What is the issue?
Everyone, including children, has the right to autonomy and self-determination over their own body, and the only person with the right to make a decision about one’s body is oneself—no one else. This is the principle of bodily integrity, which upholds everyone’s right to be free from acts against their body which they did not consent to.
Practices that violate a person’s bodily integrity can range from piercing a baby girl’s ears or being exposed to toxic chemicals without one’s knowledge, to forms of violence such as rape or medical treatment administered against a patient’s wishes.
Children are disproportionately vulnerable to violations of their bodily integrity because most violations happen at very young age when a person is unable to speak up for and defend themselves, or give — or refuse — consent.
What is the problem?
Practices that violate children’s bodily integrity have long been conducted by adults without considering children’s human rights. Some of the most abhorrent violations of children’s bodily integrity include invasive practices conducted for no medical reason on their genitals. These include virginity testing on girls, female genital mutilation, sexual maturity exams on migrant and refugee children to determine their age, routine circumcision of boys, ‘corrective’ surgeries on intersex children, and forced or coerced sterilisation of children with disabilities.
With the exception of female genital mutilation, most of these practices would be unlawful if performed on adults without their consent, but they remain legal in the majority of practicing countries when performed on children.
A number of these practices are irreversible and due to their surgical nature carry inevitable health risks. These range from infection and scarring to disfigurement, amputation, and even death. At the same time, they can have a lifelong psychological impact, with childhood victims today saying they feel shame, diminished body image, and a sense of having been abused, mutilated and deformed.
These practices also affect children’s civil rights, as when their consent is not obtained or even considered, it neglects their freedom of thought and opinion. In cases where a practice is carried out to conform to social expectations or is based on adults’ — not the child’s — religion, culture or tradition, it violates children’s own freedom of thought and religion.
What is the solution?
Greater respect for children’s rights, especially their right to bodily integrity, is key. In 2015 Malta became the first country in the world to ban ‘corrective’ surgeries on intersex children when they are not medically necessary before a child is old enough to decide for themselves. Portugal followed suit in 2018, although with a weaker law . But this type of legislation should be the norm, not the exception.
To be clear, the decision about one’s body should rest only with the person in question and be taken by them when they are old enough to give their free, prior and informed consent—or to refuse it. The only exception is when an intervention is medically necessary to save the person from serious, urgent and irreparable harm. Routine procedures such as genital surgeries or exams performed for no medical reason do not fit this exception.
Briefing paper: Sterilisation of women and girls with disabilities
Council of Europe: Resolution on children’s right to physical integrity
Discussion paper: Consenting to non-therapeutic interventions
CRIN submission to the UN: Children’s right to be heard in health-related matters