Intersex: How to Distinguish Medical Crimes from Health Care

Zwischengeschlecht.org on FacebookIGM = CRIME, Not 'Health Care' or 'Therapy'!It’s important to challenge paediatricians and other actors trying to masquerade serious human rights violations as “legitimate medical therapy” – particularly now that IGM perpetrators are aware they’re increasingly in the public spotlight, and as a result are doubling their efforts to muddying the waters.
However, with the wide range of different interventions on intersex children, and the many different forms of IGM practices, not every procedure is always easy to ascertain.

Nonetheless, in most cases this can be done quickly enough:

To determine whether a procedure performed on a child or person with intersex variations is legit or criminal, from an international human rights perspective it’s helpful to differentiate between 1. medical crimes, 2. rehabilitation for survivors and 3. genuine intersex specific health care – and to examine if the procedure in question falls into one of these categories:

  1. Medical crimes = all involuntary, non-urgent procedures imposed because of an intersex variation, including sterilising, feminising, masculinising, surgical, hormonal and other procedures = serious violations of non-derogable human rights as recognised by UN Treaty bodies, including genital mutilation, cruel, inhuman and degrading treatment falling under the prohibition of torture, harmful practices, non-consensual scientific and medical experimentation, institutionalised violence

  2. Rehabilitation = all voluntary procedures needed as a result of previous serious violations because of an intersex variation, including adequate trauma counselling = in itself also a non-derogable right

  3. Health care = all voluntary and/or urgent procedures needed because of an intersex variation, including adequate psychosocial and peer support for persons concerned and families

If one of the above categories applies, the nature of a procedure on a child or person with intersex variations can then be identified accordingly:

a)    If the procedure falls under 1., it’s a medical crime (which according to international law must be investigated, perpetrators prosecuted and punished, and victims ensured access to redress and justice, including adequate compensation and as full rehabilitation as possible). 

b)    If the procedure falls under 2. or 3., it’s legit.

Particularly in a human rights context, it’s further important to note that despite that all procedures under 1.–3. invariably take place in health care settings, and despite that legit procedures under 2. Rehabilitation also do help stabilising or improving health and can (and should!) legitimaly be offered as health care, only if a procedure falls under 3., it’s actually (intersex specific) health care and therefore a genuine health care issue, and ONLY THEN it should be framed and addressed accordingly.

On the other hand, all procedures falling under 1. Medical crimes or 2. Rehabilitation should NEVER be misrepresented as “health care issues”, but MUST ALWAYS be correctly framed and addressed under overriding (!) serious violations of non-derogable human rights and the non-derogable obligation of states to protect every child and person from such serious violations including genital mutilation and cruel and inhuman treatment, and to ensure redress for victims, including access to justice, adequate compensation, and as full rehabilitation as possible, as enshrined in various international human rights treaties recognised as applicable by the relevant UN Treaty bodies, namely CAT, CRC, CCPR, CRPD and CEDAW (however not CESCR, which does not include non-derogable rights).

(And only after the overriding serious violations of non-derogable human rights because of IGM have been firmly established and addressed, thereafter the consequential implications of IGM also in lower-ranking human rights law and corresponding fields can then be addressed adequately, including implications on health care, which can then also be addressed according to the right to the highest attainable standard of health enshrined in various conventions, now also beyond the most relevant ones covering non-derogable rights, see above CAT, CRC, CCPR, CRPD, …)

>>> Intersex human rights at the UN are under attack!!!

See also:
26 UN Reprimands for IGM – and counting …
“Harmful Medical Practice”: UN, COE, ACHPR, IACHR condemn IGM
UN Committee for the Rights of the Child (CRC) 2015: IGM = Harmful Practice
UN Committee against Torture (CAT) 2015: IGM = Inhuman Treatment or Torture
UN Human Rights Committee (CCPR) to examine IGM Practices
UN Committee on the Rights of Persons with Disabilities (CRPD) condemns IGM
56th Session of Committee against Torture reprimands 4 Governments for IGM
CAT 2011: Germany must investigate IGM practices and compensate survivors!

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