 15 February 2013.
  37. ^ "'X' gender: Germans no longer have to classify their kids as male or female". RT. 3 November 2013.
  38. ^ a b Byrne, Jack (2014). License to Be Yourself. New York: Open Society Foundations. ISBN 9781940983103. Retrieved 2014-12-28.
  39. ^ a b "Australian Government Guidelines on the Recognition of Sex and Gender, 30 May 2013". Retrieved 6 October 2014.
  40. ^ "Here's a list of 58 gender options for Facebook users". ABC. February 2014.
  41. ^ Global Action for Trans Equality (14 May 2012). "Gender identity Law in Argentina: an opportunity for all". Sexuality Policy Watch.
  42. ^ a b "X marks the spot for intersex Alex" (PDF). The West Australian. 11 January 2003.
  43. ^ "Neither man nor woman". Sydney Morning Herald. 27 June 2010.
  44. ^ "On intersex birth registrations". OII Australia. 13 November 2009.
  45. ^ "Intersex Mayor Elected in Australia". Advocate.com. December 9, 2011.
  46. ^ "Tony Briffa Of Australia's City Of Hobsons Bay Becomes World's First Intersex Mayor". The Huffington Post. December 10, 2011.
  47. ^ Briffa, Tony (2012). "About Tony". Briffa.org.
  48. ^ "OII VP Tony Briffa to wed partner in NZ ceremony - Gay News Network". Gay News Network. 27 September 2013.
  49. ^ "Australian Parliament, Explanatory Memorandum to the Sex Discrimination Amendment (Sexual Orientation, Gender Identity and Intersex Status) Bill 2013". Retrieved 6 October 2014.
  50. ^ "We welcome the Senate Inquiry report on the Exposure Draft of the Human Rights and Anti-Discrimination Bill 2012". Organisation Intersex International Australia. 21 February 2013.
  51. ^ a b Asia Pacific Forum of National Human Rights Institutions (June 2016). Promoting and Protecting Human Rights in relation to Sexual Orientation, Gender Identity and Sex Characteristics. Asia Pacific Forum of National Human Rights Institutions. p. 70. ISBN 978-0-9942513-7-4.
  52. ^ Template:Fi icon"Laki naisten ja miesten välisestä tasa-arvosta annetun lain muuttamisesta".
  53. ^ a b c "Deutsche Welle, "Third sex option on birth certificates", 1 November 2013". DW.DE. Retrieved 6 October 2014.
  54. ^ "OII Australia, "German proposals for a "third gender" on birth certificates miss the mark", 20 August 2013". OII Australia - Intersex Australia. Retrieved 6 October 2014.
  55. ^ "DISCRIMINATION (SEX AND RELATED CHARACTERISTICS) (JERSEY) REGULATIONS 2015". 2015.
  56. ^ Lawyers Collective. "Supreme Court recognises the right to determine and express one's gender; grants legal status to 'third gender'".
  57. ^ McCormick, Joseph Patrick (August 29, 2015). "India urged to include intersex people in bill protecting trans rights". Pink News.
  58. ^ "Indian silver medalist female runner at Asian Games fails gender test". International Herald Tribune. 18 December 2006.
  59. ^ "Indian runner fails gender test, loses medal". Sports.espn.go.com. 2006-12-18. Retrieved 2016-08-02.
  60. ^ "Shanti fails Doha gender test". The Telegraph. Calcutta, India. 18 December 2006.
  61. ^ "Medical experts doubt Pinki Pramanik can rape". Times of India. 14 November 2012. Retrieved 15 November 2012.
  62. ^ Court of Arbitration for Sport (July 2015). "CAS 2014/A/3759 Dutee Chand v. Athletics Federation of India (AFI) & The International Association of Athletics Federations (IAAF)" (PDF). Court of Arbitration for Sport.
  63. ^ Genel M; Simpson J; de la Chapelle A (August 4, 2016). "The olympic games and athletic sex assignment". JAMA. doi:10.1001/jama.2016.11850. ISSN 0098-7484.
  64. ^ "Ireland passes bill allowing gender marker changes on legal documents". GLAAD. Retrieved 12 September 2015.
  65. ^ "Gender Recognition Certificate". Department of Social Protection. Retrieved 13 November 2015.
  66. ^ a b Malta (April 2015), Gender Identity, Gender Expression and Sex Characteristics Act: Final version
  67. ^ Cabral, Mauro (April 8, 2015). "Making depathologization a matter of law. A comment from GATE on the Maltese Act on Gender Identity, Gender Expression and Sex Characteristics". Global Action for Trans Equality. Retrieved 2015-07-03.
  68. ^ Reuters (1 April 2015). "Surgery and Sterilization Scrapped in Malta's Benchmark LGBTI Law". The New York Times. {{cite news}}: |last= has generic name (help)
  69. ^ Dalli, Miriam (3 February 2015). "Male, Female or X: the new gender options on identification documents". Malta Today.
  70. ^ Regmi, Esan (2016). Stories of Intersex People from Nepal. Kathmandu.{{cite book}}: CS1 maint: location missing publisher (link)
  71. ^ Department of Internal Affairs. "General information regarding Declarations of Family Court as to sex to be shown on birth certificates" (PDF).
  72. ^ "Jaimie Veale - Academia.edu, "The prevalence of transsexualism among New Zealand passport holders, passports with an X sex descriptor are now available in New Zealand", 2008". Retrieved 6 October 2014.
  73. ^ "Open birth sex assignments do not reduce surgical interventions". Organisation Intersex International Australia. 4 November 2013. Retrieved 2014-12-31.
  74. ^ "Judicial Matters Amendment Act, No. 22 of 2005, Republic of South Africa, Vol. 487, Cape Town" (PDF). 11 January 2006.
  75. ^ O'Hara, Mary Emily (September 26, 2016). "Californian Becomes Second US Citizen Granted 'Non-Binary' Gender Status". NBC News. Retrieved September 26, 2016.
  76. ^ Rein, Lisa (27 October 2015). "Intersex applicants face passport discrimination, says lawsuit seeking option other than 'M' or 'F'". The Washington Post. Retrieved 1 December 2015.
  77. ^ "Intersex activist Dana Zzyym sues US State Department after having passport application denied". ABC News. 26 October 2015. {{cite news}}: |access-date= requires |url= (help)
  78. ^ interACT. "Federal Government Bans Discrimination Against Intersex People in Health Care". interactadvocates. Retrieved 2016-05-27.
  79. ^ Office for Civil Rights (OCR) (2016). "Section 1557 of the Patient Protection and Affordable Care Act" (Text). HHS.gov. Retrieved 2016-05-27.
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