Intersex rights in Chile


Between December 2015 and August 2016, the Chilean Ministry of Health issued a regulatory suspension of non-necessary cosmetic medical interventions on intersex children. The guidelines were replaced by guidance permitting intersex medical interventions.

History

In 2015, Chile briefly became the second country to protect intersex infants and children from unnecessary medical interventions, following Malta, however, the regulations were superseded the following year. Chile also has an early example of court ordered compensation awarded in the Benjamín-Maricarmen case in 2012.
In April 2018, Latin American and Caribbean intersex activists published the San José de Costa Rica statement, defining local demands.

Physical integrity and bodily autonomy

In 2015, the UN Committee on the Rights of the Child recommended that Chile recognize the rights of Chilean intersex children, and expressed concern "about cases of medically unnecessary and irreversible surgery and other treatment on intersex children":
In January 2016, the Ministry of Health of Chile ordered the suspension of unnecessary normalization treatments for intersex children, including irreversible surgery, until they reach an age when they can make decisions on their own.
The instructions were published in Circular 8, 22 December 2015, entitled "Instructions on aspects of health care to intersex children". The circular instructs the ceasing of "unnecessary "normalization" treatment of intersex children, including irreversible genital surgeries, until they are old enough to decide about their bodies", while work takes place to develop protocols that meet human rights standards. The country became the second in the world to protect intersex children from harmful practices, after Malta.
However, the 2015 circular was superseded by Circular 7 of 23 August 2016, which states that the earlier recommendation not to perform unnecessary genital surgeries does not apply to "pathologies" where sex can be clearly determined. It also does not apply in cases of congenital adrenal hyperplasia when professionals or the patient deem surgery necessary, and where a patient or their representative consents. In cases where either sex may be assigned, sex assignment and surgeries may be made by agreement between parents and multidisciplinary teams, also considering the possibility of deferring surgeries to a time when a child has manifested a sexual identity. The guidelines are based on a 2006 clinical consensus document. Brújula Intersexual describes the circular as permitting interventions without supporting long-term data, and ignoring testimonies of persons subjected to early interventions.
In July 2018, the UN Committee on the Elimination of Discrimination against Women issued concluding observations on harmful practices, recommending that Chile "explicitly prohibiting the performance of unnecessary surgical or other medical treatment on intersex children until they reach an age when they can give their free, prior and informed consent". The Committee also called for the provision of counselling and support to families, and education to medical professionals.

Claims for compensation

Benjamín-Maricarmen case

In 1993, a baby with "ambiguous genitalia" named Maricarmen, suffered an irreversible surgical intervention. It was determined by the child's medical team that the she would be raised as a girl, and her gonads and male reproductive system were removed. The parents were informed that the child had inguinal hernias. At the age of 10, in 2003, Maricarmen was to start hormone replacement therapy. In connection with this, blood tests were conducted, and these confirmed that the child's chromosomal sex was 46,XY, male. The ten-year old immediately transitioned, becoming Benjamín. Changing official documents took several years and required him to go through psychiatric and physical examinations.
On 12 August 2005, the mother filed a lawsuit against the Maule Health Service. The claim for damages was initiated in the Fourth Court of Letters of Talca, but ended up in the Supreme Court of Chile. On 14 November 2012, the Court sentenced the Maule Health Service for "lack of service" and to pay compensation of 100 million pesos for moral and psychological damages caused to Benjamín, and another 5 million for each of the parents. The ruling states that the hospital should have had exams that would allow the parents and the victim to "decide about the removal of these organs and the condition of man or woman with which they would face life and society."

Protection from discrimination

Bill on "System of Guarantees of Rights of the Childhood," includes protection from discrimination on grounds of sex characteristics and recognize the right to children and adolescents to develop their gender identity. The Bill seeks to adapt Chilean legislation to the Convention on the Rights of the Child.
On 31 August 2016, the Family Committee of the Chamber of Deputies approved these protections. On 2 May 2017, the plenary session of the Chamber of Deputies approved the bill including LGBTI categories. The bill now heads to the Senate for discussion.
Article 9 of the bill states that "no child shall be arbitrarily discriminated against because of their sexual orientation, gender identity, gender expression and sex characteristics," among other distinctions.
Article 19 based on "Identity" states that "every child has the right, from birth, to have a name, a nationality and a language of origin; to know the identity of their fathers and/or mothers; to preserve their family relations in accordance with the law; to know and practice the culture of their place of origin and, in general, to preserve and develop their own identity and idiosyncrasy, including their gender identity."
In April 2017, the Ministry for Education introduced a document entitled "Guidelines for Inclusion of lesbian, gay, bisexual, trans and intersex people in the Chilean educational system," aiming to promote inclusion and safeguard equality and non-discrimination. It considers suggestions to safeguard the rights of LGTBI children and adolescents in educational contexts; actions to support them in case they do not have the support of their families and learning objectives to address this issue.

Identification documents

The Gender Identity Law, in effect since 2019, recognizes the right to self-perceived gender identity, allowing people over 14 years to change their name and gender on all official documents without prohibitive requirements. Since 1974, the change of gender had been possible in the country through a judicial process.
Birth certificates are available at birth showing "indeterminate" sex if it is not possible to assign a sex. According to the Civil Registry, between 2006 and 2017, 269 intersex children have been registered under the category of "indeterminate sex" on official records. The change of gender on the birth certificate must be requested through the courts when the biological sex is determined.
In Chile there are two public policies based on the antidiscrimination law that are, in some way, designed to protect intersex people.
On 14 June 2012, the Ministry of Health issued Circular 21 titled "Reiterates instruction on the care of trans people in the health care network". The document stipulates the reiteration to the health services the duty of officials to respect gender identity and the social name of trans and intersex people, with emphasis on primary health care. It points out that intersex people, in comparison with trans people, "may also manifest a similar situation, when genital sex does not correspond to the gender identity that the person is developing."
On 9 November 2012, the Legal Medical Service, under the Ministry of Justice, issued Circular 1297 that instructs compliance with the "Expert Technical Guide of Forensic Sexology for trans and intersex cases." It is intended to safeguard the physical and mental integrity of people, especially ensuring the protection of dignity. The protocol mentions that trans and intersex persons will not be subjected to invasive expert reports, in addition they must be treated by their social name or the one that the person prefers.