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.
