Thursday, 19 February 2026

 Georgie CROZIER (Southern Metropolitan) (10:16): I rise to speak to the Health Safeguards for People Born with Variations in Sex Characteristics Bill 2025, and I want to acknowledge the work that has gone in to this bill. Firstly, I thank the department and the government for providing information and also the various briefings that were undertaken and provided to the opposition. Can I also acknowledge those in the Legislative Assembly who spoke on this bill a couple of weeks ago and really did highlight some of the issues and very, very strongly spoke of their personal experience with family members and also the understanding for the people that are affected by the changes that this bill seeks to make.

I also want to acknowledge some of those people that have reached out to me. I want to say thank you for doing so and for providing me with your insights, your lived experience and the sometimes very personal accounts of what you and your family members have gone through. For we that are not affected by this very complex medical condition that is affecting a number of Victorians, it is hard to contemplate, and I do thank them for being so willing to share their stories and their personal insights into those experiences. I do understand their advocacy in relation to the legislation that we are discussing today. I also want to acknowledge the many medical practitioners that reached out to me, giving their perspective on what this bill will mean. I will speak to that in more detail because it is a complex area of medicine, and it is an area that has had a very difficult past I think. Some of the practices that have occurred in the past, in decades gone by, thankfully do not now occur to the same extent that they have done.

Whilst I understand the intent of this bill, as I said, I have spoken to people about the opposition’s concerns regarding the government bringing this piece of legislation forward. But if I can just speak to what the legislation does and the background to why we are debating this today. The bill is dealing with people with innate variations in sex characteristics, sometimes also referred to as the intersex community, where those sex characteristic variations do not fit typical definitions of either male or female, and there lies a very complex part of what we are discussing today.

There are more than 40 known different variations, and these can occur in genitalia, reproductive organs, chromosomal and hormone levels and patterns and the body’s response to hormones, as I have said. The intersex traits are natural biological variations, and I think it is important to understand that this occurs. It occurs in about 1.7 per cent of births, affecting up to around 1500 babies born in Victoria each year. But not all variations are identified at birth. Sometimes they are identified when puberty hits or when somebody is in adulthood and they are undertaking or undergoing fertility testing and they find out that they have one of these biological variations. It should be noted that 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. I note the bill in those circumstances does not stop that life-threatening treatment or prevent that management from proceeding. What the bill intends to do is to provide greater clarity for practitioners and parents regarding the resolution of some of the common issues. However, some cases involve uncommon variations that require a very specific, individualised treatment plan, and that is what the bill also sets out. In Victoria, this involves around 60 to 120 cases per year around those more uncommon variations. As I said, it is a complex area of medicine.

While some medical intervention is indicated for some intersex variations, some intersex people have experienced lifelong physical and psychological consequences from deferrable medical treatment and interventions performed when they were infants or children. That is really where the essence of this bill has arisen from. Those consequences may relate to issues such as fertility, poor sexual health, urinary issues or the need for further treatments or surgeries. This has come about, as I said, as a result of some of those people who have come forward to express those very, very personal and deep and sensitive medical conditions where they have been directly affected, and it is those areas that this bill seeks to clarify and deal with. The bill also seeks to address the need for prevention of harm from such medical procedures, and treatment will not be able to proceed for cosmetic purposes or to normalise a body before the person is able to consent.

I understand and I appreciate the strong advocacy from the intersex community and the advocacy that they have done to government in relation to the government starting this process in 2021, when the health minister and government committed to implementing the (i) Am Equal: Future Directions for Victoria’s Intersex Community report, including the oversight of non-urgent medical treatment. I think it is again important to understand some of these differentiations because it is a complex area of medicine, as I have indicated. Intersex is about biological variations relating to how a person’s body develops and it is not the same as gender identity or gender dysphoria. I think the government was very clear in explaining that, and I think it is important also to understand that this is a natural biological process. Intersex refers to that natural biological process with different combinations of chromosomes or hormones that do not fit into typical male or female categories. It does have a very significant impact on those people who identify as intersex and have those medical combinations, as I have described.

There has been legislation that has come into being in other jurisdictions. I will just mention that some international jurisdictions include Spain, Portugal, Iceland, Malta and Germany, and here in Australia it is in the ACT. The ACT did enable their own legislation in 2023, but this legislation that we are discussing today is broader than the ACT model. The difference between the ACT bill and the legislation we are debating today is that it includes more of a detailed oversight framework, more detailed consent and capacity requirements, more onerous reporting obligations and stronger enforcement and review mechanisms.

In going through the bill, it is, as I said, a detailed bill, and it lays out the intent of what the bill does. I have spoken broadly about what it does. But the main purpose of the bill in establishing that legal framework, including safeguards and oversight, is 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. As I said, I have spoken to those affected by that and their family members, and they were very clear. I was so grateful for having that insight to understand the very significant and life-changing aspects that they are living with. I do appreciate the family members saying, ‘If only we had known and had taken time on this, maybe our decision would have been different.’ So I do appreciate that, and I can completely understand why the advocacy is very significant from some of those people that have been involved in the (i) Am Equal report and subsequently The Missing Voice. There are some powerful stories in The Missing Voice and some analysis around the stories of the medical interventions that did occur in the past, some of them with very significant outcomes for people.

The framework also strengthens the process for obtaining informed consent. That really is around ensuring the decisions regarding certain medical procedures or medical treatments are deferred until a person has the capacity to give informed consent, or if that is not possible, there is independent oversight. The other area around that, if I can just draw that out, is the capacity to give informed consent safeguards, which is further into the bill in clause 5. It speaks about informed voluntary consent being required before restricted medical treatment is given and it being the doctor’s responsibility to assess the capacity to give that consent. I think that is pretty well laid out in the medical code of practice, the medical board Australian Health Practitioner Regulation Agency’s (AHPRA) Good Medical Practice: A Code of Conduct for Doctors in Australia, which has been updated in recent years. It does go to this very point around obligations of medical practitioners and their professionalism. It says:

Doctors have a duty to make the care of patients their first concern and to practise medicine safely and effectively.

It also says:

Good medical practice is patient-centred.

It goes on to talk about informed consent, which is a very significant part of that medical practice, and having trust with medical practitioners. You are entrusting the decision-making from those doctors, or the team of doctors, around that particular treatment. Anyone who has been involved in extensive medical treatments will understand that. There is a very significant trust factor. It must be protected, and it must absolutely have that proper oversight and strength of oversight at all times. It says:

Informed consent is a person’s voluntary decision about medical care that is made with knowledge and understanding of the benefits and risks involved.

That is according to the code of practice. I think the vast, vast, vast majority of doctors would adhere to that and have that as their sole focus.

It states:

Caring for children and young people brings additional responsibilities and challenges for doctors.

It goes on to state that good medical practice involves:

Placing the interests and wellbeing of the child or young person first.

And it recognises the role of parents or guardians in that when appropriate. I think that part of this bill and what we were discussing around this informed consent goes to the very heart of the issue around informed consent and when a child can effectively make those decisions on their own behalf. Again, the code is very clear about speaking with children and getting their understanding, but that can vary according to the capacity of a child or young person. This bill is explicit in looking at the informed capacity and informed consent safeguards. It says:

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It is assumed that people aged 18 years and over have capacity to consent, just as is the case for any medical treatment.

But even somebody over the age of 18 may not have full capacity, so it is a very important aspect of medicine.

For children under 18, a parent is usually the decision-maker, unless they are assessed by the treating doctor as being capable of giving consent for themselves –

as I have just said:

There is no specified age for having this capacity. It depends on the child’s ability to understand the relevant information and nature of the treatment.

If capacity is present, the medical practitioner must ensure there is fully informed consent, including assessment of a person’s understanding and retention of relevant information, and ability to weigh information and communicate their decision to consent.

This is an important part, and we do have some concerns around the parental involvement. I understand the intent of the bill, but we have concerns around the parental guidance and parental involvement in that consent and the capacity to be able to have that trust with their treating doctors and to use that to manage their child.

The bill goes on with a number of exceptions. I want to just speak to another part of the bill where there have been concerns raised from the medical fraternity, and that relates to clause 7, which creates a criminal offence with a maximum penalty of two years imprisonment or 240 penalty units. The AMA has said:

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The bill applies heightened consent reporting and criminal sanctions only to children with innate variations in sex characteristics.

As they say:

Other paediatric interventions with comparable lifelong implications are not subject to equivalent statutory safeguards.

They are concerned about that element of criminality. They are concerned it will perhaps not support people coming into various disciplines, because of that low bar of sanction, because there are already regulators in place, such as the Australian Health Practitioner Regulation Agency, that can deregister a medical practitioner if they are found to be not conducting their medical practice in the way they should. They can have sanctions imposed on them. They can have certain other restrictions placed on their ability to practice. Then of course there is a civil avenue for liability as well. The AMA is very strong on this, and they have got real concerns around that, as do I, and I have made that clear with the government and with those I have spoken with.

The restricted medical treatment oversight panel will consist of a chair, deputy chair and a pool of at least two ordinary members that must include people with expertise from the following categories: lived experience of innate variations; specialist medical practitioners from relevant fields, but they are not necessarily automatically included; human rights and ethics; mental health and wellbeing professionals; and health law.

The oversight panel then assesses, as I said, the particular case and then can determine an individual case plan in a very complex case. If parents do not agree with that, then they can challenge that through a VCAT process. However, there are concerns that some of this process can delay treatments that could be dealt with earlier and that there could be unforeseen implications if treatment is deferred. There is a balance that I am trying to explain here about why some think that the treatment needs to be deferred so that people can have more time. I do appreciate that, and I do think there needs to be a proper management process to deal with those very complex cases. But the bill captures a very broad range of sex characteristic variations, and the general treatment plans for something like hypospadias, which is not uncommon, is captured in this bill. It is not in the ACT model, but it is in this. There really is, in my mind, no reason for it to be included in this bill, given that broad capturing of the characteristics, because medicos and teams of medicos are doing this work now. I have spoken to some of them who have again raised their concerns around what the government is legislating – that this will become law and this is how medical practitioners will have to be operating. It takes away from how we operate medicine more generally, because of the strict requirements of this legislation. We want to get it right. We understand the intent of the bill. We understand the government’s motivations, and I certainly understand the motivations for the advocacy that has been provided to government and provided to me and to my colleagues – I certainly do. But I just think that in terms of the balance of what the government are trying to do, they have not got it quite right.

There are some concerns, as I said, around the parental rights, the scope, the definitions of the innate variations and the composition of the panel. As I said, it does not really capture that broad understanding of what these complex cases need and whether that is a paediatric or adolescent endocrinologist, urologist, psychologist or others, just in those particular areas that have been raised with me. The panel will bring in subspecialities, but it really is very important that possibly the panel need those specialities at the outset so that they can have endocrinology, urology, gynaecology and psychology included in it. That is why the opposition is moving amendments to this bill, and I am wondering if I could have those circulated, please. We are moving a reasoned amendment to the bill only because we think it is important that we get this right. I move:

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

The reasoned amendment is off the back of concerns from medical practitioners and specialists who work in this area already. They are working at Monash Children’s Hospital and in other areas of paediatric medicine. Considerably, one of the areas that they are concerned about is that they were asked to provide feedback to the government, and in the (i) Am Equal report there is no reference to any of their concerns. So they feel that the government has not gone about the process in the way that it should have to get proper feedback so that the bill is right, so that we can get the balance right and that the intent of the bill and what is happening in current contemporary practice, not what has happened possibly in years gone by, is reflected in the bill.

Many, many areas have expressed that concern. As I said, the member feedback from the AMA – I will read this statement:

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Members hold differing views about the desirability of a legislated oversight model. Some support the principle of statutory safeguards. Others question whether diagnosed specific legislation is necessary or proportionate. Despite this divergence, members consistently identify the same practical issues: breadth and ambiguity of definitions; risk of capturing common conditions – for example, hypospadias – that require early intervention to preserve long-term function; proportionality of the criminal offence and potential chilling effects on clinician willingness to practice in this field; adequacy of medical representation on the panel and committees; the absence of mandated timelines; limited consideration of anticipated psychosocial harm; the risk of delay – inequity, stigma and loss of clinical capability; concern that severe sanctions and administrative burden may deter trainees and erode the future workforce.

They really do say this with the best intentions, because they again expressed to me that they want the government to get the bill right. I do think the bill needs to be taken out and rewritten so that those concerns are addressed. That is the reason for the moving of a reasoned amendment.

The other amendments that the coalition will be moving reflect many of those issues around the lack of paediatric and adolescent speciality disciplines on the panel, such as urology, gynaecology, psychology and endocrinology. They feel that those specialities are very much part of the smaller number that will be captured by this bill. For the very complex cases that need that multidisciplinary team approach, they should be on the panel. That is why we will be moving amendments to that effect as well as ensuring that the parent is very much part of the central decision-making process. There is just a concern that it is at arms-length. I understand, because I have spoken to those that have been affected and their parents. They have said they wish they had the guidance and the information. I think it is incredibly important that we understand that. When I have spoken to various stakeholders, they have said that we must be giving that information and guidance in a way that is contemporary and understanding of the multidisciplinary team that works around these patients now. The parent must be really there. If they have considerations and concerns and are going through a process of challenging in VCAT – it misses the point in terms of what the government is trying to do here to provide those parents with the best guidance and support.

The other area my amendments go to concerns the review. Because it is such a change and it is a very stringent piece of legislation regarding the workings of medical practitioners, I think the five-year review is too long. I think we need to be monitoring this much more closely and have that constantly being monitored. Having a five-year review is too long, and that is why we have suggested three years.

Finally, removing the clause on the criminality aspect – as practitioners and others have said, that could have unintended consequences and have a huge impact on those wanting to go into these disciplines, knowing that they could be facing criminal sanctions. They really think that there could be an unintended consequence to having this hard-line approach in this bill.

It is unnecessary. We have the AHPRA. Medical practitioners who do the wrong thing can be deregistered. They can have sanctions applied to them or restrictions put on their practice; that already occurs now. People can sue a doctor; that already happens now. But to have this criminal element, I think, is too strong. It is too much and is unnecessary, and I do not really understand why the government think in 2026, when we have got such significant oversight with the regulator AHPRA, that they need to go down this line, when other paediatric treatments and other areas of medicine do not have the same consequences, even though they can have lifelong implications as well.

In my last few moments that I have left on this bill, I want to again say thank you to all of those that have given me their insights and their experiences; I do appreciate it. I understand the advocacy. I just want the government to get this bill right, and I feel that they have not.

 Sarah MANSFIELD (Western Victoria) (10:46): I rise to speak on the Health Safeguards for People Born with Variations in Sex Characteristics Bill 2025, and the Greens will be supporting this bill. At the outset, can I acknowledge the profound harms that many intersex people and people with innate variations of sex characteristics have experienced as a result of medical interventions and practices. As someone who is part of the medical profession, it is important to recognise that while we may believe that our work is largely motivated by good intentions and founded on ethical principles of beneficence, or doing good, and non-maleficence, or doing no harm, those intentions and ethics are shaped by societal views and attitudes. There are countless examples, not only from history but that continue to this day, where the influence of these social attitudes has resulted in prejudice, discrimination, inequity and, in some cases, profound harm. That is the case for many intersex people. While this bill in many ways seeks to prevent future harms, nothing can alter the harms already caused.

This bill is long overdue. In simple terms, it aims to protect the human rights of and promote positive health outcomes for people born with innate variations in sex characteristics and intersex people by ensuring that unnecessary and irreversible medical interventions are deferred until a person is able to provide consent. This bill is fundamentally about individual autonomy and centring the human rights of the individual baby, child or young person. It is about recognising that people have a right to make decisions about their own body, and where they are unable to make that decision yet, there must be safeguards in place to ensure nothing irreversible is done that will impact that person’s quality of life or sense of self into the future.

Shamefully, we know that around the world, including here in Victoria, surgery and other medical interventions have been performed on babies and children to make their bodies conform to societal expectations of typical male or female appearance and function. In many cases these interventions were irreversible, in many cases they were not medically necessary and in far too many cases the individuals affected were not informed about what had happened to them until much later in life. I have found the pain and trauma described by people with lived experience, who have undergone irreversible interventions, profound, and some of these have been shared in Equality Australia’s report The Missing Voice, which I commend to members of this place. It is these people sharing their stories and advocating for the broader intersex community that has driven the development of the bill before us here today. It is the result of tireless advocacy from individuals and the LGBTQIA+ organisations who have campaigned tirelessly for change.

I do want to acknowledge that there are many excellent health workers and doctors who care deeply about the rights of young people with innate variations in sex characteristics, and in recognising the harms of some practices, we must also acknowledge that many people have benefited positively from the care they have received. Medical care for people born with variations in sex characteristics has evolved greatly over recent years. Decisions are not routinely made by individual practitioners in isolation but are more often the result of multidisciplinary teams consulting from a range of perspectives and coming to far more considered and holistic decisions.

But that is not universal. It is not the universal experience, even to this day. And progress alone is not protection. Young intersex people remain at risk of undergoing unnecessary medical interventions that could be deferred until they are old enough to provide informed consent. This bill introduces a structured framework to address that gap.

I now want to briefly touch on the specifics of the bill. Firstly, the bill sets up a new independent assessment panel that will have oversight in specific circumstances where medical intervention would create a permanent, irreversible change to a person’s sex characteristics. Sex characteristics in this bill are defined as they are in the Equal Opportunity Act 2010. Critically, among other expertise, these panels must include people with lived experience. The panels will also help with collecting and analysing data on treatments. Although I am aware of some of the concerns about the roles of these panels, and Ms Crozier has outlined some of those concerns that have been voiced by different stakeholders, given that this represents a new approach to decision-making, it is important to highlight that they are not a replacement for multidisciplinary teams. They play a pivotal role in care, but these panels will provide additional support for clinical decisions, oversight and transparency and ensure broad perspectives are considered. As I said earlier, critically, they will include people with lived experience, and this is a voice that is typically missing in many of the decisions that are made today.

Secondly, this bill will lead to the development of treatment plans. In hearing from many different people about this bill, some raised concerns in the frame of specific medical conditions, anatomy or chromosomal arrangements, and it is important to note this bill’s focus is not on specific medical conditions or bodies. Rather, it is on the treatments. That distinction is really important as it shifts the focus away from the idea that bodies need to be changed and onto the merits of different treatments. There are two types of treatment plan that the panel will consider for approval: general and individual treatment plans. General treatment plans provide the standards and expectations of medical intervention in certain sex characteristic variations. This is applicable where a particular application of a treatment is widely accepted as best practice. Individual treatment plans are for less common or more complex treatments or applications of those treatments. These plans are not set-and-forget. A person may have multiple plans or variations over time, depending on their evolving circumstances. Crucially, where a person cannot provide consent, treatment cannot commence until an individual treatment plan has been approved by the panel. This bill, as Ms Crozier has outlined, does not prevent urgent life-saving treatment. It does not prevent treatment required to avoid serious harm. What it does do is ensure that irreversible interventions that can safely wait are not carried out before a person has the opportunity to participate in that decision.

Thirdly, the bill sets up a more contemporary approach to consent, known as supported decision-making, which is an evolution of the perhaps more familiar concept of Gillick competence or a mature minor test. Supported decision-making recognises the age and stage a person is at with respect to the specific decision that is being made. They are provided with age-appropriate information and access to support to comprehend, retain and weigh information relating to their specific variation and effectively communicate their decision. Where a person is deemed to be able to provide consent, no treatment plan or panel approval is necessary – treatment can commence. Where an individual cannot provide consent, their treating practitioners must apply for an individual treatment plan to be approved by the panel, and that treatment cannot commence until the approval is provided.

Finally, this bill introduces criminal liability for noncompliance. This is in large part in recognition of the profound harms that have been done in the past and the need for deterrence measures commensurate with those harms. I understand and I have really heard the concerns that introducing criminal provisions is worrying for many medical practitioners, particularly given that a lot of the details of this bill and how it will operate are yet to be determined in regulations. But if you look at the legislation, the bar has been set very high for these criminal penalties. Someone has to knowingly and recklessly break these laws. In other words, it has to be a deliberate act.

A practitioner is not going to find themselves in breach of these provisions by accident.

The ACT has passed a similar framework, which was groundbreaking in Australia. However, being the first jurisdiction, lessons have been learned from their experience, and it is welcome to see that those lessons have been applied in forming the Victorian legislation. The most significant of these is the three-year implementation period. It was recognised in the ACT that more time was required for implementation. The three-year period in Victoria will allow the panel to approve many general treatment plans and create general guidance, as well as consult on regulations before individual treatment plans start coming before the panel. We have been assured that there will be broad engagement in forming this work with all those who may be impacted by these changes, including people with innate variations in sex characteristics as well as clinicians.

I have heard from some members of the medical profession regarding the lack of certainty about the practical application of some parts of this bill, given much of it, as I have said, is going to be left to regulations. While these concerns are understandable, we believe that the three-year implementation period will allow for these issues to be resolved and greater certainty to be achieved through the development of the supporting regulations. It will also allow for all those impacted by the changes, particularly clinicians and patients and families, to become familiar with the new processes. Additionally, another really important feature of this bill is the five-year review, which for clarity is actually effectively a two-year review. It will come into place two years after the panel has proceeded operating with its full responsibilities. So it takes account of that three-year implementation period, but then once everything is up and running there will be a review after two years. We believe that this is appropriate.

An early review of the panel’s operations will ensure that it is actually achieving the purpose that it was set up for and that any issues can be addressed in a timely manner. It is my hope that any concerns raised in that review will be properly considered by the government of the day. We do not want to run the risk of being at the forefront of legislative reform, only to fall behind because it is considered done. Being open to legislative amendments to the framework may be necessary, particularly as this is an area where knowledge and best practice continue to evolve.

One concern we continue to hold is about the adequacy of resourcing to ensure this bill achieves what it actually sets out to do. Not only is there a need for additional funding to support the change process, treatment plans and training, there is also a need for greater investment in peer and family support services, and it is vital that adequate resourcing is provided to ensure that this framework provides the best possible outcome for intersex people and their families.

I also hope that beyond reforming health care this bill is a trigger for a broader conversation around the stigma, discrimination and harm people born with variations in sex characteristics can experience. As I said at the start, medical practices do not occur in isolation. They are typically a reflection of broader societal attitudes. There must be greater efforts to address stigma and discrimination, and that starts with government leadership and investment in education. There is a lot of work to do, but in passing this bill we are saying to intersex people and people with variations in sex characteristics that they deserve the same respect for their autonomy and dignity as anyone else. The Greens are proud to support this bill, and I hope everyone else in this place will do the same.

 Michael GALEA (South-Eastern Metropolitan) (10:59): I am honoured to rise to speak on the Health Safeguards for People Born with Variations in Sex Characteristics Bill 2025. Today is a very important day. Today is a very special day. It is the culmination of years and years of informed lived experience, of heartfelt and passionate advocacy from members of the intersex community and indeed of a great deal of work that has been undertaken in engaging with Victoria’s intersex community, with the medical community in great detail and indeed with other stakeholders. It has been informed by reports such as (i) Am Equal and by working groups such as the LGBTIQA+ Taskforce. And it is time – it is well past time in fact.

For generations, intersex Victorians had their identities concealed, hidden, papered over, ignored. Medical procedures done to them, many of which were irreversible and without their consent, and in many, many cases without the informed consent of their parents, radically altered their lives and set them up for a great deal of hardship. I want to acknowledge and pay tribute to all of the members of Victoria’s intersex community who have raised their voice, made themselves heard and made this change happen – those from around Victoria and those who are here with us in the Parliament today. On an altogether different topic yesterday, I spoke about how people often bring issues that are of great importance to them into the Parliament, not necessarily for them to be fixed for their personal situation and circumstance but so that others do not have to go through the same hardship, the same trauma and the same suffering. I can think of no better epitome of that spirit of care for others and of righting wrongs than what is shown by the intersex community, and I applaud them for it.

For decades around the world infants and young children born with variations in sex characteristics have had medical procedures undertaken on them so that their body could appear more typically male or female. These interventions included things such as surgery and hormonal treatments, and they were quite often not medically necessary. They were in too many cases irreversible, and they were performed well before that person was able to consent. The intention of course was in most cases benign, but the consequences were anything but. We now have decades of lived experience to tell us just what those consequences are. We know that as many as 1.7 per cent of people born in this state, or at any jurisdictional level, have some variation of sex characteristics of one means or another. There is no single way of being intersex, of course. It is a deeply medically complex situation, but it is one that has for too long been ignored. We have made great steps towards it. As a recent motion from the AMA said, recognising this harm is the first step, but the next step is legislated protections with guidelines founded in lived experience and evidence. We are at that step today.

As has been noted by both previous contributions, we are not the first jurisdiction in Australia to be making these changes, to be making these important reforms, although we are the first state. We have learned from the ACT, as well as from overseas jurisdictions including Malta, Germany and others. The bill before us incorporates those lessons, and I think it is important to note that what this bill also will not do is prevent medical professionals from undertaking surgeries or treatments or other practices where it is medically critical to do so. This is about those interventions that are not medically necessary or essential that have then gone on to cause such profound distress to people later in their lives.

Dr Mansfield touched on some of the key mechanisms of what this bill will do and how it will do it. There are four broad mechanisms by which this bill will take effect. The first is the informed consent safeguards, and these ensure that all people born with variations in sex characteristics and their families will have the information and support that they need to make the most informed decision that they can. This will include providing information tailored and specific to the details of their variation, including treatment options and what the most likely or expected outcomes would be of any particular or different course of action. If the person has capacity, they will be able to provide consent to approve treatment, and if they do not, they will be supported to contribute to decision-making as far as is appropriate for their age and developmental stage, with additional oversight.

In the case of extremely young children and infants, an oversight panel will need to approve the treatment first. That leads me to the second mechanism, which is the independent legislated oversight panel, which will approve general and individual treatment plans. It will also provide and develop guidance and report on treatment data. The role of this panel will not be to obstruct care but to ensure that those irreversible decisions that are not medically necessary will not be made and that any irreversible decision will not be made without due considered care and accountability. It will ensure that the children and parents will, insofar as possible, be best informed to make the most appropriate decision for them. I do want to note in relation to Ms Crozier’s remarks in relation to the oversight panels that parents who do want more direct engagement with the panel will not in any way be restricted by this bill to do so. They will be able to speak with the panel assessment committee throughout the process.

The third mechanism is treatment plans, which will provide approval for treatments that can vary sex characteristics. This can include things such as preapproved general treatment plans which apply to more than one person, common treatments where there is an established evidence base or individualised tailored plans for those more unique circumstances. These will in effect become a flexible and responsive way of managing oversight and reducing any impact from regulatory duplication or overburden.

The fourth, which again has been canvassed by previous speakers today, is a prohibition with consequences for noncompliance. The criminal prohibition addresses that conduct which is intentional or reckless, where a medical treatment is provided to someone who is considered to be a protected person – that is, a person who is born with variations in sex characteristics who does not have the capacity to consent to a proposed medical treatment. The majority of any consequences out of this mechanism will be found in existing regulatory mechanisms, including through the Australian Health Practitioner Regulation Agency. That is specifically provided for through this bill. There is also, though, a proposed summary offence for breaches of the prohibition. The maximum penalty for the very much most serious, most intentional and/or repeated breaches is 240 penalty units or two years imprisonment. This is an important deterrent for that most extreme end of offending. But I do make the point that that offence only applies to the most egregious and reckless breaches. This does not apply to any doctor who is acting in genuine good faith. There are also of course exceptions for urgent restricted medical treatment.

This bill, as has been canvassed already by others in this chamber, is very specifically focused on supporting the intersex community and making sure that the mistakes of the past cannot be allowed to happen again. In terms of commentary pertaining to the bill, I do want to briefly address a couple of points. The first is that of unintentional consequences. There has been extensive consultation both with community and with the medical community as well. I do note on that point that the leadership of the Royal Children’s Hospital is endorsing this approach and this bill, and indeed in reference to the earlier motion I referred to from the AMA, certainly I would take that as an endorsement of this approach as well. The unintended consequences, though, are what we are already seeing. The unintended consequences are what the people, many of whom are in the gallery today, can tell us about. They have been happening for generations. This bill is about stopping that and about stopping, well intentioned or otherwise, medical treatments that cannot be changed. They permanently alter the course of someone’s life without their consent. That is a very big unintentional consequence, and that is what this bill will stop.

The other one is in relation to parental rights. This bill will not in any way take away parental rights – quite the contrary. It will support parents by making sure that those irreversible mistakes are not made and that any irreversible decision is not made without genuine consultation and informed consent with the patient and/or their parents.

At this point I would like to draw reference to some remarks I received and I believe many other members will have received in our communications and correspondence with community on this important bill. These are the words of Tony Briffa, who many will know as a fierce and long-term advocate for these reforms. Tony says this probably better than I could ever attempt to, because it comes from Tony’s lived experience. They say:

Had this Bill been law when I was a child it would have saved my parents and me from so much unnecessary pain and confusion. It would have also saved me from surgeries that removed my healthy gonads, from needing lifelong hormone replacement and numerous health complications, and it would have saved my mother from having a lifetime of guilt for what she believes she let doctors do to me even though I have never blamed her for any of those things.

The laws before us today are informed by many things, including an extensive and very long, detailed piece of consultation with the medical community. Today let the words of our intersex community carry the day and let the words of people like Tony and so many others be heard in our ears when we vote on this bill. I commend the bill to the house.

 Aiv PUGLIELLI (North-Eastern Metropolitan) (11:12): I am really pleased to be able to stand here today to also speak in support of this bill and to add to the comments that have been made by my Greens colleague Dr Sarah Mansfield in her contribution, and to see changes that will make sure that children and young people who are born with innate variations in sex characteristics will not undergo deferrable medical interventions until such a time that they can consent and make decisions about their own bodies and their own lives. This bill is testament to the tireless work of many advocates from the intersex and broader LGBTQAI+ community, and I hope right now they are feeling very proud of this change. What has been achieved will make a real difference for young people born with innate variations in sex characteristics.

My colleague Dr Mansfield has already covered the Greens’ position thoroughly with respect to this bill and has gone into more of its technical detail. I am here speaking today to add my strong support at a personal level for these reforms. As someone who identifies as part of the LGBTQAI+ community, something that I feel deeply in the work that I do, both with respect to this bill and more broadly in my work as an MP, is that I want to be staunch in my support for all members of our community who are represented by the letters LGBTQAI+. I know from speaking with many people who themselves would come under the letter ‘i’ for intersex just how much these laws will mean to them and to future generations.

As has been mentioned today already, Equality Australia’s The Missing Voice report really clearly lays out the case for these changes and the real-world impacts of failing to act. I have been honoured to meet with intersex community advocates and hear their personal stories, their experiences and their passion for this change. The harm that many people have experienced through medical interventions as babies and children is palpable. I commend all who have advocated in this space, particularly those who have advocated from their own story and their own lived experience. I commend their strength and their resilience in speaking up and pushing for this change.

People have had their choices removed before they have had the chance to have a say. Children with innate variations in sex characteristics have endured medical interventions that were not medically necessary and could have been deferred. Some of these procedures have altered their bodies in irreversible ways. Some procedures have caused them to be infertile. For some it has meant a lifetime of medication. Both the physical changes and the psychological impacts are significant.

We still have more work to do to address the stigma that faces intersex people in our community, as well as to make sure that there are supports available for the community as well as their families. But I know this is work that we are willing to do. We want to end the shame and the secrecy that have only added to the harm. We want to make sure that people feel fully supported, and that parents of children with innate variations in sex characteristics have access to the information and the support that they need to truly understand what they can do to best support their children. Intersex people and people with innate variations in sex characteristics should never be made to feel ashamed of their bodies. We are all different in our own ways. There should be no shame in our differences, and no-one should be made to feel otherwise. This bill and these hard-fought, important changes are welcome, and I commend them to the house.

 Sheena WATT (Northern Metropolitan) (11:16): Acting President Bourman, thank you so much for the call and the opportunity to rise and make a contribution to the Health Safeguards for People Born with Variations in Sex Characteristics Bill 2025. At its core this bill is about dignity and agency. It is about the fundamental right of every Victorian, regardless of the body they are born with, to make decisions about their own future and their own body. Our government committed 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. This commitment is on the back of more than 20 years of campaigning and advocacy for people born with variations in sex characteristics to have the same bodily autonomy as anyone else, a goal that has been backed up by human rights organisations and numerous national and international reports and studies.

Every person’s body is unique, but people born with variations in sex characteristics are born with physical traits, including reproductive organs, chromosomes or hormones, that do not fit typical medical definitions or binary understandings of male or female bodies. These variations are natural, they occur in up to 1.7 per cent of all births, and many people born with them will not require medical treatment. People born with variations in sex characteristics have told us that they want to make their own choices about what happens to their bodies, including being able to give informed consent to medical treatments that will impact them for the rest of their lives. This legislation recognises the experiences of people who have shared their stories of medicalisation, trauma and resilience, and it makes Victoria one of only a couple of jurisdictions in the country to enshrine these safeguards into law.

Through this bill, parents of children born with variations in sex characteristics will have access to more information and supports, enabling better healthcare outcomes and supporting informed decision-making. These children and their families deserve accurate information and access to peer and psychosocial support, and these reforms will deliver that. The bill supports parents in their responsibility, as medical decision-makers, for treatments that can have significant long-term consequences for their child. It also supports doctors to deliver best practice care by providing them with clearer guidelines and protection from some decision-making risks, through independent oversight. Importantly, there will be no change regarding urgent treatment required to save a person’s life or prevent serious, significant damage to their health. Such urgent treatments will be able to proceed without additional oversight or delay. Every person deserves the right to make decisions about their own body, and this bill responds to the clear and consistent ask from people born with variations in sex characteristics to be given that right.

While many people born with variations in sex characteristics will not require medical treatment, we know that infants and young children have historically undergone primarily cosmetic procedures so that their body can appear more typically male or female. This practice has occurred in Australia and overseas, and it continues to occur here today. Equality Australia’s The Missing Voice report found that Australian children remain at risk of harm from medical procedures that could be safely deferred.

This report highlighted the ongoing risk of harm from medical procedures that could and should be deferred until the person is old enough to give their own informed consent. The report found repeated instances of treatments, including surgery and hormones, that were not medically urgent or necessary yet were performed on children far too young to understand the lifelong consequences.

We hear from people like Stephanie Saal, who underwent two invasive surgeries from the age of three, and as an adult Stephanie learned that she might have been able to conceive a child had those surgeries not taken place. We heard from Sarah, who was told by doctors to keep her medical history a secret, leading to a lifetime of shame and anxiety. Sarah said she would give anything for the same opportunity to defer surgery that this bill now provides. Can I thank Stephanie and Sarah for sharing their stories and let them know that this bill before us responds directly to those experiences and to the clear, consistent request from the community to be given the right to choose what happens to their own bodies.

Stories like these underscore the necessity of the reforms outlined in the bill. You see, this bill also supports better medical treatment decision-making for people born with variations in sex characteristics. It empowers people with variations and supports parents to understand and explore treatment options. Doctors need clearer guidelines and protection from some decision-making risks through independent oversight, as provided in this bill, and this protection system has been under careful development since 2021, with extensive consultation with people born with variations, their families, clinicians and other experts. The bill provides for the deferral of permanent or difficult-to-reverse treatment until the person with the variation can give informed consent, unless the treatment is approved by an expert panel.

The primary features of this bill are: strengthened processes for obtaining informed consent, the establishment of an independent expert oversight panel and improved reporting requirements. Importantly, urgent treatment required to save a person’s life or prevent serious damage to their health will not be delayed. 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 in sex characteristics has come a really long way, and while it is true that some people are happy with the outcome of their treatment, these remain complex and very consequential medical procedures. It is vital that these reforms encompass all care and are backed up by the simple right of people to be able to make decisions about what happens to their own bodies. The proposed reforms consist of legislation and complementary improvements to the model of care. They cover definitions and scope, 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 a variation in sex characteristics can be complex and consequential, and these informed consent safeguards enshrine best practice for medical treatment.

While some doctors are already practising in this way, these safeguards will ensure that it becomes the standard approach. The informed consent safeguards outline consistent criteria for doctors to use when assessing whether someone has the capacity to consent. These include explaining the advantages and disadvantages of proceeding with or deferring a treatment and providing an opportunity for the person to discuss their decision with a peer or a psychosocial support worker. This ensures that people born with variations in sex characteristics and their families may get tailored information and support.

The independent oversight panel will assess and approve proposals for permanent or difficult-to-reverse treatments for people who cannot give informed consent. The panel consists of a chair, a deputy chair and ordinary members with expertise in relevant specialist medical practice, human rights, ethics, mental health, health law and lived experience of a variation in sex characteristics. In what would be a difficult and unexpected time for parents, the panel provides that layer of reassurance that their child is receiving necessary treatment in line with recognised best practice.

The panel also supports doctors by protecting them from some decision-making risks and providing some clearer guidance. Outcomes will be strengthened by the development of the two forms of treatment plans: the preapproved general treatment plans for common variations with an established evidence base and individual treatment plans submitted by doctors on a case-by-case basis for less common or more complex variations. Reforms like this would not be trusted or supported by people with lived experience without an appropriate offence, and that is what we heard. However, doctors acting in good faith have nothing to fear as the offence is carefully worded to capture only the most egregious, knowing and reckless of breaches.

We know that parents love their kids and want the very best for them, which is why this bill recognises that parents deserve more information and support. The bill strengthens support for parents so they can better understand the variations and treatment options for their child, including the risks and benefits of deferring treatment until the child can express their own preferences or provide informed consent. Some parents have expressed regret that they consented to treatment that had very long-term adverse impacts and could have been deferred. The bill upholds and enables parents in their responsibilities to make decisions in the best interests of the child while providing oversight of treatment that can have significant consequences, such as sterilisation or pain. If a child needs treatment before they can consent, this legislation ensures parents are better informed, with the reassurance of a panel confirming that the treatment is necessary and follows best practice. Parents must still give consent for treatment to proceed, and if there is a disagreement with a panel decision, internal and external review pathways are available.

Doctors at our children’s hospitals are some of the best in the world, and they have been significantly involved in the design of this bill. Doctors will be central to the work in implementing these changes, including developing treatment plans, templates and guidelines that are fit for purpose and not onerous. The legislation will assist doctors in providing best practice care and ensure that they are more protected from decision-making risks. They will be supported through tailored training and guidance and specialist clinical expertise being embedded into the panel processes.

One thing I just want to say is that some people are born with variations and are really happy with their treatment, but what I heard and saw was that others describe the trauma of having these invasive treatments undertaken before they could voice their preference. I just want to acknowledge and thank Equality Australia for their really substantial work in developing TheMissing Voice report. The very real consequences of these decisions are captured in that report, and I know many of us have looked at it with great interest.

Informed consent is required under the bill before any person receives medical treatment, and for those under 18 it is up to the treating doctor to assess their capacity also to give informed consent. A parent or guardian is usually the decision-maker for a person under 18, unless a child is assessed as capable of giving consent themselves. These safeguards do not change existing laws regarding who can make medical decisions, and that is really important to note. Instead, they ensure that all doctors are providing parents with some easy-to-understand information and the opportunity to discuss options with expert, peer or psychosocial support workers. Like other laws that protect children’s best interests, this bill limits parental decision-making only if it is safe to defer treatment until the child can make the decision for themselves.

We would not be here today debating this law if it was not for the many decades of advocacy from people born with variations in sex characteristics, including Victoria’s own Tony Briffa, and I just want to acknowledge the extraordinary efforts of Tony in helping get us to this point where we are debating this today. By passing this legislation, we in this chamber are choosing to protect the bodily autonomy of all Victorians and ensuring that our health system reflects the values of dignity and respect that every person deserves. This ensures that Victoria remains a leader in compassionate health care, and I commend this bill to the chamber.

 Georgie PURCELL (Northern Victoria) (11:29): I rise to speak in support of the Health Safeguards for People Born with Variations in Sex Characteristics Bill 2025. As the title states, the bill creates safeguards where there is a proposal for a person to undergo medical treatment to alter their sex characteristics in circumstances where they cannot provide informed consent.

As others have noted, it is important to make it very clear that these safeguards will not prevent treatment that is urgent or necessary to prevent significant harm. Sadly, though, most procedures that have been performed on unconsenting intersex people unnecessarily are deferrable and, importantly, irreversible. Instead the parents and guardians of children with variations in sex characteristics are often pressured into consenting to these procedures for their children, being told it is the best or only option for their child’s health. New parents have limited access to the information or support when making what are significant decisions about their child’s care.

The bill will improve this through the creation of a new independent expert panel. Membership of the panel will include medical practitioners, mental health professionals, those with experience in health law and, most importantly, those with lived experience of having variation in sex characteristics. The panel will provide oversight for deferrable or elective medical treatments that will result in permanent change, deferring them until they are able to provide informed consent. For health practitioners this will give clear legal and ethical frameworks, reduce decision-making and legal risk and provide best practice treatment guidance. The reporting requirements placed on the panel will also provide ongoing improvements in data collection, provide better visibility of variations and procedures and create a framework for the monitoring of treatment data. These changes are essential because the harms caused by these operations are immense and lifelong, both physically and emotionally.

Recently I heard the deeply personal story of a young intersex woman from Melbourne, M, who was born with XY chromosomes. At birth she was taken from her parents for testing without explanation. What followed was years of hospital appointments, some invasive, without her understanding why. At three she underwent surgery to ‘correct her body’. A few years later doctors realised that they had misdiagnosed her, yet she was not told the truth for years because her parents had been advised to keep it a secret. Imagine learning as a woman in early adolescence, just as your peers are forming their identities, that you had irreversible surgery as a child, that you will never have biological children, that you have XY chromosomes and that decisions about your body were made without your knowledge or your consent. M describes it as a moment everything she knew about herself was unravelling.

The irreversible consequences of her treatments were not minor. The surgery left her unable to produce her own hormones, resulting in reliance on medication for life. But the physical harm is only part of her story. When doctors advise parents to ‘correct’ a child’s body and keep the truth from them, what message does that send? M felt a deep sense of shame and need to maintain secrecy for many years. She felt that who she is must be hidden. She spoke of searching online for answers she did not yet have the language for. For M, the silence, shame and secrecy manifested in resentment towards her parents. Her parents have also felt immense guilt after making a decision that was based on their trust in doctors’ advice and went directly against what M would have wanted for her own body. M’s father has told MPs in this chamber that he wishes this legislation was in place when his daughter was born so that a fully informed decision could have been made based on much greater information and transparency.

This bill is not about preventing medical interventions that are life-saving or required to prevent serious harm. It is about supporting families of people with innate variations in sex characteristics so that they are fully informed by experts from different disciplines, not just medical, before a decision is made that could lead to irreversible consequences, parental guilt and child resentment. It is about preventing medical interventions like M’s, which she wishes never happened – unnecessary, deferrable and irreversible interventions that have lifelong physical and psychological implications for people born with variations in sex characteristics and their families.

I know both M and her dad are watching today’s debate, and I want to extend my heartfelt thanks to her for allowing me to share her story and tell the importance of this bill. I would also like to acknowledge the advocacy of the Victorian commissioner for LGBTIQA+ communities Joe Ball, Equality Australia, the Victorian Pride Lobby, Tony Briffa, Dr Sean Mulcahy and every other person and organisation who have advocated for this bill for better protections for intersex children. This bill recognises a simple but important truth, and one that I think is worth repeating: intersex bodies do not need fixing. I am proud to commend this bill to the house.

 Jacinta ERMACORA (Western Victoria) (11:36): I am very proud to make a contribution on this bill today, the Health Safeguards for People Born with Variations in Sex Characteristics Bill 2025. The bill brings Victoria in line with the Australian Capital Territory, the only jurisdiction in Australia to have banned non-consensual medical procedures on intersex people.

I recognise the many decades of advocacy and activism from people born with variations in sex characteristics who have led us to this point right here today in this chamber. This includes Victoria’s own Tony Briffa, who I just met this morning, who is known by many for being the world’s first intersex mayor and public office holder. I thank Tony for her correspondence with me, and agree it is significant that the bill has the support of the senior leadership of the Royal Children’s Hospital. If I can just quote Tony’s letter to me:

[QUOTE AWAITING VERIFICATION]

Had this bill been law when I was a child, it would have saved my parents and me from so much unnecessary pain and confusion.

She does go on to provide more detail.

The overall objectives of this bill are to establish new safeguards, oversight and reporting processes to better protect people born with variations in sex characteristics, particularly infants and young children, from harm. These include safeguards for informed consent that provide consistent criteria for clinicians to use when assessing whether someone has capacity to consent to treatment, additional oversight for medical treatments that permanently change a person’s sex characteristics or make changes that may only be reversed through further treatment, and reporting provisions for improved monitoring of treatment data. The bill also seeks to better support clinicians with the provision of new, clear, consistent information and guidelines to mitigate decision-making risks. With these objectives, the bill affirms our government’s unwavering commitment to the health of all Victorians. Our government is determined to respect the dignity and the wellbeing of people born with variations in sex characteristics, especially infants and young children.

Every person’s body is different. Being born with a variation in sex characteristics, sometimes referred to as intersex, means that a person’s body does not fit typical definitions or understandings of male or female. In that sense, it is not one or the other, it is between the two binaries that we might normally perceive. Being intersex is a naturally occurring biological variation in humans. These variations are not a disease; they are not a disorder. These variations can relate to reproductive organs, chromosomes or hormones. It is important to be clear this is not the same as being transgender or gender diverse. This bill is not about gender identity; it is about people whose biological sex characteristics vary from typical, medical or what we in our broad society would assume in our community.

It is about health care. It is about ensuring that our health system does no harm. It is about recognising that diversity in sex characteristics is a natural part of the human condition and that every person should have the right to make decisions about their own body. This legislation has been considered with great care and is the culmination of years of advocacy, consultation and consideration. It responds directly to the lived and living experiences of people born with variations in sex characteristics who have courageously shared stories of medicalisation, trauma and resilience. I want to acknowledge those who are in the chamber and those who might be watching online who are in that category of people who have advocated in this space, whether it is through personal experience of their own or their family.

Our society’s cultural expectation that sex characteristics are binary – that is, either male or female – has led to the pathologisation of what we now know and understand to be normal variations, not disease or illness and not something that needs to be necessarily corrected. Unfortunately, many have spoken about the procedures performed in infancy or early childhood to erroneously correct that assumption – procedures that were irreversible, not medically necessary and undertaken before they were able to consent. In the past, intentions may have been well intended, with a belief that normalising appearance – back to that binary perception – would protect children from stigma. The consequences have too often been devastating and lifelong. We have heard about sterilisation, chronic pain and loss of sexual function. We have heard about psychological trauma and a profound sense of violation. These characteristics have been condemned not only by people with lived experience but by human rights bodies and medical ethicists around the world. There is a growing international consensus that unnecessary medical interventions on infants and young children must end. We have listened and we have learned. Critically, there will be no change regarding urgent treatment required to save a person’s life or prevent serious or significant damage to their health. Urgent treatments will proceed without additional oversight or delay, and we will continue to rely on the expert advice of dedicated clinicians, specialists et cetera to determine urgency and act appropriately.

As mentioned, the bill before us strengthens ethical care through four key mechanisms. The first mechanism is informed consent safeguards. These safeguards ensure that people born with variations in sex characteristics and their families receive accurate and tailored information. Families will have access to peer workers and counsellors to support them in understanding options for proposed treatment and what would happen if treatment does not proceed. They will be given reasonable time to consider decisions. If a person has capacity, they will be able to consent to approved treatment themselves. If a person does not have capacity, they will still be supported to contribute to decision-making in a manner appropriate to their age and developmental stage. In the case of infants and young children there will be additional oversight before treatment can proceed. Parental decision-making is not removed. Parents and guardians will continue to consent to treatment for their child, and where proposed treatments are irreversible and not urgently required, an independent oversight panel must first approve the treatment plan.

The second mechanism will establish an independent legislated oversight panel. This panel will approve general and individual treatment plans. It will develop guidance, report on treatment data and ensure that irreversible decisions are made with the utmost care, accountability and evidence. It will support families. It will also support clinicians by reducing the burden of uncertainty that many practitioners have described when navigating the complex ethical terrain without clear guidance.

The third mechanism is the introduction of treatment plans. Treatment plans will provide formal approval for treatments that vary sex characteristics. There will be general treatment plans for common treatments with an established evidence base, and individual treatment plans for less common or more complex circumstances, with the treating clinician ordinarily drafting the treatment plan to seek the panel’s approval. General treatment plans will allow for flexibility and responsiveness. They will both reduce duplication and regulatory burden while maintaining those safeguards.

The fourth mechanism is a prohibition with consequences for noncompliance. The criminal prohibition applies to the intentional or reckless provision of restricted medical treatment to a protected person who was born with variations in sex characteristics who does not have the capacity to consent to the proposed treatment. Consequences for noncompliance will largely be supported through existing regulatory mechanisms. For example, failure to meet informed consent obligations can result in referral to the Australian Health Practitioner Regulation Agency for unprofessional conduct. However, for the most serious breaches with intentional or repeated violations of the prohibition there is a proposed summary offence. The maximum penalty is two years imprisonment or 240 penalty units. This is intended to be a meaningful deterrent.

The bill also recognises that legislation alone is not enough. Cultural change is needed within medicine, within families and within society, which is why these reforms will be supported by complementary system enhancements; improvements to the model of care; strengthened data collection to better understand variations and procedures; and resources, guidance and education to support clinicians and families in understanding their roles and responsibilities.

Implementation will be careful and considered. We will continue working closely with clinicians and people with lived and living experience to ensure individuals remain at the heart of these reforms. This legislation, after all, has been actively shaped by those with lived experience. It has been shaped by people who have spoken bravely and honestly about what happened to them, often at significant personal cost. I also recognise the clinicians who are already practising in line with the principles of this bill.

This bill reflects our government’s commitment to evidence-based policy, human rights and inclusive healthcare. It is not about ideology or politics; it is about justice and ensuring every Victorian born with variations in sex characteristics has the right to make decisions about their own body. I am particularly proud of the way this bill is structured, because it brings in the human side of the story. It provides a framework for practitioners and families. It provides community education. It provides the regulatory expectations, and it provides the punishment if proper conduct is not complied with. So really the full suite of protections are there, and I look forward to its implementation.

 John BERGER (Southern Metropolitan) (11:49): I rise today to speak on the Health Safeguards for People Born with Variations in Sex Characteristics Bill 2025. This bill covers an issue which only affects a very small number of Victorians, but for those who are impacted by its provisions those impacts can be profound.

While the issue of unwarranted and unnecessary medical treatments for people born with variations in sex characteristics is something most people would not have to think about in their daily lives, this bill does speak of many of the values which we hold as Victorians, values such as equality, personal choice and the importance of consent. These values are widely held in the Victorian community and are directly applicable to questions related to unnecessary and potentially dangerous medical procedures being conducted on somebody without their consent. I suspect that very few of my constituents in Southern Metropolitan Region would appreciate having unnecessary, irreversible and potentially dangerous medical procedures conducted on them without their consent. Likewise, parents do not usually appreciate being rushed into making sometimes life-altering medical decisions for their children for procedures which are unnecessary and potentially dangerous without being able to consult with expert advice first. The simplest way to think about this bill is to ask why would it be different for people who have variations in sex characteristics and their parents. The medical science behind this issue can be quite complicated, but the questions of equality, choice and consent are not.

Importantly, this bill does not impede the ability and duty of medical professionals to conduct urgent treatments. In cases where a treatment is genuinely urgent and necessary to protect the life or health of an individual, this bill will not stand in a doctor’s way. This is because the targets of this bill are surgeries which are not medically necessary and are often done for aesthetic reasons, to make a person’s body more typically male or female. Situations in which a young person, often in infancy, has undergone a surgical or hormonal treatment which was not considered medically necessary and which would often have irreversible effects have in the past led to serious ongoing medical problems. For some, these long-term problems might be pain, sexual dysfunction or sterilisation, as well as other issues which often vary case by case. Others are left with psychological trauma, being made to feel as if society sees the way they were born as unnatural. For some it is a simple offence to their personal right to choose for themselves. If a surgery was neither urgent nor medically necessary, then they believe that it would have been their right to choose when they were old enough to provide informed consent.

This bill creates a legal framework to help doctors, families and individuals navigate these situations and decisions, creating four key mechanisms. The first mechanism relates to the importance of informed consent and creates new safeguards to ensure that intersex people can have access to accurate and accessible medical information and the ability to seek expert advice. Next is the creation of an independent legislative oversight panel with the power to approve treatment plans, ensuring accountability and supporting children and their families through the process. The third is the creation of evidence-based, preapproved general treatment plans. The final mechanism is penalties for those clinicians who do not meet the compliance standards.

Whether they do not meet the informed consent obligation or act recklessly in their practice, this bill introduces serious consequences. The maximum penalty under this bill is a two-year prison sentence. While two years is a long time to spend in prison, people who have sex normalisation operations conducted on them without their consent sometimes face negative consequences which are lifelong. Given the seriousness of the issue and the potential harms which it can cause people, we on this side of the chamber believe that prison sentences for this behaviour can be warranted in certain situations.

Should this bill be successful and pass into law, we would not be the first jurisdiction in Australia to implement these sorts of protections, but it would be the first for a state. In 2023 the ACT government passed a similar bill offering similar protections. A number of European nations also have similar protections under law, including Spain, Germany, Portugal, Malta and Greece. Victoria is not venturing off into the unknown with this bill, but we are ahead of the other Australian states in passing historic medical protections for intersex people. The reasons we have done this here in Victoria are to do with the values which I outlined earlier: equity, choice and consent. One does not have to dig too deeply into the Allan Labor government’s record to see that this bill is not only a manifestation of these values but a continuation of these values being promulgated and actualised into public policy once again.

Equality is at the heart of the agenda of every Labor government. This includes equality of opportunity, building a society where everyone is given a chance to succeed based on their merits rather than on circumstances beyond their control.

Labor governments believe that people who are born poor should not have to live their entire lives stuck in a cycle of poverty, that people in rural areas should not be denied the opportunities which are given to those in the city, that public school students are just as deserving of world-class education as private school students and that equality under the law and freedom from discrimination should protect all Victorians regardless of race, religion, gender, sexual orientation or disability. Personal choice is another one of the key planks of any Labor government’s agenda and very much a part of the Allan Labor government’s agenda.

Our policies have empowered Victorians, giving them more power to make more decisions about their own lives. Free TAFE allows young Victorians who do not want to go to university to find a pathway into a fulfilling and often quite well-paying career. It also gives people already in the workforce more options, and many are taking up the opportunity to retrain and start a career in a new field. We are building more houses in every part of the state – the inner city, the suburbs and the regions. We are giving the next generation of Victorians a chance to live, rent and buy a home where they actually want to live. This may enable them to live closer to where they want to work and allow them to better accommodate their lifestyles and preferences. For those who already own a home, we have made it easier for them to make decisions about what they want to do with their own property, for example, reducing approval times for home owners to subdivide their property. Consent is another key value championed by this Labor government. Victoria’s nation-leading Respectful Relationships program in our schools teaches young people throughout primary and secondary school ages appropriate content about consent, rights, relationships and resilience. We have made legislative changes relating to consent, such as banning stealthing and adopting an affirmative consent model under the law to better protect victims of sexual offences.

While these three values are not only the values which we in the Allan Labor government hold, they are three which apply to this health safeguards bill and which apply across various areas of public policy. But they are not just the values which are held by members of the Australian Labor Party, they are values held all across all sections of the Victorian community, and it is important that they apply to all Victorians. We are seeking to pass this bill to ensure that equity, choice and consent are all put at the heart of the medical system that treats intersex people.

What is so important is leading a cultural change. Legislative change is important in creating the protections under the law, and that is exactly what this bill seeks to do. We hope on this side of the chamber that if this bill is successfully signed into law, it will be one that brings a cultural change within medicine and within society more broadly towards the acceptance of intersex people. Some people are born with variations in their sexual characteristics, and this is just part of the natural diversity of humans. Unfortunately, in the past an over enforcement of gender ideals and a lack of respect for the dignity of the individual have led to people having these unnecessary and potentially damaging medical procedures performed on them without their consent. Doing this is essentially telling them that there was something inherently wrong with them as a person in how they were born. Children should not have to grow up thinking that there is something wrong with them when there is not.

Parents everywhere, throughout every part of Victoria, worry about the mental health and self-image of their children. They want to see their children become confident and comfortable in their own skin. Part of that is teaching young people to be accepting of their own bodies. Parents have a good reason to worry about the mental health and self-image of young people these days. No teenager in history has been told that they are not good enough more times in 1 hour than a 14-year-old kid who spends an hour trolling through TikTok. It may be social media giving young people unrealistic expectations about what their bodies should look like or schoolyard bullying or anything else. No parent wants their child to hate or feel ashamed of their body. The same goes for children who are born intersex and their parents. In some ways the challenges which these children face are different from those of their peers, but in other ways they are very similar. While it might be difficult for a lot of people to understand what it would be like to be born with these sorts of variations in sex characteristics and how it might affect a person’s sense of identity, there are also areas where we can all empathise with those families who face the sorts of decisions which are being addressed in this bill. Society should not be saying that we have a problem with how they were born and that they ought to undergo irreversible medically unnecessary or potentially damaging procedures. Doing this without even waiting until they are old enough to consent to it or without providing the parents with adequate time and support to make an informed decision is irresponsible and offensive to the personal dignity of the individual.

Business interrupted pursuant to standing orders.