A/70/213 developmental disabilities should be abandoned as they are outdated and often violate basic rights and freedoms. Intersex children 84. “Intersex” refers mainly to physical aspects of the body and includes a wide range of natural body variations that do not conform to prevailing notions of male and female bodies. 54 Deeply rooted stereotypes around gender dichotomy and medical norms about male and female bodies have led to the establishment of a medical practice of routine interventions and surgeries on intersex people, including irreversible genital surgery and sterilization. These interventions are not always necessary on medical grounds and are often not performed with the informed consent of the persons concerned. Moreover, medical classifications currently codify intersex characteristics as pathologies or disorders. 55 85. These practices, if performed without due consideration for the best interests and evolving capacities of young children, can have detrimental, long -lasting effects on their health and well-being; violate their basic rights to physical integrity, privacy and autonomy; and may amount to ill-treatment or even torture. 56 In addition, the sex assigned at birth becomes a legal and social factor, often permanent or difficult to change, that will determine the life and development of the child and affect his/her right to develop a personal identity. 86. On the basis of international human right law and standards, 57 States should prohibit unnecessary medical or surgical treatment during infancy or early childhood in order to guarantee the bodily integrity, autonomy and sel fdetermination of the children concerned. D. Participation 87. International human rights law recognizes that individuals and groups have the right to participate in decision-making processes that affect their rights. 88. States have a legally binding obligation to ensure the participation of rights holders in priority-setting; legislative and policy development, implementation, monitoring and evaluation; and accountability for the realization of the right to health and the holistic development of the young child. All segments of the population, including the most marginalized, must be empowered to participate (A/HRC/27/31, paras. 28-30). States must create an enabling environment for participation, for example by enhancing the knowledge and awareness of stakeholders, including the parents of young children. __________________ 54 55 56 57 15-12535 OHCHR, Fact Sheet: “LGBT rights: frequently asked questions”, 2013. Commissioner for Human Rights, Council of Europe, Issue Paper: “Hu man rights and intersex people”, 2015. Joint statement by a group of United Nations and international human rights experts on the occasion of the International Day against Homophobia, Biphobia and Transp hobia, “Discriminated and made vulnerable: young LGBT and intersex people need recognition and protection of their rights”, 13 May 2015. See, for example, documents CRC/C/CHE/CO/2-4, CAT/C/DEU/CO/5, E/C.12/DEU/CO/5, CEDAW/C/CRI/CO/5-6, CRPD/C/DEU/CO/1, A/HRC/29/23, A/HRC/22/53 and A/64/272. 19/25