Promoting and Protecting Human Rights in relation to Sexual Orientation, Gender Identity and Sex Characteristics A Manual for National Human Rights Institutions Photo by UNDP/H. Nhan. A 2012 opinion from the Swiss National Advisory Commission on Biomedical Ethics sets out clear limitations on the extent to which weight should be given to psycho-social factors: Decisions are to be guided, above all, by the child’s welfare ... The limiting factor in the consideration of family/cultural circumstances will be the physical and psychological integrity of the child. An irreversible sex assignment intervention involving harmful physical and psychological consequences cannot be justified on the grounds that the family, school or social environment has difficulty in accepting the child’s natural physical characteristics. … If such interventions are performed solely with a view to integration of the child into its family and social environment, then they run counter to the child’s welfare. In addition, there is no guarantee that the intended purpose (integration) will be achieved.279 In its February 2015 concluding observations on Switzerland, the Committee on the Rights of the Child cited the recommendations of the National Advisory Commission on Biomedical Ethics in its discussion of harmful practices. The Committee urged the State Party to: 279 72 Swiss National Advisory Commission on Biomedical Ethics, On the Management of Differences of Sex Development. Ethical Issues Relating to “intersexuality”. Opinion No. 20/2012, p 13; at www.nek-cne.ch/fileadmin/nek-cne-dateien/Themen/Stellungnahmen/ en/NEK_Intersexualitaet_En.pdf. Emphasis in original.