INTERACTIVE DIALOGUE ON THE RIGHT TO HEALTH

France was in favour of decriminalizing homosexuality and abortion all over the world.

International Lesbian and Gay Association in a joint statement with Federatie van Nederlandse Verenigingen tot Integratie Van Homoseksualiteit – COC Nederland; and Swedish Federation of Lesbian, Gay, Bisexual and Transgender Rights – RFSL,

We commend the Special Rapporteur’s particular focus on the situations of trans and intersex persons. Trans and gender non-binary individuals are often deliberately or effectively denied the possibility of participation in professional sport. Lack of gender recognition laws based on self-identification, and laws criminalising trans people (either directly or indirectly), greatly restrict access to sport. Severe problems are posed by sex segregation policies, as well as arbitrary and unwarranted classifications of male and female. Policies must reflect international human rights norms, and should not require irrelevant clinical data or unnecessary medical procedures as a precondition to full participation. On a more practical level, States must remove barriers to participation, such as poorly designed changing rooms, requirements to wear clothing that might cause individual discomfort or hinder bodily movement, and restrictions on the use of sex-segregated bathrooms.

We welcome the call for consensus to be reached among all international sporting bodies and national governments on trans and gender non-binary participation in sporting competitions to reflect international human rights norms and do away with medical procedures as a precondition to full participation.

For intersex persons, a variety of ‘sex tests’ conducted to avoid the supposed risk of participating under an assumed gender to obtain a competitive advantage are a grave problem. No single test determines gender, and there is insufficient clinical evidence to establish that, for example, women with higher levels of testosterone, have a ‘substantial performance advantage’ justifying their exclusion. These tests lead to stigmatization, provide a false basis for exclusion from competitive sport, and have led to women athletes being forced or coerced into ‘treatment’ for hyperandrogenism, including unnecessary irreversible and harmful surgeries amounting to female genital mutilation. Sporting organisations must act to ensure that their policies prohibit such practices and states must guarantee this aspect of intersex persons health rights.

In the report regarding adolescents, the Special Rapporteur highlights that adolescence is an especially important time for exploration and understanding of sexuality, sexual orientation and gender identity. States should respond to the specific challenges faced by LGBTI adolescents, and mandatory school curriculum should include comprehensive and inclusive sexuality education, based on scientific evidence and human rights, with special attention given to sexuality, gender identity –including non-conforming gender identities –and sex characteristics.

Health services for adolescents, in particular those for sexual and reproductive health, must be sensitive to gender identity, sexual orientation and sex characteristics. They must be non-judgemental, treating all teenagers with dignity and respect to ensure that LGBTI adolescents do not suffer stigma, discrimination, violence, rejection by families, criminalisation and other human rights violations when seeking sexual and reproductive health services. We welcome the call to reform National Health information systems to include human rights concepts and variables, such as lesbian, gay, bisexual, intersex status. However we emphasise that transgender status should also be included.

The report notes that LGBTI adolescents are at heightened risk of mental ill-health, not least because of continued use of abusive “conversion therapies” and “treatments.” We join the Special Rapporteur’s call on States to eliminate such practices and to repeal all laws criminalising and discriminating against individuals on the basis of their sexual orientation, gender identity and expression, and sex characteristics.

We are pleased to note the Special Rapporteur’s reference to the specific hardships that intersex adolescents often experience due to irreversible and non-consensual genital and reproductive surgeries performed during their early childhood because of the natural development of their bodies. These situations may be compounded by discrimination within the family and society, and by healthcare providers, who often also lack awareness of the needs of this population and that these irreversible childhood surgeries constitute human rights violations.

We ask the Special Rapporteur whether he agrees that States should provide trans adolescents with access to gender transition-related services, affirmative counselling, balanced information and support, age-appropriate hormones and puberty blockers, and progressive steps towards self-identification of their genders.

Mr. Puras, the Special Rapporteur on the Right to health, underlined that traditions and values, while often useful, could also be used as a pretext to violate rights, for example the concept of traditional family values, which was sometimes contradictory with human rights norms and standards, as it was used to justify acts against the wellbeing of children, including various forms of violence against women, girls and children in general. In terms of measures to improve the health of adolescents, the common denominator was the recognition of their rights: the right to information, freedom of expression and opinion, protection from violence, the right to dignity, and the right to bodily integrity. The mandate took seriously the violation of rights of lesbian, gay, bisexual, transgender and intersex persons, including adolescents, and said that it was detrimental to societal health and cohesion. The Special Rapporteur stressed that models based on excessive hospitalization and medicalization must be replaced with systems centered on prevention and full participation by adolescents.