4 results
Sweden
- from PART IV - NATIONAL LEGAL DEVELOPMENTS
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- By Jameson Garland, Faculty of Law, Uppsala University, Sweden
- Edited by Jens M. Scherpe, Anatol Dutta, Tobias Helms
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- Book:
- The Legal Status of Intersex Persons
- Published by:
- Intersentia
- Published online:
- 31 January 2019
- Print publication:
- 12 September 2018, pp 255-280
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Summary
LEGAL FRAMEWORK AND STATISTICS
OVERVIEW
In many respects, Sweden was once considered a pioneering nation in the regulation of juridical gender. In 1631, Sweden became the first country in the world to establish a population registry for its inhabitants – a registry that reflected acknowledgement over time of the existence of persons who could not be classified simply as ‘male’ or ‘female’. In 1972, Sweden also became the first country in the world to enact a national scheme for changing one's registered gender, providing gender-affirming medical care in connection with such changes. The Gender Classification Act at the centre of this scheme, however, also appears to have been the first national law to endorse not only sterilisation of transgender persons, but to provide a mechanism for parents to seek changes of registered gender for children born with intersex conditions, as well as gender-conforming surgery on those children, without the children's consent. The Act emerged from the first known governmental investigation in the world to recognise the class of intersex persons – a class defined as persons who suffer from social conflict with gender registration. Though the experts that led the investigation concluded that the classes of ‘males’ and ‘females’ did not scientifically permit easy categorisation of many individuals, they nevertheless advocated that these classes should be maintained for socio-legal purposes and that all persons should be determined to ‘belong’ to one of these classes under strict legal controls. This legal scheme is expected to undergo significant transformation in 2018, as the government has announced plans to abolish the Gender Classification Act and to authorise simpler administrative changes of registered gender without any medical preconditions, with at least one such change as a matter of right.
Sweden, however, also shapes and controls juridical gender through a more far-reaching law that medicalises gender identity as binary. the Population Registration Act directs medical personnel to provide data on the gender of an infant as part of the child's juridical registration, despite governmental concessions that no sound definition exists of what constitutes a ‘male’ or ‘female’.
Evidence-Based Reviews of Medical Interventions Relative to the Gender Status of Children with Intersex Conditions and Differences of Sex Development
- from PART I - MEDICINE AND PSYCHOLOGY
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- By Jameson Garland, Faculty of Law, Uppsala University, Sweden, Milton Diamond, John A. Burns School of Medicine, University of Hawai'i, United States of America
- Edited by Jens M. Scherpe, Anatol Dutta, Tobias Helms
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- Book:
- The Legal Status of Intersex Persons
- Published by:
- Intersentia
- Published online:
- 31 January 2019
- Print publication:
- 12 September 2018, pp 81-102
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Summary
INTRODUCTION
Twenty years ago, standard clinical practice regarding the treatment of infants with intersex conditions and differences of sex development reached a critical turning point, particularly on the question of what gender to assign the affected children and whether their gender assignments should be reinforced with surgical interventions. Prior to this period, prominent clinicians tended to minimise as anomalous the statements of aggrieved adults whose bodies had been surgically modified in childhood and who suffered physical pain, genital dysfunction, loss of fertility, and sexual sensitivity, as well as those who considered the interventions a violation of their identity and personal integrity. By 1997, however, case studies had been published confirming rejections of gender assignments by older minors and adults who had been subjected to medical gender-conforming procedures in childhood. These disclosures led to the first reform guidelines proposing that while a social gender assignment for infants could be expected to continue, clinical practice should be more open to recognition of diverse gender identities and resistant to surgical interventions designed to reinforce an assigned gender. On the whole, however, clinical practitioners did not appear to embrace these guidelines. Rather, while the calls for practice changes were expected to ‘accelerate the re-examination of the clinical care of the intersex patient’, they instead marked the start of a period of a ‘crisis in clinical management’, one in which many clinicians found it difficult to change their practices without scientific evidence conclusively proving that all gender-conforming medical interventions are too risk-laden or unnecessary to support gender assignment on infants and young children.
Concerned about the quality of evidence supporting clinical practice, a group of prominent expert-clinicians organised several invitational gatherings of their colleagues to review gender-assignment practices and the medical interventions used to reinforce them. The first of these gatherings took place in Chicago in 2005 and was dubbed the Chicago Consensus, which led to the publication of a Consensus Statement the following year. This Consensus Statement recommended caution for a limited number of interventions but acknowledged that the lack of long-term outcome data was a ‘major shortfall’ of clinical practice, including gender assignment in infancy.
USA
- from North and South America
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- By Jameson Garland, Uppsala University, Sweden
- Edited by Jens M. Scherpe
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- Book:
- The Legal Status of Transsexual and Transgender Persons
- Published by:
- Intersentia
- Published online:
- 28 November 2017
- Print publication:
- 22 December 2015, pp 585-612
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Summary
LEGAL FRAMEWORK AND STATISTICS
OVERVIEW
The legal status of individuals with regard to gender is a complex matter in the United States (US), made even more so by the divisions of legal power within the nation. The US Constitution enumerates the powers that it confers on the legislative and executive branches of the federal government, authorising them to regulate taxation, interstate commerce, and international travel. As such, the federal government issues passports and establishes a national registry with identity numbers for individuals in relation to taxes, employment, and receipt of federal benefits. However, the states also have broad powers to regulate the public health and welfare within their borders, provided that they do not conflict with federal law, the US Constitution, or their own state constitutions. These jurisdictions register births and provide identity cards used in daily life. Both the federal government and the states allocate responsibility for each identity document to different agencies, with separate rules for the documents and registries that they maintain. As a result, citizens and residents of the United States may have multiple legally registered identities that are independent of each other, such that changing one document often has no impact on the other.
Persons wishing to correct their registered gender in much of the United States face numerous administrative barriers in doing so. This is largely due to the diversity of rules in the states, which are often inconsistent, even within individual jurisdictions. The most recent comprehensive study of transgender persons in the United States reported that only approximately one-fifth (21%) of persons who transitioned gender had been able to correct all of their identity documents, and two-fifths (41%) had not corrected their identity cards used in daily life. These administrative problems may explain why quality data is lacking to estimate the numbers of Americans who may have been diagnosed as transsexual or who have successfully corrected their registered gender. The US Census Bureau collects data on gender, but does not ask respondents whether their gender identity matches their gender registered at birth. Federal law protecting the privacy of health care information also effectively prevents substantial disclosure of statistics about the transgender population. As such, the full extent of the population most affected by gender registry laws remains largely unknown.
Sweden
- from Europe
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- By Jameson Garland, Uppsala University, Sweden
- Edited by Jens M. Scherpe
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- Book:
- The Legal Status of Transsexual and Transgender Persons
- Published by:
- Intersentia
- Published online:
- 28 November 2017
- Print publication:
- 22 December 2015, pp 281-312
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- Chapter
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Summary
LEGAL FRAMEWORK AND STATISTICS
OVERVIEW
In 1972, Sweden became the first country in the world to enact a national legislative scheme for changes of registered gender and legal gender status. The Gender Classification Act was also the first law of its kind to establish national rules for such changes for children with atypical sex development. On the surface, the current Act appears to be much the same statute today as it was when it came into force. The criteria for changes of registered gender under the current law, as well as the provisions for governance of medical care, are strikingly similar to those in use for the last four decades. In 2012, however, the government began a series of reforms that recently culminated in a sweeping proposal to radically overhaul the Act – not only in its regulatory aims, but at its very conceptual foundations – recognising gender identity as a human right, rather than a medical condition or registered identity that would warrant only strictly controlled changes as a matter of law. Even without these reforms, a comparison of the current Act to the original law underscores subtle, recent changes that resonate with substantive distinctions, influenced by the European Convention of Human Rights (ECHR), the Yogyakarta Principles, and the Convention on the Rights of the Child. If the proposed reforms take effect on schedule in 2016, this chapter may quickly become a mere historical chronicle of how one influential nation reconsidered its approach to conferring benefits and imposing hardships on transgender people, with the relative successes and failures of its legal scheme perhaps best measured by those whose lives are most directly affected by it.
At its inception, the Gender Classification Act integrated changes of registered gender with medical care. In part, this grew out of Sweden's universal health care system, which covers most of the costs of diagnosis and basic treatment associated with gender identity distress (clinically known as dysphoria). As early as 1968, the government recognised that much of this stress arose, in fact, from incorrect legal registrations assigned at birth. Thus, treatment for such stress was also ratified as standard care in the Act, which gives the National Board of Health and Welfare the authority to approve all genital and gonadal surgery connected with any application for a registered gender change, as well as the hospitals where certain procedures take place.