Thursday, 5 February 2026

 Emma KEALY (Lowan) (10:15): I rise today to speak on the Health Safeguards for People Born with Variations in Sex Characteristics Bill 2025. I would firstly like to acknowledge the community who have contributed strongly and advocated for changes in regard to supportive legislation to recognise that this is not only a complex area but also a very small number of people who are impacted by this. There are decisions that have been made in the past with good intent, for the most part – I would like to think that there is no malicious intent in the medical fraternity – but as we move forward we can understand more about the impacts of clinical decisions, surgical decisions and decisions which can have lifelong implications for individuals who have medical procedures undertaken upon their body when they not able to provide a voice to that. That is of course for newborns and children who have had surgical procedures undertaken which have had a lifelong impact on their mental health, on their identity and relationship with their body, and in some instances bodily functions as well – sexual function. They have had an enormous impact. I do thank those and their family members who have had the courage to advocate for changes in this area.

We have learned a lot over time, but we can always do better. Certain aspects and the intent of this legislation have a very, very good purpose. Again, I just thank people for speaking out, because it is not always a comfortable discussion. It is still taboo to talk about sexual function or genitalia. Sometimes it is something that is not disclosed when there are medical procedures or surgical procedures provided to or conducted on children or newborn babies. It is something that is uncomfortable in everyday conversation, but it should not be. For somebody who has come from a medical background, we need to be able to have these discussions in an open way. We need to be able to have these discussions in a non-judgmental way, because only through doing that can we ensure that we have better outcomes for every individual into the future.

There are a number of implications in this legislation, and from the outset I would like to outline that we will be circulating some amendments. These amendments are reflective of the consultation and feedback we have had from the community. It is from the medical community, it is from people who have gone through this journey in the past and it is feedback from particularly clinicians with expertise in this area. They are put forward in good faith because we want to ensure that, if there are going to be health safeguards, they are truly reflective of the needs of the community and do not have unintended consequences that would actually restrict or reduce the ability for individuals in Victoria to access the clinical care that they require.

I would like to first, though, go through the key aspects of this legislation as an overview, and then I will go through the rationale behind the amendments that we intend to put forward in this place, understanding that it is unlikely that they will pass this place. I will flag that these are amendments that will also be taken through the Legislative Council. Our intention is that while we should never presume, it is my understanding we will not have the opportunity to take this legislation through consideration in detail and therefore be able to actually take a vote on the specific four amendments that we are seeking to put forward. However, in light of that, we will put forward a reasoned amendment to allow this to occur.

That is the construct and the overview of our position on this, but it is very much with an outcome in mind and that we need to get this right. We need to ensure that the concerns that have been raised do not have unintended consequences and have a greater impact on children who are born with variations in sex characteristics today. It is something that, fortunately, members within both chambers and of course on both sides of the benches in Parliament have some experience with. It is a very complex area to talk about, how you establish a framework when medical decisions are being made, because research changes rapidly, treatment options change rapidly, and of course you are dealing with humans at the end of the day. While there is consistency in some particularly genetic abnormalities and how they present in individuals, humans are human, and we are all different in our own unique way. So what the medical fraternity understands to be something that is an appropriate treatment today may not apply to two different individuals presenting with the same condition – there may be a more appropriate treatment option. It is not black and white, which is why we do not always have positive outcomes. But if we can have frameworks in place – and this is something that the medical fraternity do exceptionally well, creating clinical pathways, treatment pathways to ensure there is consistency and less likelihood of inappropriate treatment being applied to individuals. This is beyond just variations in sex characteristics; this is for all clinical conditions and how they present.

I commend and would like to also thank the incredible clinicians who are involved in these decisions and treatments. It is not an easy area to work within; it is not something that is taken lightly. I think there is generally a gentle touch in how people intend to go about this. For treatment, for the most part and beyond, in dealing with individuals who present with variations in sex characteristics, the intent always should be to do no harm. That is something that is the driving force behind the medical professionals I have worked with and engaged with in the past: to do no harm. But that does not mean that unintended harm does not take place. Absolutely we support that the frameworks are put in place. We support these through legislation but, more importantly, organically, in terms of how medical practice works in Victoria and across Australia. It works and it improves every single year, because we have got amazing specialists in this state, and the medical fraternity, the healthcare fraternity, should be commended for their work in this space.

There has been very strong advocacy from the variation in sex characteristics community, sometimes known as the intersex community, for many years to legislate these changes. In 2021 the government committed to implementing the (i) Am Equal: Future Directions for Victoria’s Intersex Community report, including oversight for non-urgent medical treatment. There was some commentary in the chamber earlier this week about the term ‘intersex’. It is something that was picked up in the minister’s second-reading speech. It is not intended to cause any offence to refer to intersex. It is for convenience of debate, and I apologise if that is inappropriate or anyone is offended by that. I have been considering how clinical decisions can sometimes translate very poorly into characterisation of individuals. Through the briefings that we have had, the things that we speak about and how this is talked about in medical terms, the term ‘defect’ is sometimes used, ‘genetic defect’. Those sorts of terms are used in a way that is very clinical, and I do want to make it very, very clear that that does not define an individual, that they are defective. It is clinical terminology that sometimes does not translate well. We see that in many aspects, but I think particularly in this debate I want to make it very, very clear that no offence was intended and that translation should not be deemed as an implication on individuals at all.

Other jurisdictions have brought in similar legislation to what it is before this chamber today, including the ACT and internationally in Germany, Spain, Portugal, Iceland and Malta. We do note that the ACT enacted similar legislation to what is before us back in 2023. The Victorian model expands on what is in place in the ACT, but there is much more detail in the oversight framework. There are more detailed consent and capacity requirements outlined in this legislation, and there are more onerous reporting obligations and stronger enforcement and review mechanisms within the Victorian legislation.

To go back a step, people with innate variations in sex characteristics, also referred to as intersex, do not fit the typical definitions of male or female bodies. Now, this is something that is true, but perhaps it defers into something else from what is normal anyway. It is something that comes from a place of clinical decision and clinical terminology. We know that there are more than 40 different variations which can occur in genitalia, reproductive organs, chromosomes, hormone levels or the body’s response to hormones, which can be indicated later in life and be identified late in life as children enter into puberty. Intersex traits are natural biological variations, which occur in about 1.7 per cent of births, affecting up to 1500 babies born in Victoria each year. Not all variations are identified at birth. They are sometimes identified later on, and perhaps even into adulthood during fertility testing. The vast majority of these variations are relatively minor conditions and do not require immediate treatment, while some require urgent treatment to avoid life-threatening complications. This bill is intended to provide greater clarity for practitioners and parents regarding the resolution of those common issues.

Some cases involve more uncommon variations that require a specific treatment plan. In Victoria, this involves around 60 to 120 cases per year. While medical intervention is indicated for some intersex variations, some intersex people have experienced lifelong physical and psychological consequences from deferrable medical interventions performed when they were infants or children. These consequences may relate to issues such as fertility, poor sexual health, urinary issues or the need for further treatments or surgeries. I think this is where it really hits home for each individual and becomes relatable. In some instances, people have found out that they had treatment and medical intervention as a young child, as a newborn, only when they found out that they were infertile because they had had organs removed at that time. The implications on the mental health of those individuals cannot be overstated. It is profound. It is a sense of identity – your ability to have children, your relationship with your sexuality and your genitalia and all that follows on from that. What we are speaking about is not just around the physiological, it is also about the psychological, and I do not think that can be overstated.

This bill seeks to address the need for prevention of harm from such medical procedures. Treatment will not be able to proceed for cosmetic purposes or to normalise the body, whatever that means, before a person is able to consent. There are four main ways that the government is seeking to establish this framework to better protect against cosmetic or premature interventions without the consent of the individual who will be impacted by the treatment. The main purpose of the bill is to establish a legal framework, including safeguards and oversight, to support people born with variations in sex characteristics and their parents in making decisions about medical treatment involving permanent or significant changes, particularly when they are unable to give informed consent.

It also seeks to strengthen the process for obtaining informed consent. It ensures decisions regarding certain medical treatments are deferred until a person has capacity to give informed consent, or, if that is not possible, that there is independent oversight.

I would like to pull out some key areas of this legislation just to ensure that I cover everything within the time allocated, particularly around some of the concerns that have been raised. The Australia and New Zealand Society for Paediatric Endocrinology and Diabetes have provided correspondence that they have written to the Minister for Health, and they have also included the Shadow Minister for Health in regard to this legislation. They raised key concerns around the clinical and practical application of the definition for innate variations in sex characteristics; the proposed processes for determining informed consent and adequate engagement and understanding for those without the explicit legal right to provide consent on their own behalf, such as in paediatric patients; the inclusion of criminal penalties for the provision of clinical care, particularly if the definition or scope of innate variations in sex characteristics remains unclear, and its potential impact on access to medical care for individuals and on clinicians’ capacity and willingness to provide medical care; and on the funding and infrastructure required for implementation, including the requirement for additional dedicated clinical time and supports, psychosocial support services, expansion of multidisciplinary teams and prospective clinical data collection to facilitate assessment of outcomes. The Canberra Hospital has required a dedicated clinician solely to prepare general treatment plans, with only two plans submitted over a 12-month period due to the complexity of the process. Given Victoria’s significantly larger population and potentially greater complexity of cases, substantial additional resourcing will be essential to ensure that patient care and safety are not compromised and the composition and expertise of the proposed independent oversight panel and the governance structures for the proposed oversight panel, including timelines for feedback and mechanisms for high-priority cases.

What is most concerning to me is that the leading body for paediatric endocrinology, which of course would be one of the peak bodies whose members are managing these cases currently, provided this correspondence after this legislation was first tabled in this place, indicating that they did not feel they had been able to provide sufficient input and had not been effectively consulted as part of the formation of this legislation. I understand that they provided input to the (i) Am Equal paper. However, the views that they shared and the evidence they provided as part of that were not included in the final reporting, and so they have concerns. These concerns are also echoed by the AMA. The key concern from the AMA is in relation to the impact of criminalising certain medical procedures, particularly within an area of specialty where there are so few clinicians already. We do not want to have the unintended consequence that the threat of having to go to jail means that you choose a separate specialty or choose, as an endocrinologist, not to work with a certain cohort of young patients who present with variations in sex characteristics.

There are already mechanisms in place to deal with clinicians who do the wrong thing, whether or not it is through the Australian Health Practitioner Regulation Agency, who may deregister a specialist or apply conditions to their registration. These are already in place. It is highly unusual for a medical professional to be threatened with jail for not following a structure when the intent is believed, for the most part, to be around getting the right outcome. When it is not, AHPRA should be able to show their teeth and ensure that those medical professionals do not practise. That is certainly what they are enabled and empowered to do and should be doing. So there is a concern around the criminalisation of the failure to follow treatment plans, act outside them or act before a treatment plan is approved.

It seems like it is a very straightforward process on paper: you go through a process where there is a creation of a treatment plan informed by a specialist and that this will be available within the necessary timeframe so a clinician can take action one way or another, of course with consent obtained through that process. However, these things take time, as we have seen with the ACT example. Sometimes that time is not always available. Sometimes that can hold up or delay procedures being enacted. Sometimes it can be used to deliberately prolong or delay treatment from taking place. I put on the record the views of the medical fraternity, whether it is a paediatric endocrinologist or whether it is the AMA, who represent many other medical professions, putting forward their views and their strong concerns around that aspect.

We have also received a lot of correspondence from Dr Neil Price, who is a paediatric urologist. He is somebody who has extensive experience in treating children with urogenital anomalies. He acknowledges that there is significant stigma, secrecy and inappropriate medical responses experienced by people with variations in sex characteristics, and he strongly supports improved protections in care. That is something that is echoed by the medical fraternity. There is nobody that does not want to see better protections in place for people who are born with variations in sex characteristics. Dr Price, however, argues that this current bill is poorly drafted, overly broad and is likely to cause significant unintended harm. This is something that we should be responding to, and we should try to ensure that the legislation that passes, which is required, does not have unintended consequences and cause unintended harm to Victorians. Similar concerns were expressed particularly by the AMA in regard to the likely reduction of access to specialist care in regard to the criminal sanctions and unclear rules, which will drive experienced clinicians away from variations in sex characteristics care. Parents may lose trust and clarity around their legal authority, increasing stigma and confusion, which is absolutely not what the intent is of the legislation, and I respect that, but we need to make sure we get it right.

There has been concern raised around the proposed decision-making panel that it does not have sufficient medical expertise to be making medical decisions and may delay timely treatment. Specifically, while an individual with lived experience is mandated to be on the panel – and I support that – it does not mandate the inclusion of key clinical expertise or specialities, including endocrinology, paediatric and adolescent urology, paediatric and adolescent gynaecology, and paediatric and adolescent psychology. These are people who should be in the room making the decisions and creating the treatment plans. Given the unique cohort of presentations of VSC, or variations of sex characteristics, that we are speaking about, they are the people who are the experts in the area. They should be in the room, and that should not be something called in or out. Just make sure that they are there, making the decisions at the time.

I will move on to our amendments to ensure that they are circulated, because it is important that the intent of the amendments that we are putting forward is clear. This would ordinarily perhaps be something we could debate in this place as part of consideration in detail; however, this will not occur today. But they are amendments that we will take forward in the upper house, as I have stated. Under standing orders, I wish to advise the house of amendments to this bill and request they be circulated. For clarity, these are the amendments as opposed to the reasoned amendment.

The intent of the amendments put forward is very much reflective of the feedback that we have received in relation to people with lived experience of this and their families and carers, from the medical fraternity who have expertise in this specific area and from the legal fraternity, and they are designed around that.

It is intended to reduce the opportunity for unintended harm. Broadly, the amendments that have been circulated remove the criminal offence for noncompliance with the legislation, which is related to clause 7 on point 4 of the amendments that have been circulated. It will broaden the assessment panel so that it must include the speciality paediatric areas of endocrinology, urology, gynaecology and psychology. This is in relation to clause 19, or points 7 and 8 on the amendments that have been circulated. It includes the applicant’s parental involvement on the assessment panel in relation to clauses 34 and 37. Fourthly, we will bring forward the review of the legislation to three years after the commencement rather than five years, which is within the legislation, to allow any problems with the operation of the panel to be addressed sooner rather than later.

I have covered off on the legal requirement quite clearly that may inadvertently push medical professionals out of this very specialised field of VSC. In relation to broadening the assessment panel, I believe I have covered off on that also. To include parents in the discussions with the panel – in my experience parents perhaps are the most informed of any clinician when there is something that is not quite right with their children. Now we have access to the dark web, we have Google and we have people who are very, very up to date with what is happening, and some of it is misinformation. It would be very useful for parents to be involved in those discussions or at least be able to hear clinicians speaking about the conditions that involve their child, because parents want to make the right decision. If they can hear the pros and cons of different treatment options and of why this may be recommended in the treatment plan rather than this, it will provide, I believe, a better journey towards acceptance of the treatment plan and a smoother pathway towards support for the individual who will be the subject of this. The intent of the amendment is about trying to improve the communication flow rather than anything else. Then fourthly, to bring forward the review of the legislation – as I have stated, that is in reflection of some of the issues that have been seen in the ACT.

We understand that these amendments will not be able to be considered today, so it is only for this reason that, under the standing orders, I wish to advise the house of amendments to this bill and request they be circulated. This is a reasoned amendment. I move:

That all the words after ‘That’ be omitted and replaced with the words ‘this bill be withdrawn and redrafted to reflect further consultation with the medical sector.’

This is intended only to ensure the voices of paediatric endocrinologists and those groups who have not been involved to date who are flagging these concerns are heard. It is not intended to hold this up at all. I want to make that very, very clear. If we could put forward the amendments today, we would do so. The intention is that we know that there are opportunities here to improve this legislation. I am hopeful in this way that it is with good intent to make sure that we can get the right legislation passed and not have unintended consequences, unintended harm and an unintended reduction in the number of clinicians in this specialist field and that this be considered. In light of this amendment not being supported, I do urge the government to have those further discussions with the community, clinicians and the medical community, whether it is about with people with lived experience of dealing with the medical community and medical decisions through their diagnosis and treatment or whether it is anybody who has other relevant contributions to that and to please consider making these amendments prior to this bill being debated in the upper house.

As I said, the intention is not to delay the passage of this legislation. The intent is to strengthen it and ensure that people who are born with variations in sex characteristics can access safe care in Victoria’s health system and that we can ensure that the dignity and respect that they deserve is continued through appropriate consent and appropriate treatment.

 Vicki WARD (Eltham – Minister for Emergency Services, Minister for Natural Disaster Recovery, Minister for Equality) (10:45): Respect matters, and in this state it is paramount. I offer my respect to every person in Victoria with variations in sex characteristics. You are incredible people. I am grateful to be in a position to offer my support to this important legislation in my capacity as Minister for Equality. I thank the Minister for Health for her leadership in bringing this life-changing legislation to our department. I thank her, her team and the department for the extensive consultation they have done across community, including the medical profession, to make sure that this legislation is exactly what it needs to be, and that is exactly what it is. I do look forward to its support in this place and in the other place. I acknowledge the extraordinary leaders and advocates who have contributed to this reform, particularly Tony Briffa, who is here today, along with members of the intersex community, supporters from InterAction for Health and Human Rights, Equality Australia and those watching online.

To our Victorian community members with variations in sex characteristics: our government has seen and heard you. We have witnessed the pain of your stories run across your face as you spoke of your childhood, of your teens and of your adulthood – your lives, where so many of you had been taught from the moment you were born about shame, about the fear of being physically different and that you could be seen to not be enough. You are enough, and we want you to be proud of who you are, the beauty you contain and the strength of your spirit. We recognise the disempowerment many of you have experienced through having decisions about who you are being made for you before you even had learned to speak.

Tony Briffa is an incredible advocate for her community and has been championing the rights and wellbeing of people with variations in sex characteristics for over 25 years. The courage Tony showed in appearing on 60 Minutes to tell her story is worthy of deep respect. The trauma she endured and the choices that were made for her without her consent are deeply disturbing and upsetting. No child should have their rights ignored like that, and for this experience and for the challenging experiences that you have had, Tony, I am sorry; it should not have happened. I extend this apology to all people with variations in sex characteristics who have not received the respect they deserve. I am also grateful to our commissioner for LGBTIQA+ communities Joe Ball for his ongoing support of intersex Victorians.

In Victoria this Labor government has been determined since we were first elected to strengthen equality in this state. We aim high – for every Victorian to be equal and to feel valued for who they innately are. Victoria has a longstanding legacy of advocacy for the rights of people with variations in sex characteristics. Intersex Peer Support Australia was founded at Royal Melbourne Hospital in 1985 and played a fundamental role in providing community, belonging and connection for intersex communities at a time when it was needed most, along with advocacy, education and training. I know their fabulous 40-year anniversary celebration at the Victorian Pride Centre last year was a huge success, supported by our government through our Pride Events and Festivals Fund, and I thank the Victorian Pride Centre, Australia’s first and built by this government, for being an incredible, beautiful, safe place for joy, celebration and pride. Intersex Peer Support Australia recently merged with Intersex Human Rights Australia to form an amazing organisation, InterAction for Health and Human Rights. Their special multiday retreat enabled intersex Victorians to gather, network and community-build in safety and was supported by our government through our LGBTIQA+ sector strengthening fund.

When we say equality is not negotiable in Victoria, we mean it, and as a government we stand firm in our commitment to achieving equality for all LGBTIQA+ Victorians in both words and in actions. Our Labor government established the first, and still only, Minister for Equality in the country and the first and only dedicated commissioner for LGBTIQA+ communities, and Victorians with variations in sex characteristics are an important part of community.

Our Labor government also created the LGBTIQA+ taskforce, and I acknowledge my co-chair Adam Bourne, his leadership and his support for community. Establishing the taskforce ensures that lived experience is considered within government decision-making regarding our diverse LGBTIQA+ communities. This has strengthened voices, including intersex voices. We invested $1.3 million in the 2021–22 state budget to support recommendations from the Victorian Department of Health’s report (i) Am Equal: Future Directions for Victoria’s Intersex Community, informed by the Victorian Intersex Expert Advisory Group, and we passed strong anti-vilification reforms last year that included sex characteristics as a protected attribute under the Equal Opportunity Act 2010.

Our commitment to establishing safeguards for intersex Victorians is reflected in our Australian-first comprehensive blueprint to progress equality, Pride in Our Future: Victoria’s LGBTIQA+ Strategy 2022–23. Pride in Our Future works across four key domains: equal rights and freedoms; equitable access; accessible and inclusive services; visibility to inform decision-making; and safe, strong and sustainable communities. Through our strategic plan we will continue breaking down barriers to achieving equality for intersex Victorians, including improving their health and wellbeing outcomes and experiences of care. We have made positive progress in so many areas, and we will continue building on this work to ensure that all Victorians can live safely, wholly and freely. Today we are the first state and the second jurisdiction to establish an important health safeguards and oversight system to protect intersex people, particularly infants and young children. This is something the community have sought to see for some time, and I am glad we are finally here.

Intersex variations can include differences in anatomy and reproductive organs and hormonal and chromosomal patterns that differ from medical and social norms for male and female bodies. Variations in sex characteristics are a natural and normal part of our human diversity, representing around 1.7 per cent of the population, which means it is about as common as being born with red hair. Here in Victoria we do not just welcome diversity, we celebrate it. We know it makes us stronger. This includes the biological diversity that makes up our intersex communities and supporting their right to self-determination over non-urgent, deferrable medical treatments and interventions. Fundamentally this legislation is about dignity, about protecting the right to bodily autonomy, about protecting fertility and the human right to consent to non-urgent, avoidable medical procedures that can cause harm, harms that can originate through a lack of knowledge, awareness and understanding of the normalcy of intersex variations.

Establishing a safeguarding and protective system helps address these issues and reduce the barriers that intersex people often face when accessing health services. It is about improved health and wellbeing outcomes, better experiences of care, and empowering families, caregivers and medical practitioners to access the support they need and the information they need to ensure that all Victorians with variations in sex characteristics can thrive in an identity and a body that is theirs and theirs alone.

A recent report published by Equality Australia, The Missing Voice, gave insight into the experiences of people with variations in sex characteristics in Australia. I thank members who shared their deeply personal stories. Some words from Stephanie, for example, are:

I had been sterilised due to a decision made by clinical specialists, and I will have to live with the consequences of that for my entire life.

From Jade:

I feel robbed of an opportunity to be in my own body, instead of one some doctor picked out for me, just so I fit some imaginary binary.

And from Eli:

The biggest thing for me is that my body has never felt like it belonged to me because I don’t know what was done to it.

While these personal experiences might be hard to hear, they speak to the heart of exactly why establishing a health safeguards system for intersex people is so incredibly important. This is not about taking something away from caregivers, parents, or clinicians; it is not about preventing urgent and essential medical care. This bill is about ensuring we provide the best information, services and supports to enable the best possible decision-making that upholds the rights and autonomy of people with variations in sex characteristics. It is about individual ownership and custody of your own body, identity and fertility. I encourage all members of this place to join together and listen to intersex communities, their lived experience and the positive benefits these protections will have on whole-of-life outcomes, and I urge support of this bill.

 Tim READ (Brunswick) (10:55): I affirm the Greens’ support for this important legislation. This is a bill that seeks to protect the health and wellbeing of people born with innate variations in sex characteristics, and this bill does so by putting in place safeguards where it is proposed that a person undergo medical treatment to change their sex characteristics in circumstances where they cannot provide informed consent due to age or impairment. Importantly, this bill does not prevent treatment that is urgent and required to save a person’s life or treatment that is otherwise necessary to prevent significant physical or psychological harm. This legislation has been many years in the making, involving deep engagement particularly with those who have generously shared their lived experiences in an effort to drive change.

The bill strikes an appropriate balance between sometimes competing principles of bodily integrity, children’s right to participate in decisions about them, medical necessity and independent oversight, and, importantly, it responds to the many medical harms endured by people born with variations in their sex characteristics around the world, including here in Victoria. Surgery and other medical interventions have too often been performed on babies and children to change their sex characteristics to make their bodies align with societal expectations of typical male or female bodily appearance and function. Sometimes these interventions were irreversible and not medically necessary and many people who underwent them were never given a say in decision-making about their body and were not informed about what had happened until they were much older, and this understandably caused immense pain and trauma for those affected.

Thanks to relentless campaigning of intersex advocates and LGBTIQ+ organisations, things have improved significantly compared to the past. Decision-making is now often much more holistic and inclusive of broad perspectives compared to, say, a single surgeon giving advice about or making decisions on behalf of a child and their family. However, babies and children remain at risk of having unnecessary medical interventions to change their sex characteristics, which can wait until they are old enough to give their informed consent.

The bill introduces a range of safeguards that centre the human rights and autonomy of babies, children and adolescents with innate variations in sex characteristics, and the bill achieves this in four key ways. First, it sets out a supported decision-making framework regarding consent whereby a child or young person is provided with age-appropriate information about the treatment being considered and the implications of having or not having the treatment. This is a contemporary approach to consent that is increasingly being adopted for medical treatment for children and young people.

Second, the bill establishes an independent assessment panel to oversee general and individual medical treatment plans for treatments that could result in permanent changes to sex characteristics. Crucially, the panels will include people with lived experience. The panels will not replace current multidisciplinary teams, which play a pivotal role in care. Instead they play a complementary role, supporting them with decision-making, ensuring that important perspectives are included in that process and providing additional oversight and transparency.

Third, the bill provides for the development of treatment plans, which provide approval for treatments that vary sex characteristics. Provision is made for general treatment plans for common treatments informed by the established evidence base and individual treatment plans for more specific treatments. These will be developed by clinical experts, and the panel will provide oversight regarding their approval and administration. Importantly, these treatment plans are not set and forget; someone may have multiple treatment plans or variations to them over the course of their life, depending on the circumstances at the time.

Fourth and finally, this legislation imposes criminal liability for wilful noncompliance with the provisions of the bill related to the treatment of a protected person that does not have the capacity to consent to proposed medical treatment to change their sex characteristics, and this recognises the profound harms caused to intersex people and those with variations in sex characteristics by unnecessary medical interventions. I understand that some clinicians have expressed concerns about inadvertently falling foul of this new law. However, the bill sets a high bar for prosecution and provides that only someone who deliberately and recklessly ignores the law can be prosecuted.

The bill marks a significant change in the way treatments are considered for people with innate variations of sex characteristics. The ACT is the only other jurisdiction in Australia with similar legislation, and the Victorian legislation has taken lessons from the ACT law while maintaining its essence. Understandably, some people have questions and concerns about what this will mean for them, for their children or for their clinical practice. Given a lot of the detail is being left to regulation or to the determination of the oversight panel, there is some uncertainty about what the potential implications could be for certain treatments and practices. We have heard these concerns, but we believe that the implementation process that has been outlined will help to address many of these and that some degree of flexibility is required to allow for changes over time to reflect our evolving understanding of best practice approaches. Critically, the government’s bill allows for a three-year implementation phase, during which time general treatment plans will be developed and clinicians can become familiar with the structure and functions of the panel and the many supporting regulations that can be developed. We have been assured that the intersex community and clinicians will be deeply involved in developing these regulations.

We have also heard concerns about resourcing, and we support calls to ensure that the implementation of this bill is adequately resourced. Failure to do so will undermine the very purpose of the bill and the rights of those it seeks to protect. There needs to be greater funding for community organisations who can provide peer and family support, as well as broader community education on variations in sex characteristics. More generally, the government needs to ensure there is further policy and resourcing to help drive cultural change in the community. People born with a variation in sex characteristics face significant stigma and discrimination, and variations in sex characteristics are poorly understood by many in the broader community. There is still a long way to go to address this, but hopefully this bill marks an important step forward.

 Kat THEOPHANOUS (Northcote) (11:02): I am really pleased to rise to speak on the Health Safeguards for People Born with Variations in Sex Characteristics Bill 2025. As the title suggests, the bill relates to people who are born with physical sex characteristics that do not fit typical definitions or understandings of male or female bodies. These variations are a natural part of human diversity and occur in up to 1.7 per cent of all births. In Victoria that means up to around 1500 babies every year. Many of these children will never require medical treatment. Their bodies are healthy, functional and diverse. These are amazing people and they are not broken. Yet for decades infants and young children born with variations in sex characteristics have undergone surgical and hormonal interventions that were not medically urgent, were often primarily cosmetic and were performed long before the child was able to understand, participate in or consent to what was happening to their own body. These procedures were frequently irreversible. While many of these decisions were made with good intentions by parents wanting the best for their child and clinicians operating within the norms and guidance of the time, the consequences for many people have been devastating and lifelong.

The Allan Labor government committed in 2021 to establishing an intersex protection system as part of the (i) Am Equal report, developed by the Victorian Intersex Expert Advisory Group. That commitment came after about 20 years or more of advocacy by people born with variations in sex characteristics, advocacy calling for nothing more radical than the same bodily autonomy afforded to everybody else. It should come as no surprise to anyone that people want to make their own choices about their own bodies when they are ready, informed and supported to do so. Their call has been echoed by human rights organisations, medical experts and national and international inquiries. People have bravely shared their experiences, including of sterilisation, chronic pain, sexual dysfunction, psychological trauma and a deep sense of violation, a feeling that something fundamental was taken from them before they had a voice.

These are not rare stories; they are consistent, powerful and confronting. What they tell us is that too often there has been no clear mechanism to pause and draw on broader expertise before decisions are made that carry lifelong consequences. We have listened, and this bill introduces strengthened processes for informed consent, establishes an independent oversight panel and improves reporting and transparency requirements, all with a single clear objective: to reduce the risk of harm to children.

I want to be really clear: this is not about blame. For many families, the birth of a child with a variation in sex characteristics brings fear, uncertainty and isolation. They are often navigating complex medical information at one of the most vulnerable times of their lives without peers to turn to and with limited access to balanced long-term information. Some parents have told us of their regret that they consented to procedures without fully understanding the lifelong consequences and that those procedures could have been deferred or not occurred at all. That regret is not a failure of parenting; it is a failure of the systems that did not adequately support them. This is why strengthened information provision and independent oversight are so essential.

This bill ensures parents are better supported to understand their child’s variation, the full range of treatment options and the risks and benefits, including the option of deferred treatment until their child can express their preferences or provide informed consent themselves. It also provides reassurance through an independent expert panel. Parents can have the confidence that if treatment is recommended it is necessary, it is evidence-based and it is in the best interests of their child, not driven by outdated norms or unnecessary pressure to act. Importantly, parents will still give consent for treatment to proceed in line with an approved treatment plan and will be able to seek a review if they disagree with the panel decision. The bill does not remove parents from decision-making; it supports them to make better, more informed decisions.

I am aware that there have been hesitancies in regard to how the new measures will work in practice and in particular ensuring that children are not denied timely care due to the increased level of oversight, so it is important to note that a number of provisions ensure that necessary treatment will proceed without delay. Urgent life-saving treatment or care needed to prevent serious harm will never be delayed; that is consistent with well-established clinical practice. Urgent treatment is captured as an exemption within this bill so that doctors can act without fear of committing an offence, ensuring it is never a barrier to critical care.

There are also many other treatments that can be preapproved to proceed without delay through general treatment plans, which supports proactive care planning. The panel’s independent oversight applies only where treatment is not urgent and a person is unable to give informed consent. In those circumstances an independent expert panel will assess and approve proposals for permanent or difficult-to-reverse treatments, and that panel must consider clinical urgency and adjust approval timelines accordingly, because there are serious and complex circumstances at play here, with medical and moral implications. So the panel brings together strong medical leadership, including specialist clinicians and mental health experts, alongside expertise in lived experience, health law, human rights and ethics. It is rigorous, balanced oversight, grounded first and foremost in medical expertise and protection of the person.

Clinicians have been deeply involved in the shaping of this bill, and I am genuinely grateful for the expertise they have so generously shared. Their feedback is reflected throughout, from tightly limiting the offence to only the most egregious breaches so doctors acting in good faith are not captured to strengthening panel membership and decision-making so clinical expertise sits at the centre. Panel processes are designed to draw on relevant specialist knowledge, address clinical urgency to avoid delays in care and align with established medical practice by using existing definitions wherever possible. Importantly, implementation will be staged over three years, ensuring clinicians remain closely involved in developing guidelines, templates and training so these reforms work in practice as well as in principle.

This legislation recognises that children are not problems to be solved or bodies to be shaped to fit social norms. They are people deserving of dignity, autonomy and protection. It also recognises the significant and overlooked impacts on mental health, because when we listened to the stories – the lived experience and perspective of those with variations – we heard that many adults who underwent non-urgent interventions as children experienced anxiety, depression, trauma, difficulties with identity and a lifelong struggle to trust our medical systems. These experiences do not end in childhood, they echo across lifetimes, and this legislation is not about denying care; it is about care with consent.

It is worth noting that the reforms are also about supporting clinicians. The doctors and specialists working in our children’s hospitals are extraordinary, and this bill assists them to deliver best practice care by providing clearer guidelines, stronger frameworks and protection from some of the decision-making risks they carry. This reform has not been rushed. The development of this protection system has been underway since 2021. Victoria will be the first state and the only jurisdiction in Australia to enshrine these safeguards into law, and I acknowledge the Minister for Health for her leadership in making these reforms a priority and guiding them through this Parliament.

This matters. It matters because it sends a clear message about who we are and what we value. It says that in Victoria we believe informed consent matters and we believe that preventing harm must always come first. This reform is grounded in listening to the pain that has been shared, to the lessons we have learned and to the responsibility we carry going forward. It ensures that children are given what many before them were not: protection, time and a genuine voice in decisions about their own bodies. I commend the bill to the house.

 John PESUTTO (Hawthorn) (11:12): I rise to speak on the Health Safeguards for People Born with Variations in Sex Characteristics Bill 2025, and I do so recognising the comments made by the lead speaker for the opposition earlier, who has circulated some amendments in relation to the bill but spoke of the importance of reforms in this field. In making my remarks today I would like to acknowledge in the gallery Tony Briffa, who has been a highly recognised and very well regarded advocate in this field, and I commend Tony for the work that has been done in this space.

I begin with some reflections on some of the guiding principles which the bill purports to enshrine, which I think are universal and timeless, including, without diminishing the significance of all of the principles that the bill aims to enshrine, bodily integrity, which connotes the importance of autonomy, which we each value. We should strive to ensure for everybody that they have autonomy over their bodies and their futures. That is a very important principle, and I wish to recognise that, as well as the principle of agency, for children in particular and those with cognitive impairments who are of older age – principles that no-one can really contradict. To that extent, I just want to acknowledge at the outset that they are very important.

Reforms like the ones that this bill seeks to introduce are, you might say, overdue, certainly welcome and certainly not before time. But I think they also reflect a growing sophistication in the way we approach reforms in this field, in the health space. We have made giant strides in the area of mental health where we aim to destigmatise and talk openly and with greater candour about the challenges that people in our community face. Certainly for those in the intersex community, I can imagine that this bill will, I hope, bring great comfort for people to know that there will be improvements to the way that we deal with often very difficult questions about interventions for young children. To that extent I can say that we will not be opposing the bill but we will be moving amendments. I just want to reflect on those in my remarks today.

I want to begin with the proposal in the amendments to remove clauses 7 and 8, which seek to criminalise certain forms of medical intervention. We all want this bill to succeed. I do not think there is anybody here who does not want to see the aims of this legislation not materialise. But I think there are two issues here in particular that I would like to flag. One is a general one. I do not think as a matter of general legislative policy we should readily jump at criminalising some parts of medical practice, whether it is in the intersex field or whether it is in other areas of paediatric services, women’s reproductive health or any area of health. We already have regulatory and professional sanctions that apply, fittingly, for misconduct and material derelictions of medical and professional duty. We already have that. But it is also worth noting that there are already criminal sanctions that apply to any medical practitioner who departs in egregious ways from those standards and causes harm. They already exist. Putting aside the very important subject matter of this bill, I do not think it is helpful that we carve out particular areas of medical practice and then criminalise those when similar misconduct in other areas is not subject to the same criminal sanctions. I think there is a benefit, again as a matter of legislative policy, to have consistency across the statute books when it comes to the provision of any medical or clinical service. That is the first point I want to make about the amendment to remove clauses 7 and 8.

The other point that I want to echo, because it was a point well made by the member for Lowan, the lead speaker for the opposition, is that we do not want to deter medical practitioners from entering this important field. The idea that this will not deter them, I think, is well meaning but misplaced. I think it will have a deterrent effect when we want to encourage more practitioners into this field. We want it to be a field where there is more awareness, thankfully, of some of the choices and benefits to be had from delaying any deferrable medical procedure so that the long-term decisions that cause great harm and great trauma to individuals can certainly be avoided. It is for that reason that I do think it is unhelpful to include a criminal sanction and a criminal regime specifically for this area of medical treatment and clinical delivery.

The amendments also touch on a couple of other aspects that I just want to comment upon. The member for Lowan made the point about ensuring that there are more disciplines represented in the panels, and I think that is a sound and worthy amendment that I hope the government takes on. I think the idea of including in the panels paediatric and adolescent endocrinology, urology, gynaecology and psychology is a worthy addition and will only improve the operation of such panels. I do not know why that would not be agreed to. It does not defeat or in any way frustrate, in my view and in the view of my colleagues, the worthy aims and objectives of this bill, so I hope that the government takes on those amendments in the spirit in which they have been offered.

I also think there is merit in the amendments that the member for Lowan moved in relation to ensuring that all decision-makers can be better consulted on the way through these decisions. Again, it is not a case of amendments that will frustrate the purposes of the bill. I think in an area like this, where it is an important reform, the reforms will be better and more effective in achieving their aims if the panels are opened up to the kinds of interaction which will enable all decision-makers to feel like they have discharged their responsibilities to ensure that the very best decisions are made. After all, that is what we want in the case of this bill. I think we all recognise in this house that for far too long decisions were made that led to enormous trauma and lasting injury, hurt and physical pain for so many people. But the amendments that we are moving, I stress, are not aimed at frustrating the purposes of the bill.

I think in cases like this and reforms like this, which are long overdue, there is something to be said for a collaborative approach that ensures that when the bill finally passes, everybody has had a stake in the delivery of that reform and all issues have been considered and taken into account. As the member for Lowan said, do you want a reform to go through and pass both houses when the concerns of professional bodies like the AMA – who have raised some important and salient points, which again, do not frustrate the ultimate purposes of the bill and need not delay the passage of the bill, given that there is a long lead time before commencement. Commencement is December 2028, so there is plenty of time to ensure that all stakeholders have had the input they want to, that issues that may not have been identified or appreciated fully by the government can be weighed in the balance and that by the time the bill passes, the contributions of us as an opposition, on my side of the house, but perhaps more importantly, the professional bodies whose medical practitioners exercise their skills and knowledge in this field, have been taken into account. I would simply say to the government that there is a lot to be said for taking the opportunity, perhaps between its passage through this house and its entry into the other place, to take on board the very considered and meritorious issues that have been raised, which in no way will frustrate the government’s aims, so that we can end up with a bill that passes the other place and comes back here with those amendments and we can ensure a bill that achieves important reforms off the back of some great champions, some of whom are in the gallery today, for the benefit of all in our community.

 Gary MAAS (Narre Warren South) (11:22): I rise today to speak on the Health Safeguards for People Born with Variations in Sex Characteristics Bill 2025 and in doing so say that Labor will always stand up for every member of our community, and that includes people in our intersex community. This bill will see Victoria become the first state and second jurisdiction to enshrine in law the right for intersex people to make decisions about their own bodies. We all have a right to be free in our own bodies. People with variations in sex characteristics are born with sex characteristics that do not fit typical definitions or understandings of male or female bodies. This can include a person’s physical traits, such as their reproductive organs, chromosomes or hormones.

A protection system for people born with variations in sex characteristics has been under careful development since 2021. Consultation has been extensive. Extensive consultation with people born with variations in sex characteristics, experts, parents, the medical profession and clinicians have made clear the need for better medical treatment decision-making. Existing laws have caused some intersex people tremendous trauma, as they have allowed for permanent changes to be made to their bodies, often as children when they could not consent. And these changes and procedures are not trivial; the consequences and implications are long-lasting, just as they are traumatic. This bill is about ensuring every person has the right to make decisions about their own body, to be free within their own body.

The bill enables better and clearer medical treatment decision-making for people born with variations in sex characteristics. It also aims to better support parents to understand and explore treatment options for their children, as well as provide doctors and clinicians with clearer guidelines and protections. The bill provides for the deferral of permanent or difficult-to-reverse treatment until the person with variations can give informed consent. The primary features of the bill are strengthened processes for obtaining informed consent, the establishment of an independent expert oversight panel and improved reporting requirements.

It is a really important bill. Infants and young children born with variations in sex characteristics historically undergo cosmetic procedures so their body can appear more typically male or female.

Intersex people have told us that often the consequences of these procedures can include infertility, impaired sexual functioning, scarring, pain and trauma. Imagine finding out you are infertile, which is always tragic for someone who wants children, and then learning that the reason is due to decisions that were made outside of your control as a child. It is shattering, and this is just one of the stories to come out of the consultation reporting which has led to this bill, both by Equality Australia and in the (i) Am Equal report, which was developed by the Victorian Intersex Expert Advisory Group. It is past time for our intersex community. They deserve to determine what actions are taken and to exercise informed consent on decisions involving their own bodies.

This bill will stop decisions being made when they can be safely deferred. This bill will give intersex people autonomy over their own bodies. A choice can then be made at an age when they, as a person, understand what is happening to their body. Informed consent is required before a person receives any medical treatment. If someone is under 18, it is up to the treating doctor to determine their capacity to give consent. For a person under 18, a parent or guardian is usually the decision-maker, unless the child is assessed as capable of giving informed consent for themselves. When decisions must be made for intersex children before they are able to give their own informed consent, parents will still be required to provide that consent. Such decisions could be surgical or include other treatments, such as hormones, which when administered early in life can be permanent or very difficult to reverse. The bill will assist parents by giving them more knowledge, better understanding and more support than has been the case in the past. They will no longer face these decisions alone.

The independent expert oversight panel will assess and approve proposals for permanent or difficult-to-reverse treatments for people who cannot give consent. In what would be a difficult and unexpected time for parents, the panel will provide reassurance to parents that their child is receiving the necessary treatment in line with recognised best practice. The panel will also support doctors to provide best practice care by protecting them from some decision-making risks and providing clearer guidance. This bill also will not stop doctors from providing treatment in emergency situations. The bill helps ensure dignity, it helps ensure safety and it helps ensure respect. It makes sure that these three core values are at the heart of the care that an intersex person will receive.

In the 21st century where we recognise the impacts and the consequences on mental health and our preparedness, I guess, to speak up and to talk more readily, this bill goes a very long way to reducing the short- and long-term mental health impacts on those who are facing these extraordinarily difficult decisions.

Look, it has to be said, Victorians do not need an opposition that is not fully supportive of our LGBTQIA+ plus communities. It needs government that is committed to protecting all citizens. I still believe the opposition is deeply confused and deeply in disarray. Some of their members attend Pride marches; others attend anti-trans rallies. It shows in their position, even on this bill. They are not opposing the bill, but they are moving a reasoned amendment for longer periods of consultation. Really? Come on. You do not know what you stand for. There are no values attached to their party anymore.

The opposition’s federal colleagues have even tried to introduce wording into legislation to restore the Sex Discrimination Act 1984 to the position it was back in 2013.

Nicole Werner: On a point of order, Acting Speaker, it is a narrow bill, and I would ask the member to come back to the debate. The point of order is relevancy.

The ACTING SPEAKER (Daniela De Martino): On the point of order, I believe the member was being relevant to the bill, and I ask the member to continue speaking to the bill.

Gary MAAS: You want to take the position back to 2013, when there were definitions of ‘man’ and ‘woman’. Why would you do that? Where would that leave our intersex community? There has been much rhetoric from some of those opposite about our LGBTIQA+ community, and it certainly is not indicative of the acceptance, respect and inclusivity that every single Victorian deserves no matter how they identify.

This legislation will ensure that intersex people are not erased, that our intersex community are recognised, that they are accepted for who they are and that they are in charge of the decisions that affect them across their lifetime. Everyone should have the right to determine what happens to their own body and to be free within their own body. I recognise the advocacy and I recognise the activism that has occurred by those in the intersex community over so many years that has informed this incredibly important bill. This is so much more than just a policy update; it is recognition of the rights that intersex people have to bodily autonomy, decision-making and consent. I commend the bill to the house.

 Annabelle CLEELAND (Euroa) (11:32): I rise to speak on the Health Safeguards for People Born with Variations in Sex Characteristics Bill 2025. I have just been toying with whether we share a family story, because I know that we have got some incredibly powerful advocates in the gallery today, and I want to just start by thanking them for championing such a difficult and personal fight for such a long time and sharing so bravely the change that needs to occur. I have already heard interjections. It is such a sensitive matter, so I am going to still process whether I share what our family went through – and it is very, very mild compared to some of the heroic stories that we have heard today as well.

I think that it is fair to say that everyone that has spoken understands that at the heart of this bill are children, and children before they have a voice. The hope of everyone in this place is to protect children and to care for them, and I think I can speak confidently that everyone is here for that intention. I think also from my experience as a mother and a parent I also want to be a part of this contribution because we just want to make sure things are right for children born with innate variations in sex characteristics. I could not imagine being a parent to a newborn and trying to make decisions that would impact a child for the rest of their life. I am certainly not trying to relate at all.

My son was born with hypospadias, which is a very common abnormality – sorry, Arthur, I hope you consent to this. At 24 hours old we had to make a decision about his future. We were weighing up things, and I have got to say that, as a mother, I was full of hormones. He was my first baby and, golly, you are just overwhelmed with love and care and you have got to make some pretty profound decisions. You are taking on all of this information, and you just pray that you make the right decision, I think. You are taking it all on and you are trying to process it. You are not a medical expert; you are taking on expert advice, and you are just loving a child. All of that muddles where you are at and whether you are able to process academic and professional advice and make decisions about this tiny 3.5-kilogram child that will impact the rest of their life.

We are allowed to have nuances in this debate. We are allowed to come with our personal experience, with our community’s experience, with the advocate’s experience, and try and make the best decisions possible.

I will go back to my speaking lines because this is hard. You have heard the conversations today that the intention is to make sure that we all make the right decision. I know that there has been some criticism about the amendments, but for something of this significance, I think that a lot of them come with good meaning. I think that we want to see fair contributions that ultimately we think will make it better for that child. We are talking about decisions in the first hours of a child’s life, and maternal and paternal love and protection deserve a say in that. It is something incredibly innate and animalistic when a child is taken from you and someone else makes a decision for you. That is really hard, because as a mother you have grown this baby. I digress, but you are powerful, and I am incredibly grateful for you listening to these conversations. I hope they have been respectful, and we are incredibly grateful for everything that you have done.

I do want to acknowledge – I have spent half my contribution already, pardon – the intersex Victorians and families who so powerfully have contributed to this. Some stories are hard to hear. They have stood up and fought when they themselves did not have the voice to do so: people who have lived with lifelong complications, fertility challenges – that was the fear for my son – chronic pain, psychological trauma. Just on a side note, I hope my son does not listen to this, but he now looks at everyone’s willy and says, ‘Mum, what’s wrong with their willy?’ So I have given him confidence that things are going to be okay. You just try and manage emotions, and you try and manage decisions, and you try and do the best for your children. That is all I want to say. I think that no-one in this place wants to do anything except the best for the kids of Victoria. I certainly want to make sure that all of this is very respectful. I think that we all see that the intention of this bill is strengthening safeguards and just making sure that those irreversible decisions are not made too early or without proper consent. That is something that I absolutely genuinely support, and we have had a mild case, but we have felt like we have been there.

Vulnerable children should never be controversial. That is where we wrap our arms around it; that is where we have respectful conversations without interjections. We just listen, and we hear from our community and we hear from the people that we are representing across Victoria. We ensure we protect families without creating new risks, and that is always really hard I think in this place. We come through with an enormous amount of new laws and legislation, and we move at pace with multiple a week, and we have to sit and make sure that we are doing it with the right consultation. This is critical, because they always have lifelong consequences for people. Unintended consequences can be significant.

I reflected on when my son was born. I had not slept for I think up to two days, and we had to make some significant decisions. I just thought, ‘I’m not fit or well to necessarily do this, but I want to be informed. Give me all the information, give me an amount of time so I can process this without harming my child.’ I think that when you are exhausted or you are scared and you are looking to doctors for guidance, it is really critical that all of that is easy to digest, is not clinical, is not in a language that you do not understand, and that you still get to be that primary carer of your child with informed decisions. I think that this bill has got so much goodness to it, but we do need some refinement. The role of parents – I could not imagine not being at that table for decisions for my son. We came to the party, absolutely. We understood that the professionals were always going to have the best intentions, but they also had to consider how we lived. We lived hours away from a hospital. Complications had to be taken into consideration. It was not just a report on the desk about this little baby. It was certainly: how long can you travel to hospital? What is the level of care if there are complications? If he needs psychological support, where can you get it? Can you get it?

It is about so much more than just the potential surgery, I think. I do hope that we see that parents can become a part of that primary decision-making process. Clinicians have raised some concerns about unintentionally capturing more common or straightforward conditions with well-established treatments, and if paediatric care is drawn into a lengthy approval process, we risk delays that are not in the best interest of children. One thing we all know is that when it comes to health, timing matters incredibly; it can change the outcome significantly.

We also want to raise some feedback about the composition of the panel. If the panel is going to hold significant authority over treatment, I really hope that it sees important stakeholders and experts in paediatric endocrinology, urology, gynaecology and psychology. We need it to be that holistic safety net, with experts in mental, physical and family health as well. All of these specialists understand the complexity, the risks and the real-world consequences of delays.

I have absolutely gone rogue on my contribution. I understand the legislation, and we are largely in support of it. I hope that our recommendations and our amendments can be considered, because we certainly come from a place of wanting to protect children – I think that everyone here does. There are concerns around current safeguards, whether the criminality extension is a bit too far and ensuring the panel includes appropriate specialists. But we just want to make sure that it is practical and grounded in good medicine, and that is the balance that we are seeking.

 Nina TAYLOR (Albert Park) (11:42): I certainly am very pleased to speak to the Health Safeguards for People Born with Variations in Sex Characteristics Bill 2025, emphasising that element of health safeguards in particular, when we are talking about how these very important reforms are being handled. Ahead of going into the particulars of the bill, I did just want to address some of the concerns raised in the chamber, noting that the Victorian government did commit to introducing an intersex protection system in 2021 as part of the (i) Am Equal report, which was developed by the Victorian Intersex Expert Advisory Group, backed in by more than 20 years of campaigning and advocacy for people with variations in sex characteristics to have the same body autonomy as everyone else. When we talk about that issue of equality not being negotiable, we mean for all Victorians, none the least those with variations in sex characteristics.

I think it is fair enough, and I hope it will not be received in a negative manner necessarily, that we are querying the reasoned amendment, because we all know that a reasoned amendment kills a bill. At the end of the day, it is quite a significant, blunt exercise that will stall a bill proceeding. My concern is that it is perhaps raising unnecessary doubt about the rigour that has been applied in the development of this bill, noting that clinicians have had significant involvement in the design of the bill.

The other issue, and I raise this with absolute sensitivity, is that what has been raised, quite rightly, is some of the almost impossible pressure that parents, over time, have had in having to make decisions which we know, historically, for some may have worked out in a reasonable way but for others have had absolutely devastating consequences, and those have been raised in the chamber, such as sterilisation, trauma and medicalisation, the net effect of which ended up being a violation of those children’s rights to body autonomy. It is not about passing blame, because we are not here to presuppose the intention of those previously, and it has been going on for decades.

Nonetheless, the parents who had to make seemingly impossible decisions under pressure certainly had very sound intent, and what the bill should deliver is actually an element to reduce that pressure, so that with the building of empowerment, in terms of information for the parents, they can be better informed ahead of having to be part of making decisions on this but also to include the voice of the children, because we know they are the ones that ultimately have to live with, or who have had to live with, some pretty fundamental, irreversible medical interventions that have taken away some of the most precious experiences that others in the community are able to have.

I should say that these variations in sex characteristics are natural and occur in up to 1.7 per cent of all births in Victoria. Most people will not require medical treatment, but we know infants and children born with variations in sex characteristics have undergone primarily cosmetic procedures so their body can appear more typically male or female. As I was stating from the outset, this has occurred for decades in Australia and overseas, and these interventions, including surgical or hormonal treatments, were often not medically urgent or necessary, irreversible and performed well before the person was able to consent. As I was saying from the outset also, whilst these treatments often came from a benign place, the consequences can be lifelong – pain, sexual dysfunction, psychological trauma, a deep sense of violation and, as has been stated to the chamber, sterilisation, which would be absolutely devastating. The effect of these treatments was made clear in Equality Australia’s The Missing Voice report, which was released in December last year. The report is publicly available and certainly well worth a perusal to really understand the imperative – the absolute imperative – for pushing these reforms forward through the Parliament, noting that there has been deep and profound and careful consideration ahead of these reforms being brought before the Parliament. As I was saying before, the reasoned amendment, I would suggest, may be unnecessarily querying the rigour that underpins the legislation we have before us.

The bill provides for the deferral of permanent or difficult-to-reverse treatment until the person with variations can give informed consent. The primary features of the bill are strengthened processes for obtaining informed consent, the establishment of an independent expert oversight panel and improved reporting requirements, noting urgent treatment required to save a person’s life or prevent serious damage to their health will not be delayed. So when we are talking about the underlying theme here – and that is health safeguards – of course the best interests of the child must be prioritised, and if urgent medical treatment is required then the bill certainly will not stand in the way of that treatment being delivered. Additional oversight will only apply if the treatment is not urgent and the person is unable to give informed consent, for example, because they are an infant or a child. Medical care for people born with variations, I should say also, has come a long way, and thank goodness for that. It is true that some people with variations are happy with the outcome of their treatment, and I think that is important to note here. I believe overall this has been a very nuanced and sensitive discussion in the chamber, as it should, but I do not want to disregard the spectrum of experiences of the intersex community.

Nevertheless, there are complex and consequential medical procedures, and it is important that these reforms encompass all care and are backed up by the simple right of people being able to make decisions about what happens to their own bodies.

This will be done through four mechanisms: informed consent safeguards, an independent oversight panel, the development of treatment plans and consequences for knowing, and reckless breaches of the law. Proceeding with treatment for variations in sex characteristics can be complex and consequential. The informed consent safeguards enshrine best practice for obtaining consent. Some doctors are already practising this way. These safeguards will ensure that this is the standard approach.

In the time that I have available I do want to speak a little bit further to the clinician element. We know that clinicians in our children’s hospitals are some of the best in the world, and the care given to people born with variations, as I was saying, has come a long way. Clinicians have been significantly involved in the design of the bill. I want to reiterate that point, seeking to allay some of the concerns that have been raised by the opposition. Certainly that has been fundamental to the development of the bill. I understand clinicians will be central to the work of implementing this bill, including in the development of what is or is not eligible for a preapproved treatment plan, among other important components of implementing these changes. The legislation will assist doctors to provide best practice care. It will ensure that doctors are more protected from some decision-making risks by providing clearer guidelines and independent oversight. Importantly, specialist clinical expertise must be on the independent oversight panel. Doctors acting in good faith have nothing to fear from this legislation. The offence is carefully worded so only the most serious, knowing and reckless breaches are captured by this offence. Again, with the hope of allaying some of the concerns of those opposite, I note that Victoria is the first state or jurisdiction in Australia to enshrine these safeguards into law.

 Will FOWLES (Ringwood) (11:52): It is my pleasure to make a contribution today around the Health Safeguards for People Born with Variations in Sex Characteristics Bill 2025. I want to begin by calling out the fantastic work of so many people in getting this bill all the way from its genesis, which I guess was many, many, many years ago, but particularly from 2021 onwards. Whilst I am at times a critic of the Allan Labor government, I absolutely do not offer them any criticism; I only offer them praise around the equality agenda. The work they have done has been absolutely outstanding, but it is work that has been ultimately supported by a number of people in the community. I want to thank all of the team at InterAction for Health and Human Rights, Tony Briffa, who is the co-chair of InterAction, Paul Byrne-Moroney, Emiliana Soulio, Joe Ball, Professor Adam Bourne, Alex Potter, Janet Jukes and Sean Mulcahy, and of course Morgan Carpenter has written to me on this matter. Also, I want to thank the fantastic team at Equality Australia, including my old university mate Anna Brown but also Heather Corkhill, Emily Mulligan ,Tara Ravens, Dale Dawson, Teddy Cook, Sanjay Alapakkam, Amber Wright, Kristie Baker, Mike Hitch, Hanna Yorth and Max Pick, as well as Fiona McLeay and all of her board. These are extremely hardworking people. They are passionate advocates for their community. They do outstanding work each and every day. I think too often they are representing a cohort that does not obtain sufficient recognition not just in this place but more broadly out there in the wider world. I want to thank each and every one of them for the magnificent work that they do. So thank you all for being here. For those following along at home, thank you as well.

This is an important matter, and I want to thank the member for Euroa for her contribution particularly. I have always been a fan of the member for Euroa, but that fandom has gone up a couple of notches in recent times, not just around the bushfires and her work in the community in which so many of my family live in, in that seat, but also for her fantastic contribution today. It takes courage to talk about your own kids in this place. It takes a special kind of strength to do so without crying. She was amazing in getting through that. I think her honesty and her ability to bring to the table her lived experience demonstrate the Parliament doing its very best work.

It is the case that the coalition have moved a reasoned amendment to this bill, which is, as the member for Albert Park has correctly pointed out, a stalling or delaying procedural motion, and I will not be supporting that reasoned amendment. The coalition have also shared with me – and I thank the member for Lowan for the briefing – some textual amendments which they will be seeking to move in the other place. I have some difficulties with those textual amendments as well, and I will go to those in a moment.

I wanted to start, I think, with the Equality Australia position on some of this and make very clear that, by way of background, people with innate variations in sex characteristics, also known as intersex people, have a range of physical traits that differ from the medical and social norms for male and female bodies. Up to 1.7 per cent of the population have those traits. Fundamentally, what sits at the heart of the report that EA put together, The Missing Voice, is the importance of delay. We actually speak a lot about frustrations with delays in this place. This is one part of the universe where I think delay is a very, very positive thing. What we do not want to see is, as Morgan, I think, put it in his letter to me, the psychosocial element of parental distress guiding decision-making that might have very real, very permanent and ultimately potentially very harmful effects on people with intersex variations. We just need to hold off. Let us of course give due consideration to parental feelings about it, but as the member for Euroa has herself flagged, there is a lot going on when you have just brought a new human into the world. There is a lot of input, there are hormones running wild, there is fatigue, there is the management of all sorts of emotions and all that sort of stuff going on. It is a very, very difficult time to be making massive, massive calls about the future of your child.

What we are seeing in the evolution of the medicine around these things is that immediate action is not necessarily the right course of action. In fact there are very few genuinely urgent medical interventions that are performed on intersex children. If it can be delayed, essentially it ought to be delayed. Thanks to the work of some of the great people sitting in the gallery and following along at home, we no longer conceptualise our humanity as being binary – one or the other – or as being normal or abnormal in that way. There might have been some of that language, perhaps hurtful language, used sometimes in the contemplation of these matters. Rather, we think about the ability of people to be able to live fulfilled and fulfilling lives with, hopefully, the ability to have sex, the ability to procreate, the ability to engage with a loving partner or whatever – to be able to do all of those things and not to unnecessarily cut off the ability to have those experiences and do those things later in life due to an unnecessary and premature intervention at the time of birth. This is ultimately about putting the rights of the child first and giving them primacy – but giving them primacy by means of deferring decision making to allow that child to take the frontrunning on it.

A member in this place shared with me a news article that was published on the day that he was born. It was an article about a child with an intersex variation. Oddly, it was the front page of the Sun, as it was, and it was perhaps an unusual decision for this particular parent to take their issue to the front page. But in that case a child was born with a penis that was not entirely functional. The parent took the decision to effectively have a penectomy, I guess it is called, and to create, somewhat artificially, a vagina. They were then having an issue with getting that change in sex registered and that was the reason they went to the media about it. This was 40-odd years ago. Make no mistake, we have moved on, happily, from those sorts of circumstances, but it highlights that there has been – and I suspect to some degree there still is – a view in our society where people want to see conformity to a norm and conformity to a binary view of sex and gender that is not supported by science and not even supported by biology.

That is why we are talking here today about intersex variations, which perhaps as many as nearly 2 per cent of the population have, and by deed of the wonders of genetics they have ended up with a variation that means that they do not neatly land in one of the two boxes that some in our society would say that everyone should land in. This is not a discussion about gender – my views on all that are well known – but it is a discussion about those intersex variations and the importance of making sure that those interventions, if they are urgent, are addressed in an appropriate way but if they are not urgent are deferred. That is the better model of care.

The coalition’s textual amendments seek to remove the criminal element of this, and I want to briefly address that in what is regrettably the only 90 seconds I have left. That is not something that I would support. We understand that when we criminalise assault people are going to commit assaults and we are going to have to prosecute them for that. This is one of those circumstances where I hope there is never the need to bring a prosecution. I hope it is a crime that never needs to be enlivened, to be taken off the statute books and actually brought into the real world, because people accept it for what it is, which is a very strong and substantial piece of deterrence. We know that there are crimes on the books where we have to provide a punishment as well as deterrence. This is one that I hope only lives to provide deterrence, to provide that very, very strong message from this place as legislators, as representatives of Victorians, that you simply should not do these interventions, proceed with interventions like the ones we seek to criminalise in this bill. You should not do that unless you have ticked every appropriate box that all the safeguards have been exercised.

The consequences are substantial. We know the rates of suicidal ideation and self-harm are much, much larger amongst this community than they are with the general population. So the importance of this cannot be overstated, and it is importance that does need to be met with the weight of a potential criminal sanction. That is why, were I to be casting a vote in the other place, I would not be supporting those textual amendments. I do commend the bill to the house.

 Paul MERCURIO (Hastings) (12:02): I rise to give my contribution on the Health Safeguards for People Born with Variations in Sex Characteristics Bill 2025, which will cement our government’s support for and commitment to protecting the health and wellbeing of people born with variations in sex characteristics, with a focus on the most vulnerable – that is, infants and young children. Before I go into the substance of my debate, I do want to thank the member for Euroa for her very personal contribution. I listened carefully and I also watched. I thought the contribution and what she said was fantastic, but more important was the struggle we could see that she had as a mother and as a parent and dealing with something so beautiful and precious and so new and wanting to do the absolute best and hoping that was the case but also, I guess, being frightened and vulnerable in that moment in knowing what she should do. I have three children. I can completely understand that very frightening intersection of trying to do the best for something you have grown, you love and you want to do the best for. So I thank her for that contribution, because I thought she captured that for us wonderfully.

In regard to the reasoned amendment, it is always a shame really, isn’t it, when we are in this place and everyone agrees that the bill is great and we should move forward and there are a few issues here and there but then there is a reasoned amendment, which pretty much means you do not really agree with the bill and you want to throw it out and start again. That is how it is in this place, and that is really all I will say about that part of it.

This bill is about care, about compassion and about making sure our health system always puts people first, especially our youngest Victorians. People born with undefined or atypical sex characteristics are generally described as intersex. I was not quite sure what that meant. I would have asked my daughter what that meant, but I looked it up and I guess – I hope I do not offend anyone – but in the old language, they were known as hermaphrodites. I went, ‘Okay, I kind of get it now.’ I hope that is not offensive or upsetting, but it gave me an understanding of what intersex actually means.

It is an umbrella term for natural innate variations in human biology, including chromosomes, genitals, hormones or reproductive organs, that do not fit the typical binary definitions of male or female bodies. Being born with varied sex characteristics is distinct from being transgender or gender-diverse. Very generally, gender-diverse identity refers to a person’s internal sense of self, while intersex refers to biological characteristics.

People born with variations in sex characteristics are born with bodies that do not fit typical ideas of male or female. These variations are natural, and they occur in up to 1.7 per cent of births. For most people no medical treatment is ever needed, but for decades, both here in Australia and overseas, some infants and young children with variations in sex characteristics have undergone medical procedures that were not urgent or medically necessary. Often these were cosmetic interventions done before a child was old enough to have a say. While those decisions were often made with good intentions, we now know the lifelong harm they can cause. People with lived experience have told us about pain, trauma, loss of fertility and the deep distress of having irreversible decisions made about their bodies without consent, irreversible decisions made about children and infants who we do not yet know, irreversible decisions made about people who do not understand or know themselves as yet – and yet their lives can be and have been affected quite dramatically, and probably tragically, through these consequences. This bill responds directly to those people and those voices. It reflects more than 20 years of advocacy by people born with variations in sex characteristics, supported by human rights organisations and medical experts and backed by extensive consultation. It builds on the Victorian government’s commitment made in 2021 through the (i) Am Equal report, and it positions Victoria as a natural leader in this space.

At its heart this bill is very simple: every person deserves the right to make the decisions about their own body. What this legislation does is establish clear safeguards to protect that right while still ensuring people get the health care they need. First, it strengthens informed consent to ensure that people with variations and the parents of infants and children receive clear, tailored information about their condition, treatment options and the consequences of both proceeding with or deferring treatment. Families will also have access to peer and psychosocial supports so they are not navigating complex decisions alone or in the fog of birth and early parenting.

Second, the bill introduces an independent expert oversight panel. This panel is not about delaying care or second-guessing clinicians. It exists to ensure that permanent or difficult-to-reverse treatments for people who cannot consent are carefully considered, evidence-based and truly in the child’s best interests. For parents facing an unexpected and overwhelming situation, this provides reassurance. For clinicians, it provides clarity and shared responsibility.

Third, the bill introduces treatment plans both general and individual. General treatment plans will streamline approvals for common variations where there is a strong evidence base, reducing duplication and red tape. Individual treatment plans will apply in more complex or less common cases and be considered on their own merits.

Finally, there are consequences for serious, knowing or reckless breaches of the law. Doctors acting in good faith have nothing to fear. This offence provision is carefully drafted and exists because a scheme like this would not be trusted by people with lived experience without meaningful accountability.

Nothing in this bill delays urgent or life-saving treatment. If care is needed to save a life or prevent serious harm, it will proceed immediately, just as it does now. This bill does not remove parents from decision-making. Parents must still give consent for treatment to proceed. What it does is ensure that they are properly supported, informed and reassured that decisions align with best practice and their child’s long-term wellbeing. It also supports clinicians. Our doctors are among the best in the world, and many are already practising in line with these principles. This legislation gives them clearer guidance, stronger frameworks and protection from some of the risks that come with making complex decisions in isolation.

This bill is ultimately about getting the balance right. It recognises that when it comes to healthcare decisions, especially for infants and young children, there are multiple responsibilities at play: the responsibility of parents to care for and protect their child, the responsibility of clinicians to provide the best possible medical advice and the responsibility of government to ensure our systems do no harm.

Some people may ask why legislation is needed at all. They may say that these decisions are best left to families and doctors alone. But the reality, made clear through decades of lived experience, is that without clear safeguards irreversible decisions have too often been made too early and without the person most affected having any say at all. Importantly, this bill does not remove parents and guardians from decision-making. Parents must still give consent for treatment to proceed on their child in line with an approved treatment plan. What changes is the level of support around those decisions. Families will have access to clearer information, more time to consider options and reassurance that decisions are being made carefully based on evidence and best practice.

This legislation is about respect. It is about respect for families facing difficult and unexpected circumstances, respect for clinicians providing specialised care and, most importantly, respect for people born with variations in sex characteristics and their right to make decisions about their own body when they can do so. There is more I could say, but I just want to recognise the courage of people born with variations in sex characteristics who shared their stories to bring us to this point. We cannot undo the harm of the past, but we can do better moving forward. I commend the bill to the house.

 Cindy McLEISH (Eildon) (12:12): I rise to make a contribution to what I think is a particularly important issue and topic, the Health Safeguards for People Born with Variations in Sex Characteristics Bill 2025. I guess underlying this bill, as we have heard, is really the provision of care and support for those who have these variations, for them as individuals and certainly for their families. We need to make sure that any decisions that are made are made at the right time and that there is a framework around this. It is really important to listen to the intersex community – absolutely. It is important to understand things from their point of view, from their lived experience, because they have experience that we do not. We heard the member for Euroa, who has experience that I do not know that anybody else in this chamber has had, talk about what it is like from a parental perspective, and I think it is so important that we do that. I want to begin with a quote from the (i) Am Equal report:

Having an intersex variation is not a sexual or gender identity, it’s having variations of physical or biological traits. People with an intersex variation are as sexually and gender diverse as other people.

I thought that was a nice quote in that report and a good framework for what we are talking about today. These variations are innate, and they do not actually fit with what we see as very clearly defined sexual characteristics of male and female. People born with intersex variations have different combinations of a number of things: chromosomes, hormones and genitalia that is typically seen. There may be deficiencies in enzymes that convert hormones. Some of these traits are present at birth and others can occur at any level of development. As we have heard, these can be very, very broad. Some of them are quite simple, minor and treatable quickly and more easily, and some of them are much more complicated. As we have heard, if somebody has their urethra in the wrong spot, which brings about a curved penis which could cause issues, that is at one end of the scale, but where we have somebody who may have internal testes and female genitalia, that is really, really complicated. And it is so important that the decisions that are made are the right decisions made at the right time.

Again, I just want to mention the experience of the member for Euroa, who with her experience talked about the level of trauma and uncertainty of what to do in that situation when you have just had a child. You cannot imagine really what you have to deal with. She outlined all of these things – and that was not at the exceptionally complex end, but it still was so difficult for her as a parent to grapple with what information was out there: ‘What do we do with it? How do we make decisions? Oh, gosh, I’m exhausted! I’ve just had a baby. This is all very new.’ Sometimes we need to make decisions quickly, but we do not want irreversible decisions made quickly. I think it is talking about the consequences of the delays, working through the options and understanding the issues and what is available to people, so that, for families and practitioners, more informed decisions can be made. That is really I think at the crux of this bill here.

We know that there are physical and psychological consequences. We know that, and particularly it has been brought to light much more over the last decade or so than it has been for a long period beforehand. People being born with variations in sex characteristics would have been happening probably for centuries. These things have been there, and probably in the 1950s and 60s different treatments were undertaken. Some of those may not have been urgent. They may have been cosmetic, and tragically they may have been irreversible, which brings us to where we are today. I do not think any parent would want to intentionally bring about pain and trauma for their child and intentionally bring about lifelong harm. But what we have found with some decisions that have been made is that this is indeed what has happened. So the lived experience and understanding of informed consent, so that people are not sterilised without realising and then find out a bit later. I cannot imagine how difficult that would be.

I do want to touch a couple of things with the (i) Am Equal: Future Directions for Victoria’s Intersex Community report that was done in 2021. We are now in 2026. I had a look and read that report, and it was really quite short. I was shocked actually at how short it was. It was padded out, but there were only three pages that were particularly important, and they were around the resourcing, the health and wellbeing of people, improving future treatment – really important areas – and the next steps. One of the areas that I do want to look at is improving future treatment and developing an intersex protection system inclusive of a mechanism to prohibit deferrable medical interventions – modifying a person’s sex characteristics – without personal consent. This is one of the issues that we are dealing with today, and I thought that was a pretty powerful statement in that report.

It has been noted that the opposition do have some concerns, and these concerns are not something that we have just whipped up out of the blue. There has been consultation in this area. The composition of the panel is one of the ones that I do want to talk about. It does not specify the fields of expertise of the medical specialists that must be represented on the panel. The Departments of Health’s information pack lists specialist areas that may include endocrinology, gynaecology, obstetrics, urology, paediatrics and clinical genetics. However, within that there are some specific areas of expertise that we think should be included in those areas, particular specialists. The AMA had concerns about insufficient medical representation on the panel, especially a lack of subspecialist paediatric expertise to reflect the specific complexity, risks and timing constraints of paediatric care. They were also very much concerned about the criminal penalty component. The inclusion of specific paediatric expertise I think would strengthen this bill considerably.

I notice also that there are not a lot of other jurisdictions that have worked in this field for a long period of time for us to have any learnings from there. This is expanding what is in the ACT’s legislation, but those in Germany, Spain, Portugal, Iceland and Malta have not been in place for long enough to really learn from them.

The other thing that I want to raise is the fact that this bill comes into place on 1 December 2028, virtually in three years. The explanatory memorandum talks about allowing a staged implementation of the scheme and establishing the panel. I would not have thought establishing the panel would take some three years. The development of guidance materials– this has been on the table since 2021, and I cannot understand why the development of guidance materials has not been undertaken already. The education for health services and practitioners – that work can be done in the background so it is ready to roll out – not ‘Let’s do this and now we’ll start that work.’ I was actually quite disappointed to see what is being started now rather than having been worked on since 2021. We are now in 2026; that is quite a number of years that have been lost, I guess, where this process should and could have been sped up, and I am a little bit disappointed with that. But the issue that we are dealing with is exceptionally important, and for those who have spoken out about their lived experience, we do definitely need to listen and understand things from their point of view. Listening to the member for Euroa, we know the role of a parent in understanding the issues and the future and not making the wrong decision, because the right decisions must be made at the right time.

 Daniela DE MARTINO (Monbulk) (12:22): I rise today in strong support of the Health Safeguards for People Born with Variations in Sex Characteristics Bill 2025. This bill not only represents a long-awaited reform but is a profound and necessary affirmation of dignity, autonomy and human rights for Victorians who have for too long lived without the protections they deserve and need. It is a bill that speaks to the very heart of what it means to live freely, to have control over one’s own body, to make informed decisions about one’s own future and to be supported rather than harmed by systems designed to care for one. It is a bill that reflects decades of advocacy, courage, research and tireless community leadership by people born with variations in sex characteristics. As legislators, I am pretty sure I can say and those with me here in the chamber will agree that we often stand on the shoulders of those who have fought relentlessly, not for privilege but for recognition, for humanity and for safety. Today we honour the people born with variations in sex characteristics who have shared their lived experience and their trauma, resilience and courage. Their stories have brought us here to this moment. I am so proud that this legislation is here before the house.

We committed in 2021 to developing an intersex protection system in response to the (i) Am Equal report – for anyone who has not read it, I highly recommend doing so – and that commitment is fulfilled today. It has been shaped by more than two decades of advocacy from the intersex community, supported by human rights organisations and substantiated by national and international research. Every Victorian deserves the same right – the right to this autonomy. Yet people born with variations in sex characteristics have historically been denied this right, often in the earliest days and years of their lives, through unnecessary irreversible medical interventions performed without their consent.

Nearly three decades ago, when I was living in Manchester, I had a friend. We were having a chat about what we were doing and our plans for the future and talked about our families. We were learning about each other, as people who meet someone for the first time do. This friend told me that her parent was actually a paediatric urologist. I said, ‘Okay. What does that mean?’ I was young and did not know much. It turned out that part of her parent’s function in the hospital as a surgeon was performing the surgeries that we are talking about today.

I did not even know back then, despite the fact 1.7 per cent of people will be born with variations in sex characteristics, that it was something that had existed – pretty young, had no idea. Then when I learned that these operations were happening and I was told by this friend, I said, ‘Oh, how does that all happen and what occurs?’ She explained to me that there was a time when the parents were not even told. There was a time when there was a lot of mystery, it was shrouded in secrecy, and one of the key reasons was shame. I am so glad that we have evolved to a point now where that need not exist. It should never have existed, but it did, because as a society we had this desire for homogeneity across everything: across cultures and race and across anything where we might see differentials. Societies wanted everyone to be typical or, for use of a terrible term, normal – to all conform and sit within categories which we felt comfortable with. I think one of the reasons this was driven in the past was because of this deep sense that that is what you needed to do. You had to fit in; you could not be a bit different. Well, I think difference is something that should be celebrated and championed and enjoyed wherever possible, and I think this is another step forward. I heard the member for Hawthorn talk about our maturation as a society. I think this is another example. We have come so far in learning that it is actually quite beautiful to be different, and this is where I think I would really like to praise and commend the work done by people born with variations in sex characteristics, because that is what they are telling us. They are also saying that in the past this drive for conforming to what we consider to be typical led to harm – real, deep, irreversible harms. So I am really delighted, and that is why I really wanted to speak on this bill today. I think we have listened, which is something that I am proud that we tend to really do incredibly well here. We have turned these much-needed reforms into legislation, because most people with variations will never require medical treatment, yet for decades, these little babies, these newborns and children, were subjected to surgeries and hormonal interventions that were primarily cosmetic, intended not necessarily to preserve health but to make their bodies conform, as I said before, to what was considered a social norm.

This bill does not stop anything which is medically required where it is important – this bill will not stop that. I know there are concerns from those opposite about aspects of the criminal charges in this, but the reason they are there is that they send a really clear signal out there that this is the line in the sand. Any doctor or any clinician working in good faith need not fear those charges; it is simply there to make sure that if there is knowing or reckless disregard of the safeguards here, that is when they will be enacted. I sincerely hope we never, ever see that occur, but sometimes legislation has to really produce a very strong signal about what is considered incredibly important, and that is what this aspect does within the legislation.

I know that there has been much discussion about what the bill does, and instead I wanted to try and give a bit of voice to those who have been so courageous. I would like to just share some of the experiences and put them onto the record of Hansard, which I think is an incredibly potent ability we have as legislators, to actually record in the annals of history the experiences of those who have pioneered and led the legislative reforms that we have introduced into this place. So I just wanted to mention Tony Briffa, who talked about her experience. She was started on hormone treatment in 1981 at the age of 11 because her internal testes, when she was seven, had been removed. During her childhood she had frequent genital examinations by numerous doctors and medical students, but she was never told the truth about the way she was born and what medical interventions had been performed on her. Imagine that – having surgeries on you and not being told why, not being given that truth, and yet somehow intrinsically you know and feel what is going on but no-one confirms it for you. She said:

The surgical removal of someone’s healthy gonads without their consent is a huge violation. It wouldn’t be legally done to anyone else but done to people like me just because we’re different and not to help us in any way. I wish doctors left me alone.

And:

It’s a nonsense saying I should have been born a boy. I am not a failed boy. I was born a girl with an innate variation of sex characteristics. Who are doctors to say what and who I should have been. I am proudly me.

They are profound, beautiful words, and it is the courage of people like Tony – as I say, please read this report; read these individual stories.

It is the courage of Margie, Michelle, Jade, Stephanie, Mimi, Max, Sarah, David, Agli and Eli. It is the courage of people such as those who have come out and shared their stories that we really have to thank, acknowledge and admire, because that is what we do, all of us, when we enter here and represent the people in our constituencies and broadly across Victoria: we come in and we create changes in legislation to make this a better place for everyone – not just for those who, as I said at the beginning of my contribution, conform to society’s norms but for everyone, in all their difference, in all their beauty and in everything that they bring with them as humans.

That is the importance of legislation like this. It makes me incredibly proud that it is here today. I know so much work and advocacy have gone into this. It has been developed over several years to make sure that we get it right, and I am incredibly pleased to speak on it today. I know that it will make a profound difference to that 1.7 per cent of children who are born in the future with variations in sex characteristics. I know it will give assurance to clinicians in the field. I know it has been welcomed by many because it is giving them that assurance and structure. I am really pleased that the way forward is much brighter for all of those born with variations in sex characteristics. I give my thanks to all those pioneers with courage who have shared their stories and to everyone involved in developing this legislation. I commend the bill to the house.

 Chris CREWTHER (Mornington) (12:32): I rise to speak on the Health Safeguards for People Born with Variations in Sex Characteristics Bill 2025. I want to affirm the Liberal and National coalition’s support for the intent of this bill: to protect children and individuals with intersex traits from non-consensual and potentially harmful procedures. This legislation aims to ensure that deferrable, irreversible medical interventions on infants and children born with innate variations in sex characteristics are postponed until the person can provide informed consent. Urgent interventions needed to save a life or prevent serious harm will still proceed without delay, but all other non-essential treatments will require oversight by a new independent panel. The fundamental purpose of the bill is safeguarding vulnerable children’s bodily integrity and future autonomy, and that is one that we on this side wholeheartedly endorse.

I also want to acknowledge the intersex community’s advocacy and lived experience. In supporting these reforms we must acknowledge the longstanding advocacy of the intersex community. This legislation is, in many ways, the culmination of years of advocacy, consultation and reflection by people born with variations in sex characteristics. Brave Australians with intersex variations have spoken out about the trauma of unnecessary medical interventions carried out without their consent. Their stories have brought us to this historic moment – stories of surgeries resulting in infertility, loss of sensation, psychological distress and a profound violation of autonomy. I want to pay tribute to the individuals and the advocacy groups who have shown leadership and courage. We recognise that for too long their rights were not adequately or properly protected. This bill responds directly to their call that unnecessary medical interventions on infants and young children with variations must end. Wherever possible, decisions about a child’s sex characteristics should be deferred until the child can participate and give informed consent, because these decisions are deeply personal and lifelong and should centre on the person most affected.

In fact this is not a new conversation. In the week that I was born, in August 1983, my parents kept a copy of a newspaper clipping from that week of a front page to put in my baby book. I managed to get my wife to find it last night amongst our treasure trove in our library. The front page carried the story of a mother with a child with variations in sex characteristics speaking publicly about the profound complexities, uncertainties and lifelong consequences they were confronting on behalf of their baby. In that case doctors recommended irreversible decisions about that child’s body before that child could speak, understand or consent. Medical practitioners concluded that the child’s sex characteristics did not fit neatly within existing norms, and surgical intervention was undertaken in infancy to assign a sex that was thought at the time to offer the most normal future.

I want to quote from this article. I do not want to name the people because it may be that the person named as a baby back nearly 43 years ago may not want their story to be brought up again, so I will change the names. It talks about a 15-month-old baby, who I will call Kirsty, who was officially born a male and named Tom, as I will call them. This is a situation where this 15-month-old, Kirsty, was born a male without a functional penis but on the advice of doctors this baby’s mother decided on sex change surgery despite them having 99 per cent male chromosomes. The mother said the decision to bring up the baby as a girl was not easy. The article said:

‘Bringing her up as a girl gives her the chance of being able to have sex,’ she said.

‘As a male sexual experiences would have had to be homosexual.’

We probably realise today that that would not actually have necessarily been the case, but those were the thoughts at the time. Doctors told the mother that her baby would be best brought up as a girl. When the baby was eight months old the doctors recommended lifelong interventions to that baby. That was the first stage of sex change surgery which would take place, and then there would be another stage, when the child was eight or 10, to construct a vagina. Although that baby would never be able to have babies themselves, it was thought that that person could lead a sexual life as a female rather than as a male. The article says:

Often in cases where there is ambiguous genitalia no sex is given until the parents and doctors have an opportunity to think about it, and a considered decision is made about the sex of rearing which is in the best interests of the child.

In this child’s case it was evident that there would be problems with the penis later on, and they had recommended a change from male across to female. These decisions were not made maliciously at the time. They were made within the limits of the medical knowledge, social attitudes and legal frameworks of the era, but the consequences made are lifelong. This child will have grown up carrying decisions made by others about their body, identity and future – decisions that cannot be undone. More than four decades on, their story reminds us of these challenges that have existed for generations and that too often decisions were made without the voice of the person most affected.

I will note as well that this situation reflects a historical case and is an example of intersex management and early sex assignment surgery, which predate many modern discussions about consent and gender identity. In the early 1980s doctors sometimes made decisions for infants with ambiguous genitalia based on what they believed would provide the most normal life outcome, a practice that later became subject to ethical debate. It underscores why this Parliament now has the responsibility today to ensure that children born with variations in sex characteristics are protected, supported and given the time and autonomy to make informed choices about their own bodies when they are able to do so.

There are of course some key concerns and consequences with respect to this bill, though, because with any change you also have to consider things that might not fit in the norm into the future. One is with respect to a potentially overbroad definition of innate variations in sex characteristics. The bill defines an innate variation in sex characteristics very broadly: essentially any congenital condition involving atypical development of sex characteristics. Even common conditions could be captured. Hypospadias, for example, a condition affecting about one in 150 to 300 baby boys where the urethral opening is not at the tip of the penis, appears to fall under the bill’s scope. Surgical experts have pointed out that conditions like this or other conditions like epispadias or bladder exstrophy – I am sorry if I pronounced those incorrectly – medically need to be corrected due to the potential for lower urinary tract and renal damage and should not need approval by an oversight committee since they do not involve any ambiguity about sex or gender identity. By casting the net so wide there could be unintended consequences.

Another aspect is ensuring parental rights and input. Protecting children’s rights does not necessarily mean excluding parents from the process. On the contrary, parents are almost always striving to do what is best for their child’s health and happiness. Under the bill’s current framework, once the child is deemed a protected person incapable of informed consent, decisions about any restricted treatment will go before the oversight panel and its committees, effectively taking ultimate decision-making authority out of parents’ hands.

Another aspect is the composition of the independent oversight panel in clause 15. We support the concept of a restricted medical treatment oversight panel bringing multidisciplinary scrutiny to proposed treatments. But our concern is that there is no explicit paediatric requirement. Many decisions will involve infants and children, but the bill does not guarantee paediatric subspecialist expertise. So our proposed fix is to amend clause 15 and/or clause 19 to require paediatric subspecialty expertise on the panel. Another concern as well is the criminal offence for practitioners under clause 7, which again could have unintended consequences.

Talking about these points, we have put together amendments. We support the bill, but at the same time we need to have amendments to address some of these concerns. Some of the amendments we are putting forward include (1) removing the new criminal offence under clause 7, (2) explicitly mandating paediatric medical expertise on the panel by amending clause 15 and/or clause 19, (3) increasing parental involvement in the panel process by amending clause 15 and (4) conducting a statutory review after three years by amending clause 56. Ultimately I reiterate that the coalition supports the core intent of this bill, which constitutes an important step towards affirming the rights of individuals who have historically been unseen and unheard. At the same time our duty as legislators is to ensure that a well-intentioned law works in practice, and we must be vigilant against unintended consequences. I do urge that these amendments be supported along with the bill.

 Mathew HILAKARI (Point Cook) (12:42): It is a real privilege to rise in this place and make a contribution on the Health Safeguards for People Born with Variations in Sex Characteristics Bill 2025, and I say it is a privilege because it is a first for states; it is not a first for every jurisdiction in Australia. But it is a real privilege to stand here and stand amongst people who have been fighting for these changes for so long. Primum non nocere: first do no harm. This is a central aspect of this bill. It puts it into practice.

I want to thank, firstly, those people who shared their stories in the Parliament last year in a session coordinated by the minister Mary-Anne Thomas. Like the member for Monbulk, I would like to read some of those stories into this house, because I think it really brings home the reasons why we are considering this bill in front of us today, and I hope for its speedy passage in the other place. Stephanie was there, and she talked about her experience. She was born in Queensland in 1995, and it was not possible for doctors to determine her sex at the time. I encourage members of the Parliament to look at the book called The Missing Voice, which is distributed by Equality Australia. It is an extraordinary piece of work and tells the stories and the reasons why this legislation is here. Before her mother could hold her Stephanie was taken away for a raft of tests, and when the doctors returned, her parents were told their baby had both male and female anatomy and chromosomes. They were also told they could not take Stephanie home until she had feminising surgery to normalise her sex characteristics. Stephanie said:

My parents faced the worst moment any parent could have – being told their child needed to be fixed and corrected instead of celebrating their newborn.

How true is that. Stephanie, you came with such great courage that day.

Stephanie had had, by the age of three, two invasive surgeries and various tests, including the removal of internal testes, after doctors told her parents they could become cancerous later in life. This was a commonality of what members of Parliament and ministers heard that day. After an incorrect diagnosis at birth Stephanie was finally found to have an incredibly rare intersex variation. Later on she went to see an endocrinologist for hormone treatments because her body does not produce oestrogen. During one of these visits she was given the devastating news that she might have been able to conceive a child if she had not had surgery as a baby. Stephanie had been, in her words:

…sterilised due to a decision made by clinical specialists, and I will have to live with the consequences of that for my entire life. An intersex person should never be made to feel ashamed of their body, and parents should never be told that they should be embarrassed for having an intersex child. We are beautiful.

Stephanie, thank you so much for what you gave to inform us that day. I often think us MPs have a mile wide of knowledge, an inch deep, and you just improve that depth by being here in the Parliament, alongside others.

The member for Monbulk stole my thunder – and I am just talking generally, not to the gallery directly, Acting Speaker – because I wanted to read some of your words, Tony Briffa, into the Parliament as well. I have known Tony for a long time now through political associations, firstly – we did not always agree, but there are lots of things we agree on – and also as a local councillor and mayor of the community I represent in Hobsons Bay. It is great to see you in a prominent position of leadership in the community, and I am so thankful for that leadership. The quotes that Tony has in this book, and that the member for Monbulk has read out, are very appropriate. I thank you for putting these into writing so they are part of the record, and I thank the member for Monbulk for putting those words on the record. A few moments ago I was talking to Tony about her advocacy in this space. It has lasted since – she was mentioning the health minister at the time – Minister Thwaites, so it goes back a long period of time. People have been working so hard on this for such a period of time, so it is a great day to see the legislation in this house today, and that is why I am so hopeful for its speedy passage over in the chamber next door. ‘Speedy passage,’ the member for Eildon said, and she is right. It is exceptionally important to listen. This is an exceptionally important issue; that is what she said. But it is also exceptionally important – and I use a quote from Thwaites’s time of government: ‘Bracks listens and acts.’ It is the ‘acts’ part which is just as important as listening. I do not want to see this bill delayed any longer. I know that we will have legislation that comes back before our houses from time to time, because we have not got it perfect, but we should never let perfect be the enemy of the good, and this is a good bill. It does good things.

I thank everyone particularly who shared their stories on that day. I want to thank Sean Mulcahy, a person known to me for a long time through Monash University, and also Anna Brown, who has done such important work at Equality Australia in fighting against inequality. I want to thank Mary-Anne Thomas’s office and her staff and those people within the department who have helped to draft this bill and bring it forward, because it has been a long time coming. We certainly had the 2021 (i) Am Equal report, which was developed by the Victorian Intersex Expert Advisory Group. I want to thank them for their work, and at the time the Victorian government committed to introducing legislation like this. This commitment is on the back of more than 20 years campaigning and advocacy for people with variations in sex characteristics to have their bodily autonomy recognised as anybody else’s is. This has been backed by human rights organisations of course and numerous national and international reports. Thank you to everyone who has been part of that campaign and those bodies.

Everybody’s body is different. People with variations in sex characteristics are born with sex characteristics that do not fit typical definitions or understanding of male or female bodies. This can include a person’s physical traits, their reproductive organs, chromosomes or hormones. When we talk about variations in sex characteristics, they are not a minuscule part of our community; it is 1.7 per cent of our population. The Minister for Emergency Services earlier in the day mentioned that is about similar and in line with those people with red hair in our community. In a Parliament where we have more than 128 members, on average that should mean there are two and a little bit members of Parliament who share variations in sex characteristics. This is not an unusual thing in our community; it is actually quite normal.

It is not unreasonable for people with variations in sex characteristics to expect to make an informed choice and an informed choice by them about their future. I know I have discussed with my colleagues, earlier this week and today, what we want as parents when our children are born. Of course we want our children to have the easiest life possible – any variation. We worry about our children’s future, and we want our children’s future to be great. It is a normal thing for parents to be concerned about that, but we also want our children to have a great life now and into adulthood. When people can make their own considerations about their future, that is the point in time that non-necessary medical interventions should be made or not be made. It is about people having autonomy over their lives. I understand of course that there are medical interventions needed for emergencies. Everyone accepts that. Everyone accepts that those healthcare decisions should be made. I do really understand the importance of this in a one-inch way, but I am so glad that those people close to me have deepened that understanding.

A lot of people have brought this bill to this place, and we should be thankful for their efforts, because it is not easy to open up your life and your experiences in places like this, in public forums and in advocacy across all parts of our community and lives. With that, I hope that it has a speedy passage through both this chamber and the next chamber. I thank particularly the ministerial advisers, who I know do so much work in this space and who help to guide these things through the Parliament. I commend this bill to the house.

 David SOUTHWICK (Caulfield) (12:52): It is a pleasure to rise and make some comments on the Health Safeguards for People Born with Variations in Sex Characteristics Bill 2025. I acknowledge the many contributions that are being made in this chamber and the important contributions that have been made and the sensitivity around this very, very important bill that we are discussing. I also want to particularly put on record the longstanding advocacy from the intersex community and what they have been doing in their fight and in their struggle – those with lived experience, such as Joe Ball, the commissioner for LGBTIQA+ plus communities; Anna Brown from Equality Australia; and Tony Briffa, who I am going to get to shortly, a tireless campaigner and fighter for these rights and also for broader issues. These changes that we are talking about today really deal with unnecessary medical interventions on children at a time when these medical interventions cannot be reversed and cannot be changed, and the trauma that causes for many of these kids is trauma that is left with them forever. But also the issues around fertility are things that, because of the irreversibility of these medical interventions, cannot be changed. So it is very, very important that we talk about that, and it is very important that we look at how we can improve the legislation that we have before us.

The legislation deals with people with innate variations in sex characteristics, also referred to as intersex, who do not fit within the typical definitions of having male or female bodies. There are 40 known different variations, and these can occur in genitalia, reproductive organs, chromosomes, hormone levels and body responses to hormones. Intersex traits are natural biological variations. As we have heard, they can occur in about 1.7 per cent of births, affecting up to 1000 babies born in Victoria each year. Again, not all variations are identified in birth, and these can sometimes be identified a lot later on in puberty or adulthood. The vast majority are relatively minor and do not require immediate medical treatment, while some do. When they are life threatening they certainly do, and that is something that must continue. But that is not what this bill deals with at the moment. This bill is intended to provide greater clarity for practitioners and parents regarding the resolution of common issues, and the cases that we are talking about are somewhere between 60 and 120 cases a year.

As I said, while some medical intervention is indicated for some intersex variations, some people have experienced lifelong physical and psychological consequences from deferrable medical interventions performed when they were infants or children. These consequences may relate to issues such as fertility, poor sexual health, urinary issues or needing further treatments or surgeries. The bill tends to look at clarifying that and look at ways of ensuring that those with lived experience have the opportunity to be part of the process and that we resolve these matters to ensure that we do not have unintended consequences as a result of medical interventions.

I know that we have heard already from those opposite about the need to move hastily – the member for Point Cook raised that. I note that the bill only comes into play three years from now in December 2028. So although we are debating it now, there are still a number of years before these matters are actually changed. I do want to put that on record, because it is one thing to try and make a political point about this – we have seen that a lot of people have not done that, and we should all be trying to work together on this – but the point of the matter is that we still have until 2028 until we see any changes at all in the bill that we are talking about right now. Also, in that time, in this, as part of clause 2 of the bill, there are items like development of guidelines and materials, education for health services practitioners and affected communities. That should happen now. That stuff can be happening now, and it should be happening now. I also again want to commend the advocates of the intersex community that are doing that and have been doing that for years, because without education, without understanding, unfortunately we see decisions that are made without informed choice. People have made decisions and have had years of neglect because they have not had the education and the understanding, which I want to get to right now.

I want to put on record the tireless work of Tony Briffa and what Tony has done in tackling this issue. I met Tony 20 years ago, but as Antoinette. I know Tony still likes me to call her Antoinette, and I do, because that is how we know one another. We went to uni together. We campaigned back at that stage, and we took over the student union at Footscray Institute, with me as president and Antoinette as vice-president. We sought to trailblaze back then. I have watched the journey, but I did lose contact. I know in the meantime Antoinette had a terrible motorbike accident. It was two years, and she almost lost her life and could not walk. At that time she decided to live life, tell people who she was and to come out and talk proudly as an intersex person. It was that campaign that has ended in where we are now with all of this. I say well done to you because you have fought that fight and you have been out there living who you are, and that is what we should be doing. They are absolutely the kinds of things that we are talking about right now. I think it is really important. Also, I just put on record that you have been a mayor twice and a deputy mayor, and not just on issues around being intersex but on advocating for people in the west. So thank you for what you have done.

We do have a long way to go. This is a very, very important bill. We do need to ensure that we protect children. We talk a lot about children as an important point, particularly when these kinds of things are irreversible. I know the coalition has amendments which we have put forward, and we will go through those in the process. But we must do what we can to make all people’s lives better. We must do that, and our jobs in this Parliament are about doing that. We may not always agree on everything, and we certainly have different ways of being able to fight for things in terms of the changes that we all make, but at the end of the day we are talking about people, we are talking about people’s lives and we are talking about ensuring that they can live their lives equally and fairly like everybody else. That is why these kinds of changes are important, and that is why we must be debating these kinds of bills that we have before the house today.

Sitting suspended 12:59 pm until 2:02 pm.

Business interrupted under standing orders.