Promoting and Protecting Human Rights in relation to Sexual Orientation, Gender Identity and Sex Characteristics A Manual for National Human Rights Institutions 4.3.3. Female genital mutilation NGOs in both Australia and New Zealand have made submissions to government agencies, NHRIs and UN treaty monitoring bodies criticising laws that, while rightly prohibiting female genital mutilation, allow similar surgical interventions on intersex girls.288 In both countries, relevant laws exempt so-called ‘sexnormalising’ surgeries on intersex people because they are regarded as being medically beneficial or therapeutic.289 This is despite explicit provisions stating that a procedure cannot be justified as necessary, desirable or therapeutic simply because it is part of a social, cultural or religious custom or practice. The NGOs OII Australia and the Intersex Trust Aotearoa New Zealand have argued that surgical alterations to make intersex children’s genitals ‘normal’ or ‘socially acceptable’ amount to genital mutilation and should be legally prohibited.290 Human rights concerns about genital surgeries on intersex infants and children, performed for nonmedical reasons, are noted in the 2015 report of the High Commissioner for Human Rights on female genital mutilation. They appear in a section highlighting constraints and challenges that States face in their efforts to meet their obligations to respect, protect and fulfil the rights of women and children to live free from female genital mutilation.291 4.3.4. Defining intersex variations as serious genetic disorders ‘Preimplantation genetic diagnosis’ refers to the process of screening embryos for specific genetic diseases before implanting them in a uterus. The ethics of preimplantation genetic diagnosis to select against intersex traits was the subject of 11 papers in the October 2013 issue of the American Journal of Bioethics.292 A May 2015 report from the Commissioner for Human Rights of the Council of Europe raised concerns that the use of this procedure to identify and reject embryos with intersex variations violates ethical and human rights standards.293 In April 2014 and September 2015, OII Australia made submissions to Australia’s National Health and Medical Research Council calling for the prohibition of genetic testing to select against intersex traits.294 It criticised the assumption that intersex variations are “serious genetic conditions”, identifying this as the underlying rationale for preimplantation diagnosis. OII Australia recommended that testing and diagnosis should be limited to instances where a major physical or mental impairment may severely limit a person’s quality of life. 4.3.5. Continuing health issues for intersex people There are often lifelong physical and emotional implications that follow surgeries and other medical interventions performed on intersex children and infants. These can include sterility, genital insensitivity and impaired sexual function, chronic pain, bleeding or infections, post-surgical depression or trauma (including in response to experiences of rape), significant scarring and metabolic imbalances.295 74 288 For example, OII Australia, Submission to the Australian Human Rights Commission: Sexual Orientation, Gender Identity and Intersex Rights Snapshot Report, February 2015; Intersex Trust Aotearoa New Zealand, Alternate NGO Submission on the sixth periodic report to the United Nations on the Convention against Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment from New Zealand, January 2015. 289 New Zealand Crimes Act 1961, s. 204A; Attorney General’s Department, Review of Australia’s Female Genital Mutilation Legal Framework – Final Report, 2013. 290 This argument directly challenges the psycho-social rationale that surgeries are necessary to improve opportunities for marriage or intimate relationships. 291 OHCHR, Good practices and major challenges in preventing and eliminating female genital mutilation, 2015, A/HRC/29/20, para. 62 . 292 American Journal of Bioethics, Vol. 1 Issue 1, 2013. 293 Commissioner for Human Rights of the Council of Europe, 2015, p. 30. 294 See https://oii.org.au/29939/nhmrc-genetic-selection-intersex-traits/. 295 M. Cabral and M. Carpenter, 2015.