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Being intersex in the EU today often means living a life of adversity, defined by a deprivation of fundamental rights. With widespread experiences of acute exclusion, discrimination and victimisation, the plight of intersex persons today warrants an urgent response and targeted support. This must begin with an acknowledgement of the specific problems these people face in their enjoyment of fundamental rights and be accompanied by efforts to raise awareness about the diversity and the needs of intersex persons. The experiences of intersex persons are the most negative among LGBTIQ survey groups, and their struggles are emblematic of the long road to equality for all, including all LGBTIQ persons. Attacks against EU values, human rights and European democracies by foreign and European actors, especially through online hate speech anti-LGBTIQ campaigns, weaponise the ignorance of the general population about intersex and trans persons, spreading disinformation, hatred and calls to violence against intersex LGBTIQ persons. EU research shows how identity-based disinformation attacking European democracies spreads online hatred against LGBTIQ persons, with campaigns reflected in the LGBTIQ survey data. It shows that identity-based online hatred campaigns are encountered too frequently online by LGBTIQ survey respondents. These are campaigns about LGBTIQ represented as ‘propaganda’ or ‘gender ideology’, about LGBTIQ people posing a threat to ‘traditional values’, about being ‘unnatural’ or mentally ill or posing a sexual threat and calls for violence against LGBTIQ persons. The defence of their rights by the EU and its Member States is therefore a part of a wider fight to defend European values and the EU acquis on fundamental rights.
The EU LGBTIQ Survey III by FRA provides a unique dataset as the largest global survey on the life experiences of intersex persons. The data and evidence on the realities and lived experiences of intersex respondents within this survey offer the necessary evidence-based prompt for policy action by the EU and the Member States. Duty bearers are required to take such legal/policy action, across all sectors: judicial, healthcare, education, employment and social welfare and protection. Nevertheless, little has changed in the decade since the 2015 FRA report on the rights of intersex persons, despite calls by EU, regional and global institutions for law and policy addressing pressing issues that still afflict intersex persons and threaten or violate their rights.
The EU LGBTIQ Survey III results reveal the everyday reality of intersex persons and the serious challenges they face. These results should spur action on the part of Member States to increase their efforts to respect, protect and fulfil the fundamental rights of intersex Europeans. About six in ten intersex respondents said that surgery or hormonal treatment to modify their sex characteristics was conducted without their free, prior and fully informed consent or that of their parents, irrespective of whether these were non-vital interventions. Ending non-vital medical interventions and ensuring free, prior and fully informed consent prior to any medical intervention are the first and fundamental steps in this process. Access to effective redress and reparation and safeguards protecting against such practices are steps needed in this direction. Combating hate crime and speech should be a priority, including because they lead to further discrimination, repeat victimisation and exclusion. Similarly, access to quality healthcare recognising their specific needs and ensuring relevant specialised training of healthcare practitioners is needed. In this context, intersex persons need to be able to affirm their gender identity if it is not aligned with the legal sex or gender assigned at birth, access legal gender recognition and change names or references and gender markers in official documents.
Based on the valuable data evidence provided by the survey, the next sections provide ideas and recommendations in the way forward to support the EU and Member States in ensuring the protection the fundamental rights of intersex persons.
In light of the alarming survey findings regarding the absence of free and fully informed consent prior to interventions to modify sex characteristics through medical interventions, the Member States are urged to adopt and implement laws that safeguard intersex persons by ending IGM, non-vital ‘sex-normalising’ treatments, surgeries and medical treatments performed on intersex children without their free, prior and fully informed consent, in line with the 2019 Parliament resolution on the rights of intersex persons, the 2017 Parliamentary Assembly of the Council of Europe resolution ‘Promoting the human rights of and eliminating discrimination against intersex persons’ and the ECRI General Policy Recommendation N°17 on preventing and combating intolerance and discrimination against LGBTI people and a ban of IGM. Member States should ensure that gender markers in identity documents and birth registries reflect a person’s GIE.
The survey results reveal that a disproportionately high proportion of four in ten intersex respondents have experienced ‘conversion’ practices, which are interventions designed to modify a person’s sexual orientation or gender identity. Such harmful practices are clearly distinct from gender reassignment interventions that are initiated and performed by persons who want to modify their body and reassign their gender identity with their prior, free and fully informed consent. The proportion for intersex persons is much higher compared with other LGBTIQ survey respondents’ groups and the survey average of one in four. The call to ban conversion practices, as urged by the EU (in its equality strategy) and European and UN bodies, is supported by this survey’s findings. Furthermore, a European citizens’ initiative with more than 1 200 000 signatures calls on the Commission to propose a binding legal ban on conversion practices targeting LGBTQ+ citizens.
Member States should ban ‘conversion therapies’ by clearly defining and sanctioning in law a range of prohibited practices and their advertisement. Consistent with the terms of Article 4 of the Charter, Member States should provide effective legal protection for intersex persons from torture and cruel, inhuman or degrading treatment and from intrusive and irreversible interventions relating to their sexual orientation, gender identity, gender expression or sex characteristics. The example of Member States to ban ‘conversion practices’ could be followed, to ensure the full respect of intersex persons’ human dignity and guarantee mental integrity, autonomy and self-determination, irrespective of sexual orientation, gender identity and gender expression of intersex persons.
Large proportions of intersex respondents say that they experience violence and harassment because of being LGBTIQ, but few said that they have reported such incidents to the police or any other organisation. Respondents said they did not report such physical or sexual attacks because they did not trust the police or because they feared homophobic/transphobic reactions from the police.
As the survey data show, hate crime and hate speech against intersex persons have reached alarmingly high levels. Member States are urged to extend and strengthen legal protection by recognising sex characteristics as an aggravating bias motivation and for the inclusion of the former in the list of EU crimes.
EU crimes are particularly serious crimes that take place across the EU and which have impact beyond national borders and are criminalised in EU law. There is currently a list of 10 EU crimes (terrorism, trafficking in human beings, sexual exploitation of women and children, illicit drug trafficking, illicit arms trafficking, money laundering, corruption, counterfeiting of means of payment, computer crime, organised crime). In December 2021, the Commission adopted a communication on ‘A more inclusive and protective Europe: extending the list of EU crimes to hate speech and hate crime’, which aims to trigger a Council decision to add hate crime and hate speech to the current list of EU crimes as laid down in Article 83 of the Treaty on the Functioning of the European Union, consistent with the Commission’s proposal on ‘A more inclusive and protective Europe: extending the list of EU crimes to hate speech and hate crime’.
Almost half of intersex respondents say that in the last 12 months they have seen, often or always, online calls for violence against LGBTIQ people more frequently than other survey groups, (e.g. threats of death, rape, beating, slapping). The online hatred confronted by intersex persons indicates the need for prompt and effective intervention by Member States.
FRA has recommended that Member States consider including sexual orientation, gender identity, gender expression and sex characteristics as aggravating bias motivations in criminal law, drawing on the work of the High-Level Group on combating hate speech and hate crime, as well as the Subgroup on Equality Data under the High-Level Group on non-discrimination, equality and diversity. This would facilitate the effective recording, investigation and prosecution of hate crimes against LGBTIQ people.
In responding to the alarming increase of hate speech and hatred online, the Member States should ensure the full and effective implementation of the Digital Services Act, which entered into force on 17 February 2024 and includes several provisions regarding the obligations of online platforms to protect the fundamental rights of users.
An acute threat to intersex persons and to the cohesion of European democracies is LGBTIQ identity-based disinformation, as shown by recent EU research data. The survey data and other Commission research should motivate Member States to address the threat of such disinformation campaigns against EU societies and democracies, and to use existing EU and national legislation to tackle disinformation that puts intersex persons and LGBTIQ people generally at risk of hate crime and hate speech. In this spirit, the Member States and their competent authorities are encouraged to consult and build on the findings of the Commission research regarding FIMI, and to train their competent authorities and services to effectively detect, analyse and confront identity-based disinformation targeting intersex and LGBTIQ persons.
While most of the LGBTIQ Survey III groups report a marginal decrease of discrimination experiences compared with 2019, in 2023 intersex survey respondents report the same elevated levels (61 %) as in 2019 (62 %). The highest rates of discrimination experiences are reported by intersex respondents in employment (38 %), an area protected by EU law on the grounds of gender and sexual orientation.
The EU LGBTIQ Survey III results confirm the need to redouble efforts to provide stronger and more comprehensive protection from discrimination on more grounds and in all areas of life. The FRA data, in this and other discrimination and victimisation surveys, provide the evidence base to support the EU and Member States to enact consistent and effective protection against discrimination by extending to other grounds, including sexual orientation, gender identity and sex characteristics. Similarly, it is important to extend protection from discrimination in different areas of life and beyond employment and occupation, which are not currently covered by EU secondary legislation. In February 2025, the Commission withdrew the proposed horizontal equal treatment directive from its programme. However, at the time of writing, after the Commission’s consultations with the Parliament and civil society, there are ongoing discussions in the Council to find a solution aimed at promoting the adoption of the proposed directive.
r. FRA survey findings, including those documented in this report, evince the need for comprehensive protection for intersex persons against discrimination in all aspects of life. Indeed, most Member States have already extended protection against discrimination in their national legislation, such that EU-analogous EU regulation would bring EU law in line with the developments in the national legal frameworks.
The survey data on the discrimination experiences of intersex persons in different areas of life and on different grounds highlight and support the need to adopt legislation adding sex characteristics to the protected grounds and efficiently addressing intersectional discrimination. The former would also be consistent with the 2019 Parliament resolution on the rights of intersex persons (2019) and Directive (EU) 2024/1500 of the European Parliament and of the Council of 14 May 2024 on standards for equality bodies in the field of equal treatment and equal opportunities between women and men in matters of employment and occupation, and amending Directives 2006/54/EC and 2010/41/EU, which includes sex characteristics among the victimisation grounds and acknowledges intersectional discrimination as a combination of sex and one or more of the grounds protected under EU law.
Intersex respondents in the 2023 survey were more likely than other groups to report incidents of discrimination to the relevant authorities or other bodies. Among those who do not, most say it is because they do not believe that anything would change or happen; moreover, they do not report incidents despite the high level of awareness of equality bodies among the survey respondents. Therefore, the Member States should ensure that their equality bodies are adequately empowered, mandated and resourced to fulfil their roles and obligations under the existing EU law governing equality bodies, including standards guaranteeing their independence and financial, human and technical capacity, so that LGBTIQ people, including intersex persons, can be confident that they will be heard and helped if they report discrimination. Moreover, all Member States should transpose and implement the EU directives on binding standards for equality bodies into their national law swiftly and effectively.
The survey found that intersex persons often feel discriminated against on several grounds based on multiple and intersecting characteristics. One in five (20 %) of the respondents who feel discriminated against as LGBTIQ people mention ‘disability’, 19 % indicate ‘age’, 13 % ‘religion or belief’ and 15 % cite their ‘ethnic or immigrant background’ as additional grounds for discrimination.
In line with the most recent EU law-making, the recommendations by the Parliament and based on the data of the LGBTIQ Survey III, the EU co-legislator should consider broadening the concept of discrimination to include a clear and operational reference to intersectional discrimination in existing and new legislation in the area of equality and non-discrimination. This would enable the EU and Member States to reinforce legal protection against intersectional discrimination as a combination of different grounds.
The survey data reveal a troubling situation for intersex persons in schools across the EU. Three out of four of intersex respondents say that they were bullied at school. Among them, trans and non-binary intersex persons were the most affected.
Member States need to ensure that all educational settings – particularly schools – provide a safe, inclusive and supportive learning environment, free from harassment, bullying and violence, for all LGBTI children and young people, including intersex. National educational authorities should consider establishing school-based mechanisms to report and penalise bullying. The EU and Member States should develop measures to address bullying and harassment in educational settings, sharing promising practices and adopting a zero-tolerance approach to harassment and bullying of LGBTIQ students and teachers. Member States could use the guidelines in ‘A Compendium on Comprehensive Sexuality Education’ (2023), compiled by the United Nations Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health, the Independent Expert on protection against violence and discrimination based on sexual orientation and gender identity, the Special Rapporteur on the right to education and the Working Group on discrimination against women and girls. Within the framework of EU programmes such as Erasmus+, educational authorities and professionals can benefit from training and peer learning among schools and educators, including sharing promising practices, in order to tackle homophobic and transphobic bullying.
The survey found that intersex persons face severe obstacles in accessing healthcare, in many cases leading to forgoing treatment, avoiding seeking necessary healthcare or in some cases even being refused treatment by medical professionals. One in five among those intersex respondents who faced difficulties say that they faced problems in accessing emergency care or that they had to change their general practitioners due to negative reactions.
Member States should ensure that intersex persons enjoy equal access to good quality, affordable preventive and curative healthcare, taking account of any specific medical needs. To achieve this, medical professionals providing primary and secondary healthcare services should be trained about the particular health needs of intersex persons and appropriate, rights-compliant ways to treat them.
Regarding mental health, more than half of all intersex respondents have contemplated suicide in the year before the survey.
The alarming results about suicidal thoughts and attempts should prompt the Member States to provide more effective support to intersex persons in need of health and mental health services, access to housing and protection from poverty and homelessness.
Furthermore, the survey results indicate that intersex respondents experience homelessness at disproportionately higher rates, compared with the general population and other LGBTIQ survey groups.
In conclusion, the EU LGBTIQ III survey results shed light on the grim realities in the lives of intersex respondents in different areas of life, in light of which Member States are urged to step up their efforts to respect, protect and fulfil the rights of intersex persons. They should, moreover, promote these rights by raising awareness about intersex persons and their innate variations of sex characteristics, through capacity building and training, to ensure they are supported and strengthened to carry out their duties in a human-rights compliant manner. Based on the survey findings and past FRA research reports like Professionally speaking: challenges to achieving equality for LGBT people (2016), Member States are encouraged to focus in particular on professionals and curricula in all levels of education, healthcare, medical staff, psychological support and social welfare practitioners, law enforcement and judiciary, and civil servants in state–citizen relations and points of contact with the public. In this regard, the contribution and partnership with intersex and LGBTIQ organisations and networks is essential to ensure a participatory approach.