The World Health Organization (WHO) has joined forces with UN Women, UN AIDS, UNICEF, the United Nations Population Fund, the United Nations Development Programme and the Office of the High Commissioner for Human Rights (OHCHR) to condemn the forced sterilization of transgender and intersex people in a groundbreaking report.
The report, ‘Eliminating forced, coercive and otherwise involuntary sterilization – An interagency statement,’ is the strongest statement in support of the rights of transgender and intersex people to be recognized as the gender they identify with without having to undergo invasive surgical procedures at a global level and was released on 30 May.
The report notes that voluntary sterilization is an important form of contraception in many parts of the world but condemns interventions against a person’s will or where people are coerced into sterilization to meet government guidelines.
‘Sterilization is an important option for individuals and couples to control their fertility,’ the report reads, ‘Sterilization is one of the most widely used forms of contraception in the world.’
‘ When performed according to appropriate clinical standards with informed consent, sterilization methods such as vasectomy and tubal ligation are safe and effective means of permanently controlling fertility.
‘However, in some countries, people belonging to certain population groups, including people living with HIV, persons with disabilities, indigenous peoples and ethnic minorities, and transgender and intersex persons, continue to be sterilized without their full, free and informed consent.
‘Sterilization without full, free and informed consent has been variously described by international, regional and national human rights bodies as an involuntary, coercive and/or forced practice, and as a violation of fundamental human rights, including the right to health, the right to information, the right to privacy, the right to decide on the number and spacing of children, the right to found a family and the right to be free from discrimination.
‘Human rights bodies have also recognized that forced sterilization is a violation of the right to be free from torture and other cruel, inhuman or degrading treatment or punishment.
‘International human rights bodies and professional organizations have explicitly condemned coercive population policies and programmes, noting that decisions about sterilization should not be subject to arbitrary requirements imposed by the government and that states’ obligations to protect persons from such treatment extend into the private sphere, including where such practices are committed by private individuals, such as health-care professionals.
‘Any form of involuntary, coercive or forced sterilization violates ethical principles, including respect for autonomy and physical integrity, beneficence and non-maleficence.’
It has been standard procedure in many countries for intersex infants (those born with characteristics that make their sex indeterminate) to be subjected to ‘corrective’ surgery to assign them a male or female gender after birth while many countries also force transgender people to undergo gender affirming surgery before they can be legally recognized as the gender they identify with.
Many intersex people who have been subjected to such surgical interventions have found in puberty that they have been assigned a gender that they do not feel is correct for them.
‘Some groups, such as transgender and intersex persons, also have a long history of discrimination and abuse related to sterilization, which continues to this day,’ the report notes.
‘Such violations are reflected, for example, in the various legal and medical requirements, including for sterilization, to which transgender and intersex persons have been subjected in order to obtain birth certificates and other legal documents that match their preferred gender.
‘Intersex persons, in particular, have been subjected to cosmetic and other non- medically necessary surgery in infancy, leading to sterility, without informed consent of either the person in question or their parents or guardians. Such practices have also been recognized as human rights violations by international human rights bodies and national courts.’
This is the strongest statement to date by the WHO who still classify transgender people as suffering from ‘Gender Dysphoria / Gender Identity Disorders.’
New WHO guidelines are due to be released in 2015 and transgender rights activists around the world are hoping the organization will adopt non-pathologizing language when they are released.