UN treaty assess countries鈥� human rights records and make recommendations for improvement on how human rights can be improved.
We are working to understand how decision-makers can better follow UN recommendations on intersex healthcare and what changes are needed to meet Aotearoa New Zealand鈥檚 human rights obligations.
Our research looks at advice from UN treaty monitoring bodies since 2016. These bodies have raised concerns that children with sex variations in Aotearoa New Zealand often undergo unnecessary medical procedures before they can give informed consent. Families and those affected also receive too little support and too few remedies and this needs to change.
Read more about what the UN has said to Aotearoa New Zealand.
UN Committee on the Rights of the Child
Harmful practices
25. The Committee recommends that the State party: 鈥�
(b) Develop and implement a child rights-based health-care protocol for intersex children, setting the procedures and steps to be followed by health teams, ensuring that no one is subjected to unnecessary medical or surgical treatment during infancy or childhood, guaranteeing the rights of children to bodily integrity, autonomy and self-determination and provide families with intersex children with adequate counselling and support;
(c) Promptly investigate incidents of surgical and other medical treatment of intersex children without informed consent and adopt legal provisions to provide redress to victims of such treatment, including adequate compensation;
(d) Educate and train medical and psychological professionals on the range of biological and physical sexual diversity and on the consequences of unnecessary surgical and other medical interventions on intersex children;
(e) Extend free access to surgical interventions and medical treatment related to their intersex condition to intersex children between the age of 16 and 18.
E. Violence against children (arts. 19, 24 (3), 28 (2), 34, 37 (a) and 39)
Violence against children, including sexual violence, abuse and neglect
23. The Committee welcomes the establishment in 2019 of the Independent Children鈥檚 Monitor and its reporting function on government adherence to the national care standards that organizations having legal custody of children are required to meet; the creation in 2018 of the Royal Commission of Inquiry into Historical Abuse in State Care and in the Care of Faith-based Institutions; and the establishment in 2018 of the joint venture for family violence and sexual violence to foster government agency collaboration and innovation in addressing the issue, and the formalization of this arrangement in 2021 as the Te Puna Aonui Executive Board for the Elimination of Family Violence and Sexual Violence, noting its specific focus on children, M膩ori, Pasifika and lesbian, gay, bisexual, transgender and intersex persons, and persons with disabilities.
The Committee also welcomes the significant increase in financial and human resources dedicated to strengthening the response to child abuse, family violence and sexual violence, and for the care and protection and youth justice systems. However, the Committee remains seriously concerned about the persistent rates of abuse and neglect of, and violence against, children, particularly domestic violence, noting the higher risk faced by M膩ori, Pasifika and lesbian, gay, bisexual, transgender and intersex children, and children with disabilities. It is further concerned about the limited access to child-friendly reporting channels, physical and psychological rehabilitation and health services, including mental health services, that are available to children who have suffered violence, trauma or abuse.
24. In the light of its general comment No. 13 (2011) and target 16.2 of the Sustainable Development Goals, the Committee urges the State party:
(a) To strengthen and centralize the collection and analysis of disaggregated data on children who are victims of all forms of violence, such as domestic violence, bullying and sexual exploitation and abuse, with a view to assessing the extent of the phenomenon and formulating and implementing, with the participation of children, a comprehensive strategy for preventing and combating all forms of violence against children, with special attention paid to the situation of M膩ori, Pasifika, lesbian, gay, bisexual, transgender and intersex children and children with disabilities; 鈥�
Harmful practices
25. The Committee 鈥� recalls its previous recommendations and further recommends that the State party: 鈥�
(b) Finalize the guidelines and protocol being developed by the Intersex Working Group, ensuring that it sets out guarantees for the mental and bodily integrity, autonomy and self-determination of intersex children including by:
(i) Prohibiting non-urgent and non-essential (including feminizing or masculinizing) medical or surgical treatment of intersex children before they are of sufficient age or maturity to make their own decisions and provide free, prior and informed consent;
(ii) Ensuring independent oversight of decision-making to ensure that medical treatments for children with intersex traits who are unable to consent are necessary, urgent and the least invasive option;
(iii) Providing redress to victims of non-urgent and non-essential treatment, including appropriate compensation;
(c) Ensure that all intersex children, adolescents and their families have access to community-based psychosocial and peer support.
UN Committee against Torture
Intersex persons
53. While noting the establishment, in 2017, of the Child and Youth Intersex Clinical Network, the Committee is concerned about reports of cases of unnecessary surgery and other medical treatment with lifelong consequences, including severe pain and suffering, to which intersex children have been subjected before they reach an age at which they are able to provide their free, prior and informed consent. It is also concerned about the inadequate provision of support and counselling for the families of intersex children and of redress and rehabilitation for victims (arts. 2 and 16).13
54. The State party should:
(a) Finalize the guidelines and protocol being developed by the Child and Youth Intersex Clinical Network, ensuring that they set out guarantees for the mental and bodily integrity, autonomy and self-determination of intersex children.
(b) Consider adopting legislative provisions that explicitly prohibit the performance of non-urgent and non-essential medical or surgical treatment of intersex children before they are of sufficient age or maturity to make their own decisions and provide free, prior and informed consent.
(c) Ensure independent oversight of decision-making to ensure that medical treatments for children with intersex traits who are unable to consent are necessary and urgent and the least invasive option.
(d) Provide redress to victims of non-urgent and non-essential treatment, including appropriate compensation and rehabilitation, and ensure that all intersex children and adolescents and their families receive professional counselling services and psychological and social support.
UN Committee on the Elimination of Discrimination against Women
Discriminatory stereotypes and harmful practices
23. While noting the efforts made by the State party to eliminate negative stereotypes affecting women, the Committee expresses concern about the following: 鈥�
(b) The conduct of medically unnecessary procedures on intersex infants and children before they reach an age at which they are able to provide their free, prior and informed consent, and the inadequate provision of support and counselling for the families of intersex children and of remedies for victims.
24. The Committee 鈥� further recommends that the State party: 鈥�
(c) Adopt clear legislative provisions explicitly prohibiting the performance of unnecessary surgical or other medical treatment on intersex children before they reach the legal age of consent, provide the families of intersex children with adequate counselling and support and provide redress to intersex persons who have undergone such unnecessary surgical or medical treatment.
Domestic legal framework
8. The Committee 鈥� also notes the ongoing review of the adequacy of legal protections for transgender, non-binary and intersex women, a report on which is to be published in June 2025. The Committee notes with concern, however, that the focus of the Law Commission is on sex characteristics rather than self-identification and reiterates its previous concern regarding the lack of explicit protections under the New Zealand Human Rights Act 1993 against discrimination based on gender identity, gender expression or sex characteristics.
9. The Committee reiterates its previous recommendation to amend the New Zealand Human Rights Act 1993, with a view to providing explicit protections against discrimination based on gender identity, gender expression and sex characteristics, and to ensure the meaningful and effective participation of women in all their diversity, as well as women community representatives and public service providers, in future consultations.
UN Committee on the Rights of Persons with Disabilities
Protecting the integrity of the person (art. 17)
(b) The lack of a prohibition on non-urgent, intrusive and irreversible medical interventions or the imposition of hormones on intersex infants and children before an age at which they can provide informed consent; 鈥�
(d) The lack of data in relation to sterilization and abortion procedures performed on persons with disabilities without their personal consent, non-urgent medical interventions on intersex children without their consent and growth attenuation treatment.
36. The Committee urges the State party to: 鈥�
(b) Adopt clear legislative provisions that explicitly prohibit the performance of unnecessary, invasive and irreversible medical interventions, including surgical, hormonal or other medical procedures on intersex children before an age at which they can provide informed consent;
(c) Recalling previous recommendations made by the Committee on the Rights of the Child, develop and implement a child rights-based health-care protocol for intersex children, setting the procedures and steps to be followed by health teams, ensuring that no one is subjected to unnecessary medical or surgical treatment during infancy or childhood, guaranteeing the rights of children to bodily integrity, autonomy and self-determination, and provide families with intersex children with adequate counselling and support; 鈥�
(e) Adopt legal provisions to provide legal remedies and holistic redress to victims of medical interventions performed without personal consent, including access to support and recovery services and adequate compensation;
(f) Develop measures to ensure reporting and data collection on sterilization, contraception and abortion procedures performed without personal consent, on non-urgent medical interventions performed on intersex children and on growth attenuation treatment.