MALTA: Ban on infant intersex surgery

The Star Observer (Australia)
April 2, 2015

Malta the first country to outlaw forced surgical intervention on intersex minors

MALTA has become the first country in the world to outlaw medical practitioners or other professionals from conducting any involuntary or coerced surgical intervention on minors with intersex variations.

The Gender Identity Gender Expression and Sex Characteristics Act was passed through Maltese Parliament with cross party support, without a vote, in the early of the morning in Australian time.

A first of its kind around the world, the passage of the bill has been met with praise by Organisation Intersex International (OII) Australia, along with various European intersex and trans* organisations.

The new law officially recognises the right to bodily integrity and physical autonomy and protects intersex infants and children from non-necessary medical interventions. These sorts of medical procedures still take place in Australia and around the world, with parental distress or improving marriage prospects as common reasons for it.

Malta’s Gender Identity Gender Expression and Sex Characteristics Act also meets several other key demands of the intersex movement, including the 2013 recommendations of an Australian Senate committee report.

The relevant part of the act reads:
“It shall be unlawful for medical practitioners or other professionals to conduct any sex assignment treatment and/or surgical intervention on the sex characteristics of a minor which treatment and/or intervention can be deferred until the person to be treated can provide informed consent: Provided that such sex assignment treatment and/or surgical intervention on the sex characteristics of the minor shall be conducted if the minor gives informed consent through the person exercising parental authority or the tutor of the minor.

“In exceptional circumstances treatment may be effected once agreement is reached between the Interdisciplinary Team and the persons exercising parental authority or tutor of the minor who is still unable to provide consent: Provided that medical intervention which is driven by social factors without the consent of the minor, will be in violation of this act.”

The Interdisciplinary Team will be appointed by the government, alongside a larger working group that includes human rights experts, to establish improved treatment protocols “in line with current medical best practices and human rights standards”.

The new Maltese law also provides for an administrative mechanism for the recognition of gender identity, and protection from discrimination for intersex and trans* people.

While OII Australia president Morgan Carpenter said he “warmly” congratulated the Maltese government and parliament, he urged Australian parliamentarians to pass similar legislation, as well.
“This is legislation that Australian governments should be enacting, to implement the recommendations of the 2013 Senate committee report on the involuntary and coerced sterilisation of intersex people,” he said.

“Non-necessary medical interventions still take place on infants and children with intersex variations, across Australia, for rationales that include managing parental distress, social stigma and even ‘improving marriage prospects’.

“These violate international human rights standards and Australian governments must act.”

Intersex people are born with bodies that don’t meet stereotypical expectations for male and female, including a range of genetic, hormonal and anatomical differences in sex characteristics. People with intersex variations have as diverse a range of gender identities as non-intersex people. 

MALTA: Parliament considering intersex protection

The Times of Malta
February 16, 2015

Healthy hermaphrodite’ is both man and woman

Castrated at seven – but now welcoming Malta’s stance on ‘intersex’

by Claudia Calleja
When Tony Briffa was seven years old doctors in Australia made a choice that was never theirs to make – castration.

Tony was born with healthy testes, as well as a vagina, and doctors decided it made more sense for Tony to live life as a woman – called Antoinette.

But Tony – who was born intersex – never felt comfortable being a woman, or a man for that matter.
“Nature – many would say God – made me a healthy hermaphrodite... I tried my best to be a woman but I couldn’t keep up the lie forever. Something was going to give.

“At 30 I rejected what the doctors had done to me and started living life as a man. I was open about my past, about the way I was born, and what doctors had done to me. Now, at the age of 44, I am comfortable explaining I am both a man and a woman,” Tony tells Times of Malta.

It is because of this personal bitter experience that Tony, born to Maltese immigrants in Australia, is glad that the Maltese government is doing something about this through the Gender Identity Bill, currently being debated in Parliament.

The draft Bill proposes prohibiting doctors from carrying out surgery on intersex children unless it is a medical emergency.

It also allows parents to wait until an intersex child turns 14 to officially register the gender as male or female.

Tony agrees that the law should not allow doctors to change the physical sex of a child, unless it is medically essential. “Sadly, castrations and physical sex changes are exactly what happen to children all over the world – it happened to me. As a Maltese person I am very proud Malta is the first country to stand up and put a stop to it,” says Tony who was born with Partial Androgen Insensitivity Syndrome.

“I was born with the same chromosomal pattern and testes like typical boys but because my body doesn’t fully respond to testosterone I was also born with a vagina.

“Doctors decided I should be raised as a girl because my genitals appeared more female than male, but incredibly they also chose to castrate me even though there was no medical need to remove my healthy testes and they didn’t know what I would want when I was older,” Tony adds.

Tony spent many years on female hormone treatment but never identified with the imposed gender.
"Doctors decided I should be raised as a girl because my genitals appeared more female than male, but incredibly they also chose to castrate me even though there was no medical need.

“I struggled being the girl and woman doctors wanted me to be. How could I deny the real me and keep up the charade? How would I have relationships? I was lonely, confused and profoundly sad.
“Although I threw myself into my career, community work and music, my personal life suffered enormously. It affected my relationship with my parents and siblings and I avoided intimate relationships.

“I often considered ending my life,” Tony recalls.

At the age of 30 Tony renounced this imposition and lived as a man for some time. But this too felt wrong.

Tony then understood that happiness lay in being true to nature – and embracing both genders.

Armed with this new confidence Tony became the first openly intersex mayor in the Western World – serving as deputy mayor of the City of Hobsons Bay, Victoria, between 2009 and 2011, and mayor between 2011 and 2012.

Tony believes the Gender Identity Bill is important because it will stop doctors from imposing genders.

It will also ensure people could have their gender recognised without having to lie and be ashamed.
Tony has had a female and a male birth certificate and now has a blank one. Legal issues presented by Tony’s non-specific birth certificate meant marriage was not possible in Australia where the law only allows a union between a man and a woman. In September 2013, Tony married Manja Sommeling in New Zealand.

Documents, Tony believes, should not refer to a person’s gender “because it’s irrelevant”. But, if gender markers are to stay, then there should be ‘M’ or ‘F’ for those who feel male or female.

There should, however, also be additional categories such as ‘M and F’ for adult intersex people that want their sex to be recognised for what nature made them, and ‘X’ for people who feel outside of the male and female categories.

“Personally, I would not want ‘X’ on my documentation,” Tony says.