Opinion

Understanding intersex challenges: Expanding policy and legal avenues

To honour equality and human dignity we need to re-evaluate our cultural narratives and institutional frameworks which perpetuate discriminations against intersex individuals

By Arya Kharel and Esan Regmi

In the pride spectrum, 'intersex' individuals are often overlooked. Unlike other gender identities that revolve around sexual orientation, intersex is an umbrella term that refers to a range of biological variations in sex characteristics that do not fit the traditional definitions of male or female. Many South Asian parents see an intersex child as a punishment from the gods for their sins in past lives. These cultural and religious beliefs compounded by lack of understanding and societal pressure influence the decisions of both parent and medical professionals, often resulting in either abortion or 'correction' of intersex variations to align with binary norms. These medical practices, performed without informed consent, specifically in infancy or childhood, further complicates the problem; leading to physical and psychological harm. This action violates the right to bodily integrity and autonomy, protected under Universal Declaration of Human Rights (UDHR) and the International Covenant on Civil and Political Rights (ICCPR).

Additionally, non-consensual medical procedures and the disclosure of an individual's intersex status can lead to breaches of privacy and confidentiality, violating the protections outlined in the Convention on the Rights of the Child (CRC). Furthermore, the right to health, guaranteed under Article-12 of the International Covenant on Economic, Social and Cultural Rights (ICESCR), is also compromised as many medical professionals lack adequate training on intersex variations.

Legal documentation is a major issue in many jurisdictions, including Nepal, as birth certificates and official records are limited to binary category. According to theOffice of the High Commissioner for Human rights (OHCHR), around 1.7 percent of the population is born with intersex traits. With no firm population figures for the people with intersex variations, data on intersex fetuses were abortedfor fear of stigma, lack of understanding of intersex variations and reliable mechanisms to collect data. Nepal's 2021 census didn't collect data on intersex population. This leads to difficulty in conducting research and becomes a challenge in providing state protection that caters to the need of the intersex populations. The rigidity gives rise to the absence of a suitable category for intersex individuals often resulting in bureaucratic hurdles and administrative oversight. This complicates the process of obtaining crucial identification documents, creating implications in school enrollment, employment opportunities, marriage, inheritance and family rights.

Here is a dilemma faced by an intersex person.'There are distinct male and female bathrooms, and I don't fit into any. The society sees me as one gender while your body presents characteristics of another. To avoid the discomfort, I refrain from drinking water in addition to prolonged withholding which led to serious issues like kidney stone.' This gap in gender-neutral facilities reflects the failure to be able to incorporate intersex experiences, reinforces exclusionary mechanisms and stigma.

On April 4 this year, the Human Rights Council adopted a resolution calling on the member states to enhance their efforts in order to combat discrimination, violence and other harmful practices against intersex people. It calls for action to address the root causes of discrimination, such as stereotypes, the spread of misconceptions and inaccurate information, stigma and taboos, and to work to fulfill the highest attainable standard of physical and mental well-being for the intersex community.

In Nepal, the first national gathering of intersex people was hosted on February 8-9, 2016. It brought together 13 intersex people of diverse gender identities and sexual orientations from across Nepal as well as representatives from the Ministry of Women, Children and Social Welfare, National Human Rights Commission of Nepal (NHRC), UNDP and UNICEF, as well as legal experts. Following this, in 2020, the intersex community of Nepal presented demands on gender recognition that included infants' right to a birth certificate marked as intersex, intersex people's right to change name and gender marker, ensure self-determination, use of correct gendered terms, ensure right to privacy on one's intersex status, medical records and personal gender history, ensure dignity, bodily integrity and autonomy, and the removal of obligatory 'other gender' or 'third gender' marking to intersex people.

The Committee on the Elimination of Discrimination against Women (CEDAW), in its recommendations to Nepal's sixth periodic report, urged the country to take important steps to protect intersex children and individuals from harm. These included laws to ban unnecessary medical procedures on intersex children until they are old enough to give their consent and training for medical professionals to understand the rights of intersex persons.

The government must ensure legal protection and social inclusion through the creation and enforcement of intersex-inclusive policies that align with Nepal's international commitments, including the CRC, the CEDAW and several UN Human Rights resolutions. Additionally, comprehensive research and awareness programmes can be launched at local, provincial and national levels. Complementing these efforts, the NHRC can take a proactive stance by investigating human rights violations against intersex individuals, focusing specifically on non-consensual and unnecessary surgeries performed on intersex children.

To honour equality and human dignity we need to re-evaluate our cultural narratives and institutional frameworks which perpetuate discriminations against intersex individuals so as to create a society which acknowledges the existence of intersex individuals while celebrating their inherent humanity.