Question – Surgery on Intersex Children
Questions asked by the Hon. Meg Webb MLC on 16 March 2023 and answered by the Premier and Minister for Health on 30 March 2023.
In correspondence to Mr Sam Klintworth, National Director, Amnesty International Australia, dated 1 December 2021, the then-Deputy Premier and Health Minister, Jeremy Rockliff stated “I am advised that no surgeries to modify the sex characteristics of children are performed in Tasmania.” However, Commonwealth health data (per Medicare codes and sourced from here and here) on procedures conducted in Tasmania, indicates that at least 19 surgeries were conducted in Tasmania from July 2018 to July 2022 on children aged 14 years and younger which would be characterised as surgeries to modify innate sex characteristics of children.
Given this data, can the government:
1 Confirm whether surgeries to modify innate sex characteristics are, in fact, performed in Tasmania on some children who have variations of innate sex characteristics (intersex).
ANSWER 1: There is no concrete data about the prevalence of babies born with intersex variations in Tasmania. National estimates of prevalence of intersex conditions vary, though it is estimated at around 1.6 per cent of all births, noting that intersex traits may be identified at birth, during adolescence, or later in life.
Most infants born with intersex variations do not require surgical interventions, however, some babies are born with intersex variations which, if left untreated, can lead to serious health issues. This includes conditions such as congenital adrenal hyperplasia, which may be fatal if left untreated.
Conditions like these are considered medical emergencies, and it may be necessary to perform surgical interventions on these patients to avoid adverse health outcomes.
Paediatric surgery involving the genitals would only be undertaken in a Tasmanian public hospital if it was considered medically essential to restore, obtain or repair vital physiological function.
2. Explain why data relating to surgeries conducted on children to modify innate sex characteristics is not collected by the State?
ANSWER 2: There is no nationally agreed definition of intersex, which impacts the ability to collect this data.
3. Confirm whether the Government supports the banning of non-consensual surgeries on children with variations of innate sex characteristics, in line with the UN Joint Statement on the Human Rights of Intersex Persons, the AMA LGBTIQA+ Health Position Statement (2021) and the Australian Human Rights Commission Report ‘Ensuring health and bodily integrity: towards a human rights approach for people born with variations in sex characteristics’ (2021).
ANSWER 3: The Tasmanian Government is committed to making decisions based on expert advice, and with priority focus on best practice and patient-centred care.
4. Confirm whether the Government intends to develop Tasmanian legislation to ban non-consensual surgeries on children with variations of innate sex characteristics, and if so, when development of legislation will commence?
ANSWER 4: The Tasmanian Government is considering the recommendations made by the Tasmanian Law Reform Institute on the legal recognition of sex and gender. Through this, the Tasmanian Government is considering the scope of issues related to relevant medical interventions on intersex minors, including policies, procedures, guidelines, frameworks and data collection; the current arrangements in Tasmania, the arrangements in other jurisdictions, and the needs of Tasmanian families.
5. Provide copies of any current policies, procedures, guidelines or frameworks in use in the state’s public hospital system which relate to surgeries conducted on children to modify innate sex characteristics.
ANSWER 5: As above, paediatric surgery for intersex infants and children is very infrequent in Tasmania’s public hospital system. The THS has an Elective Surgery Procedures Not Routinely Performed (Attachment 1, also available online) document, which states that the THS does not perform gender reassignment surgery, unless there are exceptional clinical indications, due to congenital abnormalities in a child.
6. Provide details on any training or education undertaken by health professionals in public hospitals in Tasmania from July 2018 to July 2022, including the type of training or education provided, the number and location of any training or education sessions, and the number of attendees.
ANSWER 6: There are no available records on training and education undertaken by health professionals related to this topic.
Additional information provided by the government 23 May 2023:
See more of Meg’s questions in Parliament.
