Promoting and Protecting Human Rights in relation to Sexual Orientation, Gender Identity and Sex Characteristics A Manual for National Human Rights Institutions It is reportedly common for so-called ‘sex-normalising’ surgeries to be performed on intersex infants and children in China. The exceptions are usually in remote and poor areas where health care resources are scarce and families cannot afford medical costs. These families face barriers accessing the health care that their child may need, including support to deal with discrimination from family members, medical workers or the broader community.263 In November 2015, the Committee against Torture raised concerns about involuntary, irreversible surgeries on intersex children in its review of China (including Hong Kong and Macau).264 In some parts of the region, religious authorities play a role in influencing parents’ attitudes to bodily diversity and decisions about surgeries on intersex infants. In Indonesia, babies born with visibly ambiguous genitals at major hospitals often undergo ‘normalising’ surgeries if parents can afford the cost. Parents frequently make these decisions based on advice from religious authorities.265 There are significant gaps in knowledge about practices in other parts of the region. However, there is no evidence to suggest that intersex people’s right to physical integrity is protected explicitly in domestic laws, regulations or practice guidelines in any country in Asia and the Pacific. On the contrary, laws and policies that prohibit female genital mutilation may give explicit permission for genital surgeries to ‘normalise’ the bodies of intersex infants and children.266 In Viet Nam, a 2008 decree on sex reassignment provides an insight into how intersex people and their bodies are perceived. The decree legalised sex reassignment surgeries for people with ‘congenital sex deficits’ or whose sex cannot be determined as male or female (based on chromosome analysis or the appearance of the genitals).267 It encouraged surgeries for intersex people at “the earliest age”.268 Parents make written requests for surgeries for any child under the age of 16. The Law on Child Protection, Care and Education includes no mention of intersex children or protection against surgeries.269 Decisions about a person’s sex and the required treatment rest with medical practitioners and are based on their assessment of how the intersex person “may best integrate with the society psychologically, physiologically and socially”.270 0n 24 November 2015, the National Assembly of Viet Nam passed a new Civil Code that will come into effect on 1 January 2017. It includes the right of people to reassign their sex if they have a “sex disability or their sex is not defined and requires medical intervention”.271 This provision reinforces perceptions that intersex people have a disability and continues to enable involuntary surgeries on intersex infants. 70 263 UNDP and USAID, Being LGBT in Asia: China Country Report, 2014, p. 29. 264 Committee against Torture. ‘Committee against Torture considers report of China’, 18 November 2015; media report at www. ohchr.org/EN/NewsEvents/Pages/DisplayNews.aspx?NewsID=16774&LangID. The Committee’s concluding observations were published in December 2015. 265 UNDP and USAID, Being LGBT in Asia: Indonesia Country Report, 2014, p. 21. 266 Examples include exceptions in section 5.1.37 of Australia’s Criminal Code, Division 9 – Female Genital Mutilation, and in section 204A of New Zealand’s Crimes Act 1961. 267 Government of Viet Nam, Decree No. 88/2008/ND-CP of August 5, 2008, on Sex Reassignment, article 1; at http://kenfoxlaw. com/resources/legal-documents/governmental-decrees/2547-vbpl.html. 268 Ibid, article 9(3)(b). 269 UNDP and USAID, Being LGBT in Asia: Viet Nam Country Report, 2014, p. 21. 270 Government of Viet Nam, Decree No. 88/2008/ND-CP of August 5, 2008, on Sex Reassignment, article 9(3)(a). 271 Civil Code, article 36 (1). Article 37 removes the legal ban on ‘sex change surgery’ and enables legal gender recognition for people who have undergone such surgeries.