Tuesday, July 26 2011

Shadow Report CEDAW 2011

>>> deutsch      >>> http://intersex.schattenbericht.org

Shadow Report to the 5th and 6th National Report of the the Republic of Costa Rica on the United Nations Convention on the Elimination of All Forms of Discrimination Against Women (CEDAW), 27.06.2011

>>> Download as PDF (238 kb)

Compiled by:
IGLHRC
MULABI
Natasha Jiménez

This Shadow Report was considered by the 49th Session of the Committee on the Elimination of Discrimination against Women (CEDAW) in New York, July 11-29 2011.

The entry on Intersex Genital Mutilation on p. 8-11 of the shadow report:

Intersex People (9) and the Right to Health:

An intersex condition is much more common than most people are aware. For instance, 1.7% of the world population is intersex; 1 of every 200 births is of an intersex person; and there are as many intersex people in the world as people with red hair. (10) The typical medical response to an intersex condition is medical intervention. Yet, sex assignment surgeries performed in intersex persons create feelings of betrayal, mistrust and depression. (11)

In the past, the prevailing opinion in medical circles was that it was best to assign a sex to an intersex child as soon as possible, often on the basis of the child’s external genitalia and not even related to their chromosomal make-up. Parents were instructed that there should be no ambiguity in their minds about their child’s sex. Surgery was quickly scheduled to extirpate the testicular or ovarian tissue of the “undesirable” sex with irreparable consequences in relation to reproductive capacity.

The aim of surgery was allegedly to normalize the genitals and prevent suffering later in life because of lack of conformity with binary sexual standards.

As a general rule, female genitals were considered more easily “rebuildable” than functional male ones, so whenever the “right” choice was not evident, a child was assigned to the female sex.

Most intersex children in Cost Rica undergo surgical intervention before reaching two years of age. The most common manifestation of intersexuality treated at the Hospital Nacional de Niños (National Children’s Hospital) is congenital adrenal hyperplasia, detected through tests performed four days after a baby is born. 12 But in spite of the good intentions of the interdisciplinary team of the National Children’s Hospital, intersex persons suffer as a result of the scars and insensitivity produced by surgery (among other consequences)

In 2006, the American National Academy of Paediatrics recommended that sex assignment surgeries cease to be performed on intersex children.
Yet the Assistant Director of the National Children’s Hospital stated in an interview with newspaper Al Día that the notion that intersex persons could choose their gender and sex when reaching adolescence was inaccurate and solely promoted by extremists. (13) Mulabi / Latin American Space for Sexualities and Rights, the International Gay and Lesbian Human Rights Commission and others are concerned that the hospital has disregarded the recommendation of the national authority on pediatric care and is performing discredited surgeries. Furthermore, these organizations argue for the right to self-determine one's own body and for the need to stop the practice of surgeries that attempt to “normalize” bodies, particularly on children who cannot consent, based on subjective criteria.

Though experts the National Children’s Hospital report that five to ten children per year are born with genital ambiguity, there are few documented cases. However the Urology Journal of San Juan de Dios Hospital, reported the account of 16 year old boy with congenital adrenal hyperplasia (one of many manifestations of intersexuality). Doctors wanted to perform a bilateral orchidectomy (the surgical removal of both testicles) on him and then insert a prosthesis but the boy himself and his family did not allow the procedure. (14)

This kind of interventions for the sole purpose of conforming the bodies of intersex people to social standards of gender binary, and their implications for the reproductive, psychological and physical integrity are a clear violation of Article 12 of the convention.

(9) Intersex Persons: Some babies are born with genitalia and reproductive organs that do not fit with the patterns culturally accepted as defining “female” or “male” anatomy. The older term for this disease –hermaphroditism‐ blends together the names of a Greek god and goddess, Hermes and Aphrodite. Hermes was the god of male sexuality (among other things) and Aphrodite the goddess of sexuality, love and female beauty.
(10) Fausto‐Sterling, Anne (2000) Sexing the body: gender politics and the construction of sexuality. Basic Books. NewYork.
(11) Cabral, Mauro (2009) Interdicciones
(12) Congenital Adrenal Hyperplasia refers to a group of hereditary disorders affecting the adrenal glands. Congenital suprarenal hyperplasia can affect both boys and girls. People suffering this condition lack an enzyme required by the suprarenal gland to produce the cortisol and aldosterone hormones. Without these hormones, the body produces more androgens, a type of male sexual hormone, causing the early (or inappropriate) onset of male characteristics. About 1 of every 10,000‐18,000 children are born with congenital suprarenal hyperplasia.
(13) Interviewed by journalist Franklin Arroyo, from newspaper Al Día. (http://www.mentesana.net/tag/genitalidad‐ambigua/)
(14) Urology Journal at BINASS (Biblioteca Nacional de Salud y Seguridad Social de la Caja Costarricense de Seguro Social) http://www.binasss.sa.cr/revistas/rmcc/563/art11.htm

The recommendation Re: Intersex Genital Mutilation on p. 13 of the shadow report:

That corrective or sex assignment surgeries cease to be the preferred option for treating intersex children at the National Children’s Hospital, and that the parents of these children are supported by specific counselling and orientation groups that will provide them with the necessary tools to deal with this situation in the best way possible, always having the best interests of the intersex person as a guiding principle. One way to achieve this is by implementing a care policy for the intersex population that will allow them to decide in the future the best way to be followed because it is their lives that are being affected.

Note: Unfortunately, in its >>> Concluding Observations (PDF, 68 kb) the Committee only mentioned intersex once, and as a "tail light" to LBT, furthermore criticising "abuse and mistreatment by health service providers" and calling for "appropriate training" to "health service providers, in order to avoid abuse and mistreatment of these women" (CEDAW/C/CRI/CO/5-6, see p. 9 para 40-41).

In September 2012, the UN Office of the High Commissioner for Human Rights (OHCHR) referenced para 40 in its publication >>> "Born free and equal" (PDF 1.7 mb) with regards to the the following statement:

Statement by OHCHR Re: Intersex Genital Mutilation in "Born Free and Equal", p. 51:

"In addition, intersex children, who are born with atypical sex characteristics, are often subjected to discrimination and medically unnecessary surgery, performed without their informed consent, or that of their parents, in an attempt to fix their sex."

>>> OHCHR: "Born free and equal" (HR/PUB/12/06, PDF 1.7 mb)

Monday, November 22 2010

Shadow Report CESCR 2010

>>> deutsch      >>> http://intersex.schattenbericht.org

Shadow Report to the 5th National Report of the Federal Republic of Germany on the United Nations Covenant on Social, Economical, and Cultural Human Rights (ICESCR)
(Incl. Addendum - Case Studies)

>>> Download as PDF (175 kb)

>>> Executive Summary 

Compiled by:
Intersexuelle Menschen e.V. / XY-Frauen
Association of Intersexed People / XY-Women

On November 2r3d 2010, a Delegation of Intersexuelle Menschen e.V. presented this Shadow Report to the UN-Committee in Geneva preparing the 46th Session in Geneva in May 2011. 

Monday, July 21 2008

Shadow Report CEDAW 2008

>>> deutsch      >>> http://intersex.schattenbericht.org

Shadow Report to the 6th National Report of the Federal Republic of Germany on the United Nations Convention on the Elimination of All Forms of Discrimination Against Women (CEDAW)

>>> Download as PDF (606 kb)


>>> Executive Summary      >>> as PDF (119 kb)

Compiled by:

Intersexuelle Menschen e.V. / XY-Frauen
Association of Intersexed People / XY-Women


On July 21st 2008, a Delegation of  Intersexuelle Menschen e.V. presented this Shadow Report to the UN-Committee in New York preparing the 43rd Session in Geneva in January 2009.

Executive Summary

1. Summary
2. Questions to the German Federal Government
Table of Contents Shadow Report CEDAW 2008

Introduction / Summary

On the basis of the beliefs and experiences of the authors, this shadow report is devoted to revealing the denied human rights of intersexual persons as they are standardized in the UN Convention on the Eliminate all forms of Discrimination Against Women (CEDAW), and respectively, in conjunction with Article 3 CEDAW, as well as other UN human rights treaties.
 
According to the legal point of view of by the authors of this report, CEDAW embraces the protection against discrimination, of all persons who are physically and clearly not belonging to a male gender. Only through this expansive comprehension can it be assured that this protection will be fulfilled for people who have been falsely assigned to a male or female gender. According to the views ond experiences of the authors the implementation of an effective protection of persons who have been defined as intersexual or “DSD” (Disorder of Sexual Development) is not given through medical science.
 
Within intersexual people both, female and male physical characteristics can be found. But next to the variety of their sex chromosomes and/or genitalia, in the majority of cases, no further pathological criteria exist. Despite, in Germany as well as in numerous other countries, intersexual persons are target of irreversible medication and surgery from early childhood on. Consequently, these medical interferences result in life-long obligatory medical treatment.
 
In the majority of cases, intersexual children will be medically treated in order to visually and mentally adjust them to what is perceived as being “female” in the respective cultural contexts. This is done although a medical indication as well as a quality control is completely absent. There are also cases however in which medical scientists try to adjust intersexual persons to a male gender. This then includes the wrongful extraction of completely intact female genitals and sexual organs, with brutal consequences concerning the possibility of motherhood, selfperception and body image, as well as sexual self determination.
 
It is a fact that these persons are forced into a gender whereby they loose their natural, individual development potential. The necessity of medical interferences is justified through social aspects, for instance, the concern that the intersexual child without clearly defined sexual characteristics could become a victim of sexual discrimination.
 
Official estimates classify approximately 80,000 - 120,000 people who live in Germany today, with a medical classification of being “intersexual” (“DSD”, Disorder of Sexual Development).
 
CEDAW prohibits every form of discrimination on the basis of gender: “the term ‘discrimination against women’ shall mean any distinction, exclusion or restriction made on the basis of sex” (Article 1). This poses the duty onto the member states “to take all appropriate measures to eliminate discrimination against women by any person, organization or enterprise” (Article 2). Thereby, CEDAW already calls for the contracting state: “to modify the social and cultural patterns of conduct of men and women, with a view to achieving the elimination of prejudices and customary and all other practices which are based on the idea of the inferiority or the superiority of either of the sexes or on stereotyped roles for men and women”. From the perspective of intersexual persons, this modification to eliminate sexual stereotypes as well as the construction of a binary order in which only women and man exist, is essential for the life and survival of intersexual persons.
 
The aim of this shadow report is to clarify the physical, psychological and social situation of intersexual people in Germany, with the goal of a full-fledged realization and implementation of the human rights of all intersexual persons. Germany, as a contracting party to CEDAW, may no longer ignore the massive infringements and violations of human rights of intersexed people. Germany is obliged to undertake “all appropriate measures, including legislation, to modify or abolish existing laws, regulations, customs and practices which constitute discrimination against women” (Article 2) in order to make sure that women can execute their rights and freedoms.
 
In its sixth state report to CEDAW the German German Government gives no attention to the concerns of intersexual persons. Therefore, with the shadow report the authors express their hope that CEDAW confronts the German government face to face with the issue, and encourages that they will care for the full implementation of the human rights of intersexual persons (in alliance with Art. 3 CEDAW as well as other human rights norms and treaties of the United Nations).
 
The intersexual women provide their own shadow report because of the very specific forms of violence and discriminations they are exposed to. Nevertheless, in the preparation process of German shadow reports to CEDAW, the intersexual women were linked to and part of the NGO platform who compiled the main alternative report to CEDAW (the German Women`s Council).
 
Intersexuality touches on a multitude of universal human and women’s rights. This report concentrates on depicting human rights violations on the basis of lacking implementation of Articles 1-5 (underlying principles of the CEDAW Convention: Equality, Non-Discrimination and State Obligation), Article 10 (Education), Article 12 (Health) and Article 16 (Marriage and Family).
 
All human rights are universal, interdependent and interrelated. Following Article 28 of the Universal Declaration of Human Rights (UDHR), “every human being is entitled to a social and international order in which the rights and freedoms can be fully realized”. Also CEDAW stressed in the Preamble, “…that all human beings are born free and equal in dignity and rights… without distinction of any kind, including distinction based on sex”. This gives a reason to hope for a recognition of intersexual people who need help and support for the respect, the protection and fulfillment of their rights.
 
Given the sense of universal and interdependent human rights, the concerns of intersexual people will need to be communicated to other UN treaty bodies [particularly to the Human Rights Committee, the Committee on Economical, Social and Cultural Rights, to the Children’s Rights Committee (CRC) and the Committee Against Torture (CAT)] as well as to the Special Rapporteurs for the protection against torture and violence against women and children.

Questions to the German Federal Government

1. What will the German Government undertake to ensure that the dignity and right to a life free of discrimination (Article 1 in connection with Article 3 CEDAW) also becomes possible for intersexual people?

2. When will the German Government acknowledge the reports of NGOs, representatives of self-help groups and existing research results concerning the living condition of intersexual women / people, and take up a dialog with the affected persons, their associations and self-help groups?

3. In what sort of time frame will the German Government undertake steps to make sure the medical standards of treatment for intersexually born persons are congruent with the requirements of the ratified UN contracts?

4. When will the medical professional societies be asked by the German Government to introduce standards of treatment free of discrimination under active inclusion and participation of the affected persons?

5. When and how will the German Government ensure, that intersexual people are requested to make a decision on which sex / gender they belong to, no sooner than when they themselves are fully able to make this decision?

6. What will the German Government undertake to make sure that in the future no irreversible medical interventions at intersexual people occur without their own informed decision ?

7. When and how will the German Government introduce a human rights based treatment of intersexual persons and guarantee it permanently, so that no more discrimination occurs from laws and orders?

8. When will the German Government introduce the concept of the sexual variations in their legislation and ordinances?

9. Which laws will the German Government update, acknowledging the existence of intersexual persons and when?

10. When will the German Government acknowledge the victims of irreversible surgery and medical experiments and grant them legal advice, legal security and an integration within the social order?

11. Will the German Government promote binding laws, free of discrimination, which guarantee the intersexually born the same access to medical achievements as all people?

12. What will the German Government do during the next four years for the construction of specified competence centers and for the education of trained professional staff for the treatment of intersexual people?

13. What will the German Government undertake during the next four years to educate consultation teams with the participation of intersexual people?

14. How will the Government legally regulate the limitation of claims for compensation for damages due to the withholding of medical documents and information?


15. How will the German Government make sure that intersexual persons are admitted an observer status with all scientific studies concerning their minority?

16. Will the German Government during the next four years promote or support a truth commission which contributes to the public awareness and which regulates the compensation (according to Canadian model) of intersexual people injured by medical treatment or non-treatment?

17. In which way and when will the German Government compensate the disadvantages which intersexual people have suffered by the treatments?

18. When will the German Government define which physical and psychological damages due to the false treatment of intersexual people correspond to the degree of impediment / decrease of the capacity to work ?

19. When will the German Government remove the existing discriminations of intersexual persons in civil status law and marriage law?

20. When will the German Government put on new research projects (as e.g., the research group Hamburg) or continue investigating the situation of intersexual adults extensively, and when will these results show clear effects for intersexual persons?

Table of Contents Shadow Report CEDAW 2008

>>> Executive Summary      >>> Downloads

Introduction / Executive Summary   5

Questions to the German Federal Government   7

1.       Preamble and Article 1-5 CEDAW   9
1.1     Definition - What is Intersexuality?   9
1.2     Denial and Ignorance of the German Government   10

2.       Article 5a 10c (Education)   11
2.1     Prof. Dr. John Money`s Gender Theories and their Violations to Human Rights   11

3.       Article 12 (Health)   12
3.1     Problems in Parents - Child Relations   12
3.2     Medical Experiments on Human Beings   13
3.3     List of Human Rights Violations as a Result of the Treatment according
           to the “Standards" developed by Prof. Dr. John Money   13
3.3.1  Removal of Gonads (Castration)   13
3.3.2  Genital Amputation   14
3.3.3  Effective Protection of Rights   14
3.3.4  Documentation of Treatment   15
3.3.5  Irreversible Genital Surgery of Minors and Adults   15
3.3.6  Off–Label Use of Pharmaceuticals   15
3.3.7  Consequences of Treatment in Scope of Medical Definition   16

4.       Article 16 (Marriage and Family)   16
4.1     Violation of the Preeminence of the Best Interest of the Child and
           the Protection of the Identity of the Child   17
4.2     Illegal Concealment and Denial of Access to Medical Records   17
4.3     Equal Right to Marriage   18

5.       Special Mechanisms   18
5.1     A Possibility of Reconciliation: Truth Commission to Raise Awareness
           on the Violation of Women’s and Human Rights of Intersex People   18

6.       Claims and Recommendations   19
6.1     The Claims of the Persons Concerned   19
6.2     Necessary Aid Programs for Persons   20

Addendum - Case Studies   21
1. Case Study “Nella”   22
2. Case Study “Christina T.”   26
3. Links   30
4. Prof. Dr. Milton Diamond / Assistant Prof. Hazel Glenn-Beh: “An Emerging
    Ethical and Medical Dilemma: Should Physicians Perform Sex Assignment on
    Infants with Ambiguous Genitalia?”   33

Apendix (German Texts)
5. The “Medical Standard“ according to Prof. Dr. John Money   84
6. Intersexualität. Die alltägliche Folter in Deutschland. Ein Forschungsbericht,
    Humboldt University, Berlin   86
7. Answer of the German Federal Government to a Parliamentarian question
    on the issue of intersexuality (dealt with in writing); 2001/2007   128

A4. CEDAW 2008 Link List

Links – Intersexuality


Associations and Self-Help-Groups
www.intersexuelle-menschen.net
www.xy-frauen.de
www.swyer.de
www.ags-initiative.de
www.bodieslikeours.org
www.intersex.ch
www.101intersex.de
http://hometown.aol.de/Querkreuzer/000inhaltsverzeichnis.htm
http://web.archive.org/web/20010710070555/http://home.t-online.de/home/aggpg/chron.htm
www.hermaphroditos.de
http://genderfreenation.de
http://blog.zwischengeschlecht.info
http://www.intersexualite.org/Deutsch-Index.html#anchor_640

Christiane Völling
http://blog.zwischengeschlecht.info/post/2008/02/07/Sieg-fur-Christiane-Volling
http//www.sueddeutsche.de/panorama/artikel/930/156517/
http://www.faz.net/s/Rub8E1390D3396F422B869A49268EE3F15C/Doc~EDF4E310F3A40486F8D5016D4CDBCA912~ATpl~Ecommon~Scontent.html
http://www.3sat.de/3sat.php?http://www.3sat.de/kulturzeit/themen/123354/index.html
http://www.ruhrnachrichten.de/nachrichten/nrw/art1544,137587
http://www.focus.de/panorama/welt/prozess_aid_229141.html
http://oii-usa.blogspot.com/2008/02/press-release-congratulations-to.html
http://www.rbb-online.de/polylux/druckversion/index.jsp?key=rbb_beitrag_mini_7179468
http://www.spiegel.de/spiegel/0,1518,517983-3,00.html
http://www.tagesanzeiger.ch/dyn/wissen/medizin/838827.html

German Federal Government
http://209.85.129.104/search?q=cache:nU48w9BTA6IJ:dip.bundestag.de/btd/14/056/1405627.pdf

Research and Sciences
www.forschergruppe-intersex.de
www.netzwerk-is.de
www.nichtdnet.psych.psu.de
www.uke.uni-hamburg.de
www.forschergruppe-is.uk-sh.de

Law
http://www.zerp.uni-bremen.de/deutsch/pdf/plett_intersexualitaet.pdf
http://www.justiz.nrw.de/nrwe/lgs/koeln/lg_koeln/j2008/25_O_179_07grundurteil20080206.html
http://www.netzwerk-is.uk-sh.de/is/fileadmin/documents/publikationen/Kipra505_UdeKoeller.pdf
http://de.indymedia.org/2007/11/199653.shtml
http://www.lobby-fuer-menschenrechte.de/Intersexualitaet02.php#top4
http://www.lobby-fuer-menschenrechte.de/Intersexualitaet02.php#top21
http://edoc.hu-berlin.de/miscellanies/menschenrechte-27763/5/PDF/5.pdf

Reports, Films, Texts
http://images.zeit.de/text/2000/40/200040_intersexneu.xml
http://www.die-katze-ist-kein-vogel.de/intersex/nur%20INTERSEX.pdf
http://www.das-verordnete-geschlecht.de/portrait.htm

Truth Commissions

South Africa:
www.doj.gov.za/trc/legal/act9534.htm
www.doj.gov.za/trc/media/1999/9903/s990304k.htm
www.fxi.org.za/archive/Linked/update/9510/html5.htm
www.csvr.org.za/papers/papr2r2.htm
www.csvr.org.za/papers/papr2r1.htm
www.info.gov.za/gazette/bills/2003/b34-03.pdf
www.info.gov.za/gazette/bills/2003/b34b-03.pdf
www.lrc.org.za/Focus_Areas/TRC.asp

Wikipedia:
http://en.wikipedia.org/wiki/Truth_commission

Canada:
www.irsr-rqpi.gc.ca/english/truth_reconciliation_commission.html
www.hiddenfromhistory.org

Liberia:
www.ictj.org/static/Africa/Liberia/liberiatrcact.eng.pdf

Ost-Timor:
http://de.wikipedia.org/wiki/Wahrheits-_und_Freundschaftskommission_%28Osttimor%29

Sierra Leone:
www.sierra-leone.org/trcbook-TRCAct.html

Peru:
http://de.wikipedia.org/wiki/Kommission_f%C3%BCr_Wahrheit_und_Vers%C3%B6hnung_%28Peru%29
and www.cverdad.org.pe

Fiji:
http://en.wikipedia.org/wiki/Reconciliation_and_Unity_Commission_%28Fiji%29

Argentinia:
http://en.wikipedia.org/wiki/Comisi%C3%B3n_Nacional_sobre_la_Desaparici%C3%B3n
http://www.nuncamas.org/english/library/nevagain/nevagain_001.htm

Marocco:
http://en.wikipedia.org/wiki/Equity_and_Reconciliation_Commission_%28Morocco%29
http://www.ier.ma/

Guatemala:
http://en.wikipedia.org/wiki/Historical_Clarification_Commission

Chile:
http://en.wikipedia.org/wiki/Rettig_Report

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