雙性人的權益
更新日期：2020年7月24日
前言
相對於其他性小眾，雙性人（intersex）在香港較少被市民留意，故他們所面對的困難往往不為人所知。本文會介紹一些國家涉及雙性人在生理改造、性別確定、婚姻及歧視方面的法例，以及不同取態將會帶來的影響。
雙性人的定義
聯合國人權事務高級專員辦事處指出，雙性人是在解剖學、性器官及／或染色體中未能分辨為男或女的人。他們會認為自己的身份是「男」或「女」或兩者均不是。雙性這現象並不關乎性傾向（sex orientation）或性別身份（gender identity）。[1] 歐洲委員會亦認為雙性與變性的傾向（transsexuality）不同，後者指一個人已有確定的生理性別，但認為自己是另一個性別的人。[2] 故此，雙性純粹是一種生理現象，它不能與性傾向或性別身份混為一談。
出生時的性別正常化手術
為免危害生命，有部份雙性人在出世時需進行手術。但亦有部份父母為了使孩子可被認定為男或女，部份雙性人出世時會被迫接受性別正常化手術（sex normalizing surgery）；有人認為這種做法日後會為他們帶來重大的生理及心理創傷。一些國際組織（如：世界衛生組織、[3] 歐洲委員會[4] 及聯合國[5] ）強調雙性人的自主性，呼籲停止這種未經他們同意的手術。在國家層面，馬爾他是首個國家立法禁止醫生進行這種手術。[6]
性別的確定
若雙性人在出世時沒有進行性別正常化手術，那麼他們的性別應如何界定？ 我們先看看雙性人的訴求。
雙性人對性別的訴求
2013年國際雙性人論壇提出，雙性人在出世時的性別應先定為「男」或「女」，待他們成長後，按其意願決定需否更改（包括可選擇「男」或「女」之外的性別分類）。[7] 該論壇亦認為，長遠來說，性別不應在出生證書或其他身份證明文件中出現。[8]
澳洲的國際雙性人組織（Organization Intersex International Australia，簡稱OII，該組織的名字已於2018年更改為澳洲雙性人人權 Intersex Human Rights Australia）認為，基於第三性別可能帶來的負面標籤效應，第三性別須在當事人同意下才可使用，故不宜將第三性別加諸於心智未成熟的兒童。[9] 家長應先按雙性人嬰兒的最近似性別界定他為「男」或「女」，待他成熟後再按其意願決定需否更改。
在香港，雙性人人士向立法會提交的報告中，呼籲政府立法修例，讓香港有男和女以外的中性性別給雙性人按個人意願去選擇。[10]
涉及性別的法例
部份國家（包括德國，[11] 新西蘭，及澳洲的某些州份）容許那些未能確定性別的嬰兒在出生證書的性別選擇「男」、「女」或「未確定」（unspecified / indeterminate）。部份人士反對這做法，指出那些性別被界定為「未確定」的兒童難以在這個二元性別的社會裡健康地成長，「未確定」的標籤會對這些兒童造成歧視，並且促使家長更想為孩子進行性別正常化手術。[12]
隨著雙性人成長後，他們會漸漸意識到自己的性別身份，而這性別身份可能與他在出生證書上的性別不同。若他在出生時被界定為「男」（「女」），他長大後可能會認為自己是 「女」（「男」），或認為自己既不是「男」亦不是「女」；若他在出生時的性別為「未確定」，他長大後可能會認為自己是「男」或「女」。
有鑑於此，一些國家（如：新西蘭及澳洲的某些州份）容許成年（或經家長同意的未成年人士）的雙性人更改其在出生證書的性別，包括由「男」（「女」）變「女」（「男」），由「男」或「女」變為「未確定」，或由「未確定」變為「男」或「女」。更改性別須符合一些條件，而不同國家的要求不同。在新西蘭，若想將性別變為「男」或「女」，雙性人需進行性別重置手術（雖然重置的程度視乎個別人士而定），但在澳洲的澳大利亞首都特區（Australian Capital Territory）則沒有此要求。
除了出生證書外，其他的證件或政府記錄內亦載列了公民的性別。在澳洲聯邦政府的公民記錄中，雙性人可選擇或修改其性別為「男」、「女」或「X」（unspecified / indeterminate / intersex），而毋須進行性別重置手術。[13] 護照方面，部份國家（包括澳洲，新西蘭，[14] 印度，尼泊爾等）容許雙性人在護照上的性別定為「未確定」。另一方面，考慮到雙性人在外國的安全等因素，部份國家容許他們在護照上的性別不同於他們在其他證件上的性別（例如：護照上是「男」或「女」但其他證件是「未確定」。）[15]
婚姻
雙性人組織當中亦有要求雙性人有結婚及組織家庭的權利。[16] 在英國，進行了變性手術的雙性人的婚姻是有效的。英國一位丈夫要求法庭宣佈他與妻子（一個進行了變性手術的雙性人）的婚姻無效，理由是妻子不是「女性」，而婚姻須是一男與一女的結合。法庭認為，縱使該名妻子的領養父母希望她成為男性，但她自出世後無論在自我身份認同及在生活上均表現為女性，故法庭裁定她在婚姻關係中是「女性」，而她與丈夫的婚姻是有效的。[17] 但該案件未有觸及一位未有進行變性手術的雙性人可否結婚的問題。
反歧視
澳洲是首個立法禁止歧視雙性人的國家。2011年澳洲人權委員會發表有關性傾向、性別身份及雙性人歧視的報告，指出在澳洲存在對該類人士的歧視、詆毀、騷擾及欺凌。[18] 2012年澳洲政府發出了反歧視條例草案，將性傾向及性別身份列入歧視因素；在參議院審議期間，進一步將雙性人身份納入歧視因素。2013年條例通過，禁止在僱用、教育、租住、商品及服務提供等範疇作出基於性別、性傾向、性別身份及雙性人身份的歧視。[19] 與其他歧視因素不同，對雙性人的歧視不存在宗教豁免，原因為澳洲的宗教團體表示禁止對雙性人的歧視不會影響良心及宗教自由。[20]
容納雙性人的政策與措施
在二元性別的社會裡，雙性人在生活上會面對不少困難。有鑑於此，一些國家制定了政策與措施去協助雙性人解決生活上的困難。在澳洲，醫療的提供（Medicare）不再以病人的性別作為提供服務的重要參考，雙性人在接受醫療時亦毋須披露或解釋自己的性別，因為病人可接受甚麼治療已與他的性別無關。[21] 另外，澳洲政府亦資助安全校園計劃，促進對不同性傾向、性別身份及雙性人學生的接納及包容。[22]
（原文於2015年10月29日刊於本社網站，其後曾作修訂。）
[1] “An intersex person is born with sexual anatomy, reproductive organs, and/or chromosome patterns that do not fit the typical definition of male or female. This may be apparent at birth or become so later in life. An intersex person may identify as male or female or as neither. Intersex status is not about sexual orientation or gender identity: intersex people experience the same range of sexual orientations and gender identities as non-intersex people.” Quote from: FREE & EQUAL UNITED NATIONS FOR LGBT EQUALITY, “FACT SHEET: LGBT Rights: Frequently Asked Questions,” FREE & EQUAL UNITED NATIONS, accessed October 29, 2015, https://www.unfe.org/system/unfe-7-UN_Fact_Sheets_v6_-_FAQ.pdf.
[2] “The term ‘intersex’ refers to atypical and internal and/or external anatomical sexual characteristics, where features usually regarded as male or female may be mixed to some degree. This is a naturally occurring variation in humans and not a medical condition. It is to be distinguished from transsexuality, a phenomenon where someone has an evident sex, but feels as if he or she belongs to the other sex and is therefore ready to undergo a medical intervention altering his or her natural sex.” Quote from: Committee on Social Affairs, Health and Sustainable Development, “Children’s right to physical integrity; C. Explanatory memorandum by Ms Rupprecht, rapporteur,” Parliamentary Assembly, last modified September 6, 2013, http://www.assembly.coe.int/nw/xml/XRef/Xref-XML2HTML-en.asp?fileid=20057&lang=en.
[3] OHCHR, UN Women, UNAIDS, UNDP, UNFPA, UNICEF and WHO, “Eliminating forced, coercive and otherwise involuntary sterilization: An interagency statement,” World Health Organization, accessed October 29, 2015, http://www.who.int/reproductivehealth/publications/gender_rights/eliminating-forced-sterilization/en/.
[4] Parliamentary Assembly, “Children’s right to physical integrity,” Parliamentary Assembly, last modified October 1, 2013, http://www.assembly.coe.int/nw/xml/XRef/Xref-XML2HTML-en.asp?fileid=20174&lang=en.
[5] “Report of the Special Rapporteur on torture and other cruel, inhuman or degrading treatment or punishment, Juan E. Méndez,” UNITED NATIONS HUMAN RIGHTS OFFICE OF THE HIGH COMISSIONER, last modified February 1 ,2013, http://www.ohchr.org/Documents/HRBodies/HRCouncil/RegularSession/Session22/A.HRC.22.53_English.pdf.
[6] “Gender Identity, Gender Expression and Sex Characteristics Act (Malta, 2015),” TGEU, Transgender Europe, last modified March 26, 2015, http://tgeu.org/gender-identity-gender-expression-sex-characteristics-act-malta-2015/.
[7] “To register intersex children as females or males, with the awareness that, like all people, they may grow up to identify with a different sex or gender. To ensure that sex or gender classifications are amendable through a simple administrative procedure at the request of the individuals concerned. All adults and capable minors should be able to choose between female (F), male (M), non-binary or multiple options.” Quote from: “ Malta Declaration,” OII EUROPE, Organisation Intersex International Europe, last modified December 1, 2013, https://oiieurope.org/malta-declaration/.
[8] “In the future, as with race or religion, sex or gender should not be a category on birth certificates or identification documents for anybody.” Quote from: “ Malta Declaration.”
[9] “Defining intersex as a third classification for infants and children with intersex variations, as is the case in ACT, places children at risk. Persons so assigned have lesser rights, and will face stigma and outing in school and other environments, and we oppose such classification, without the voluntary and informed consent of the person so classified, as a human rights abuse.” Quote from: OII Australia, “Submission to the Australian Human Rights Commission: Sexual Orientation, Gender Identity and Intersex Rights Snapshot Report,” Intersex Human Rights Australia, last modified February 6, 2015, https://ihra.org.au/wp-content/uploads/2015/01/OII-Australia-SOGII-Submission-2015.pdf.
[10] Small Luk ELa 藩離以外——認識和關愛雙性人：〈就「公民權利和政治權利國際公約」致政制事務委員會 審議會 意見書 雙性人在香港的困境：再思法律與保障〉，中華人民共和國 香港特別行政區立法會，網站：http://www.legco.gov.hk/yr12-13/chinese/panels/ca/papers/ca0520cb2-1179-6-ec.pdf（最後參閱日期：2015年10月29日）。
[11] “If the child can be assigned to neither the female nor the male sex, then the child is to be entered into the register of births without such a specification.” Quote from: “Sham package for Intersex: Leaving sex entry open is not an option,” OII EUROPE, Organisation Intersex International Europe, last modified February 15, 2013, http://oiieurope.org/bluff-package-for-inter-leaving-sex-entry-open-is-not-an-option/.
[12] Hida Viloria, “Op-ed: Germany’s Third-Gender Law Fails on Equality,” ADVOCATE, last modified November 6, 2013, http://www.advocate.com/commentary/2013/11/06/op-ed-germany%E2%80%99s-third-gender-law-fails-equality.
[13] See paragraph 18 & 21 in Australian Government, “Australian Government Guidelines on the Recognition of Sex and Gender,” Australian Government, Attorney-General’s Department, last modified November 2015, http://www.ag.gov.au/Publications/Documents/AustralianGovernmentGuidelinesontheRecognitionofSexandGender/AustralianGovernmentGuidelinesontheRecognitionofSexandGender.PDF.
[14] “Changing your gender identity on your passport,” Te Mata Uruwhenua Identity and Passports, last modified May 18, 2020, https://www.passports.govt.nz/what-you-need-to-renew-or-apply-for-a-passport/information/.
[15] “…there are legitimate reasons people may hold conflicting documents. For example, people who identify primarily as X may want to hold a passport in a particular gender to ensure their safety while travelling overseas.” Quote from: paragraph 28 in Australian Government, “Australian Government Guidelines on the Recognition of Sex and Gender.”
[16] “To ensure the provision of all human rights and citizenship rights to intersex people, including the right to marry and form a family.” Quote from: “Public Statement by the Third International Intersex Forum,”OII EUROPE, Organisation Intersex International Europe, last modified December 1, 2013, https://oiieurope.org/public-statement-by-the-third-international-intersex-forum/.
[17] W v W (physical inter-sex) [2001] Fam. 111 (England).
[18] Australian Human Rights Commission, 2011 Addressing sexual orientation and sex and/or gender identity discrimination Consultation report (Sydney: Australian Human Rights Commission, 2011), 9–16, http://www.humanrights.gov.au/sites/default/files/document/publication/SGI_2011.pdf.
[19] “Sex Discrimination Amendment (Sexual Orientation, Gender Identity and Intersex Status) Act 2013,” Federal Register of Legislation, last modified June 17, 2013, http://www.comlaw.gov.au/Details/C2013A00098.
[20] “No religious organisation identified how intersex status could cause injury to the religious susceptibilities of its adherents. Consequently, prohibiting discrimination on the basis of intersex status will not limit the right to freedom of thought, conscience and religion or belief.” Quote from page 9 in “SEX DISCRIMINATION AMENDMENT (SEXUAL ORIENTATION, GENDER IDENTITY AND INTERSEX STATUS) BILL 2013,” PARLIAMENT of AUSTRALIA, accessed October 29, 2015, https://parlinfo.aph.gov.au/parlInfo/download/legislation/ems/r5026_ems_1fcd9245-33ff-4b3a-81b9-7fdc7eb91b9b/upload_pdf/378454%20.pdf;fileType=application%2Fpdf#search=%22legislation/ems/r5026_ems_1fcd9245-33ff-4b3a-81b9-7fdc7eb91b9b%22; “The Government has not been informed of any religious doctrines which require discrimination on the ground of intersex status. Therefore, intersex status is not included in this exception.” Quote from page 20 in “SEX DISCRIMINATION AMENDMENT (SEXUAL ORIENTATION, GENDER IDENTITY AND INTERSEX STATUS) BILL 2013.”
[21] Dan Harrison, “Gender discrimination to be removed from Medicare,” The Sydney Morning Herald, last modified July 24, 2013, http://www.smh.com.au/federal-politics/political-news/gender-discrimination-to-be-removed-from-medicare-20130723-2qi4m.html.
[22] Safe Schools Coalition, AUS, accessed October 29, 2015, http://www.safeschoolscoalition.org.au/.
