Julie A. Greenberg

International Legal Developments Protecting the Autonomy Rights of Sexual Minorities: Who Should Decide the Appropriate Treatment for an Intersex Child?

During the past decade, the dominant medical protocol for the treatment of intersex infants has come under heavy attack. One of the current debates centers on whether parents should be allowed to consent to nonmedically necessary genital surgery on their intersex infants. Some activists insist that a moratorium on all such surgeries should be imposed until these children reach the age of consent and can make their own decisions. Others believe that parents should be allowed to consent to these surgeries on behalf of their children, but maintain that informed consent procedures must be enhanced. Finally, some argue that the autonomy rights of the intersex infant require that courts review the parental consent to ensure that ethical standards are maintained. Thus far, the Constitutional Court of Colombia is the only high court to have rendered a decision on this issue. This essay discusses the Colombia decision and analyzes recent court decisions from Europe, Australia and the United States involving other sexual minorities to determine how these courts may resolve this issue if they are brought into the controversy. It concludes that courts may not be the ideal forum to resolve these issues because judges may render a decision based upon their own prejudices or stereotypes.

Legal, ethical, and human rights considerations for physicians treating children with atypical or ambiguous genitalia

Some governments, human rights organizations, intersex organizations, and doctors have called for a moratorium on genital and gonadal surgeries for infants born with atypical or ambiguous genitalia. Moratorium supporters believe that the surgeries carry physical and emotional risks, the psychosocial benefits of these procedures have not been proven, and the surgeries violate the patients׳ fundamental human rights if they are performed before these patients can provide informed consent. Given these calls for a moratorium, treatment teams must determine how to treat their patients and how to counsel their patients׳ parents. This article examines the treatment teams׳ ethical and legal responsibilities and provides advice for treatment teams to follow that will protect their patients and their practices.