At present, gaps in service delivery are filled by community organisations which are not funded to do this work. Peer-led support models provide protective factors but are not sustainable longterm without adequate resourcing.230 Responses by, and for, the community have the most buy-in and success, but tend to be the least resourced, operating on minimal funding and/or run by volunteers.231 He Ara Oranga confirmed that responses to strengthen protective factors for SOGIESC-diverse people are best led by them in a collaborative way with health services.232 Medical interventions to alter sex characteristics Accounts and testimonies from intersex people in Aotearoa New Zealand and overseas have described the key human rights issue impacting their lives.233 These include the practices of nonlife preserving surgical and hormonal intervention at an age before a person can participate in decisions related to the management of their health; a pathologising approach to normalising diverse sex characteristics. Such practices violate the right to bodily autonomy, and associated rights to freedom from torture and ill-treatment.234 The surgical approach to genital normalisation became common in the 1970s and has been used to justify performing thousands of surgeries on people with variations of sex characteristics.235 Sex characteristics are not binary, but bimodal.236 Differences in the definitions of intersex have implications on which variations are counted,237 with only some variations visible at birth. When a new-born baby is visibly intersex, ‘genital normalisation’ surgeries often take place, including in present-day New Zealand.238 These procedures make intersex bodies conform to sex and gender stereotypes by altering internal and external organs to make them ‘consistent.’239 These practices have lifelong physical and mental consequences and are rooted in the idea that women must be able to have vaginal intercourse and men must be able to stand to urinate. Section 204A(3)(a) of the Crimes Act makes such procedures legal in New Zealand.240 Intersex people who have been subject to medical or surgical intervention often have difficulty accessing their complete health records, despite the legal requirement of retention of, and access to, these files.241 Because of the intention to minimise diversity and normalise sex characteristics, some people are told their Protective factors are characteristics associated with a lower likelihood of negative outcomes. In contrast, risk factors are characteristics at the biological, psychological, family, community, or cultural level that precede and are associated with a higher likelihood of negative outcomes. See Substance Abuse and Mental Health Services Administration “Risk and Protective Factors” SAMHSA <www.samhsa.gov> 231 Aotearoa New Zealand IDAHOBIT Day Coalition Submission to the Universal Periodic Review (2018). 232 He Ara Oranga: Report of the Government Inquiry into Mental Health and Addiction (4 December 2018) at 37. 233 New Zealand Human Rights Commission Intersex roundtable report 2016: The practice of genital normalisation on intersex children in Aotearoa New Zealand (Wellington, 2016) at 10; Steph Lum (ed) YOUth and I: Issue 1; Amnesty International “Taiwan: Valentine’s Day for intersex activist Hiker” (14 February 2018) <https://www.amnesty.org/en/>; United Nations Office of the High Commissioner for Human Rights Background Note on Human Rights Violations against Intersex people (October 2019). 234 United Nations Office of the High Commissioner for Human Rights “Free & Equal fact sheet: Intersex” (October 2015) United Nations Free & Equal <www.unfe.org>. 235 In the 1960s, New Zealand-American psychologist John Money developed a hypothesis that gender was social and environmental rather than innate, and as such could be changed via nurture. He believed that surgical intervention to an infant or child’s sex characteristics, including their genitals, to conform to ‘ideal’ male or female standards, would result in successful gender assignment. 236 The bell curves of ‘male’ and ‘female’ sex characteristics overlap, rather than being mutually exclusive in two distinct and separate (binary) categories. Bimodal distribution means to have two peaks. 237 New Zealand Human Rights Commission Intersex roundtable report 2016: The practice of genital normalisation on intersex children in Aotearoa New Zealand (Wellington, 2016) at 2; Georgiann Davis Contesting Intersex: The Dubious Diagnosis (NYU Press, New York, 2015). 238 Committee Against Torture Seventh periodic report submitted by New Zealand under article 19 of the Convention pursuant to the optional reporting procedure, due in 2019 (25 September 2019) at [329] and [330]. 239 United Nations Office of the High Commissioner for Human Rights Background Note on Human Rights Violations against Intersex people (October 2019); Dainius Pūras Report to the General Assembly on the Right of everyone to the enjoyment of the highest attainable standard of physical and mental health UN Doc A/70/213 (30 July 2015) at [84] and [85]. 240 The Crimes (Definition of Female Genital Mutilation) Amendment Bill 2019 (194-1) will expand the definition of female genital mutilation to be consistent with that of the World Health Organization, but does not provide protection for normalising procedures on the genitals of intersex children. 241 Vee Blackwood “Upholding rights of intersex people to obtain early health records” (2 March 2018) Office of the Privacy Commissioner <http://www.privacy.org.nz/>. 230 41