Intersex Activism, Medical Power/Knowledge and the Scalar Limitations of the United Nations

Abstract

This article considers the extent to which human rights mechanisms can ameliorate intersex rights at a sub-national, or medico-local, level. It engages with both intersex activism and the academy where the United Nations (UN) has become understood as a key mechanism through which to challenge day-to-day practices of healthcare practitioners and bring an end to nontherapeutic surgical and hormonal interventions on intersex infants and children. Using the UK as an example, this article examines how and why the UN’s engagement with intersex has had little effect on the medical regulation of intersex people. To do so, the article draws on legal geography to examine how scale prevents the UN from having a clear and lasting impact on domestic issues – particularly those in healthcare settings. The different ways in which intersex bodies are recognised and regulated at different scales, coupled with the UN’s inability to form dialogue with the institutions of the state, such as the healthcare profession, are problematic barriers to challenge practice at the medico-local scale.

Intersex Epistemologies? Reviewing Relevant Perspectives in Intersex Studies

“…The reviewed authors describe the engagement of regional and international human rights bodies with intersex issues, such as the UN, the Council of Europe, the European Parliament, or the Inter-American Commission on Human Rights, analyzing their resolutions and recommendations (Bauer et al 2020;Carpenter 2020;Garland and Travis 2022;Garland et al 2022;Pikramenou 2019;Ravesloot 2021;Sterling 2021;Travis 2015;Winter Pereira 2022;Zelayandía-González 2023). They also review the implementation of their recommendations in national contexts (Carpenter 2018b;Duggan and McNamara 2021;Garland and Travis 2022;Ní Mhuirthile et al 2022;von Wahl 2021).…”

“…605-6). Garland et al (2022) analyze the limitations that intersex-related UN recommendations face in their local implementation, specifically the prohibition of non-consensual surgeries and other medical treatment on intersex minors, framing them as "Scalar Limitations" (p. 1). Travis (2015) reviews the protection of intersex rights in EU anti-discrimination law.…”

“…Several of the reviewed authors echo these critiques and debates, discussing critically the role, limitations, and contradictions of legal third sex/gender categories (Botha 2018;Carpenter 2018b;Carpenter and Jordens 2022;Cossutta 2018;Garland and Travis 2022;Schotel and Mügge 2021;Travis 2015;von Wahl 2021). Cabral highlight that "assigning intersex people to a third sex category purifies the standard gender framework of non-standard embodiments, rendering them as an abject 'other', distinguished from endosex men and women" (p. 192) and conclude: "Ultimately, we hope for a future where legal gender markers are irrelevant, or no longer legally required at all" (p. 196).…”

Intersex Interventions as Human Rights Violations: The European Court of Human Rights Sets Out Guiding Principles in M v France

“…One such example is the United Kingdom, which refrains from enacting special legislation, but rather maintains that the responsibility to evaluate the appropriateness and necessity of interventions lies in the hands of medical professionals. 52 In the words of Garland, Lalor and Travis, this ambiguity leads to a 'shift in responsibility' from the state and public authorities to the individual medical expert. 53 Such national approaches could come under further scrutiny in the light of M v France, which connects these interventions to the non-derogable prohibition of torture and ill-treatment, clearly prompting Member States' obligations of due diligence.…”

The Growing Visibility of Intersex Demands at the United Nations: A Review of the Treaty Bodies’ Concluding Observations

“…A notable exception is the work of Saskia Ravesloot (2021), who has followed the inclusion of intersex issues in the recommendations of the Human Rights Council's Universal Periodic Review, looking specifically at the nature, content, and framing of such recommendations. More recently, Garland et al (2022) also analysed the barriers and challenges in transposing international recommendations into domestic change. My research aims to expand the current literature on intersex activist groups' engagements with international institutions and supplement existing gaps concerning UN treaty bodies.…”