People with innate variations in sex characteristics, sometimes referred to as 'intersex', are born with sex characteristics that do not fit typical definitions or understandings of male or female bodies. This can include a person's physical traits (such as reproductive organs), chromosomes, or hormones, and can become evident prior to or at birth, at puberty, or later in life.
Biological variations are natural and occur in up to 1.7% of all births.
Being born with a variation in sex characteristics is different from being trans or gender diverse. While a variation in sex characteristics is something a person is born with, being trans or gender diverse is a matter of how someone feels about their gender identity relative to the sex they were assigned at birth.
For some people born with variations in sex characteristics, surgery or hormonal treatments are medically necessary or lifesaving. However, some experience lasting consequences, harm, or trauma related to deferrable treatment provided early in life.
Proposed health reforms
The Victorian Government wants all people to experience excellent health and wellbeing.
For people born with variations in sex characteristics, this commitment is outlined in more detail in (i) Am Equal: Future Directions for Victoria’s Intersex Community and Pride in our future: Victoria's LGBTIQA+ strategy .
In particular, the Victorian Government has committed to establish new health safeguards, oversight, and reporting processes to better support people born with variations in sex characteristics and their families to make decisions about their healthcare. Improved reporting will mean greater accountability and transparency about variations and treatments being performed.
Who has been consulted on the proposed changes?
The Victorian Government has undertaken broad consultation since 2021, engaging with:
- people born with variations in sex characteristics and their families
- specialist health practitioners and service providers
- health sector peak bodies and professional groups
- experts in law, regulations, and human rights
- Victorian Government advisory groups.
After this extensive consultation, the Victorian Government is now working to deliver this commitment through new legislation, as well as improved health supports for individuals and their families.
More information about the consultation which inform these changes can be found on Engage Victoria, see Victoria's intersex protection .
What will the proposed changes mean for people born with variations in sex characteristics?
The proposed legislation will ensure that the most vulnerable, particularly infants and young children, do not receive deferrable or elective medical treatments that permanently change their bodies until they are old enough to consent, if it is safe to defer treatment.
It will mean that people with variations have greater agency over their bodies and more opportunity to give informed consent to the care and treatment they receive.
It will also ensure that people with variations are provided with more information and supports than are currently available, including:
- tailored, developmentally appropriate information about their individual variations, treatment options, and what would happen if they did not receive treatment
- supports to help people either give informed consent for themselves or contribute to decisions about their care in developmentally appropriate ways
- access to expert peer, family, and psychosocial supports, such as counselling, community groups, and education.
What will the proposed changes mean for parents and guardians?
Currently, parents and guardians of children with variations in sex characteristics have limited access to information or support when making significant decisions about their child's care.
The proposed reforms will give parents and guardians more information and supports. This means they will be well placed to give consent on behalf of their child to medically necessary treatments, if their child is not yet able to give consent.
This will include being provided with:
- tailored information about their child's individual variation, care needs, treatment options, the risks of proposed treatment, and what would happen if their child did not receive treatment
- access to expert peer, family, psychosocial, and decision-making supports as needed.
An additional level of oversight and approval will also be established. This will protect the best interests of the child and ensure that permanent or difficult to reverse treatments only occur if necessary.
This oversight will not replace parent and guardian decision making. Parents and guardians must still give consent for treatment to proceed on their child, in line with an approved treatment plan.
If a proposed treatment is not approved, it will not be able to proceed until the child's circumstances change, for example because they get older and are able to give consent. In this situation, parents and guardians will continue to be supported by health services as their child develops.
Why do we need legislative change?
While most people born with variations in sex characteristics live happy and healthy lives, some experience lasting consequences, harm, or trauma related to deferrable treatment provided early in life.
For many decades, people with variations and human rights organisations have advocated for the ability to make and contribute to lifelong decisions that will affect them and their bodies. This new legislation will protect their right to do so.
As our understanding of variations in sex characteristics and best practice healthcare continues to evolve, it is important that people with variations, the parents and guardians of children with variations, and health professionals are supported with accurate, accessible information so they can make the best healthcare decisions for their circumstances.
The proposed reforms will enshrine best practice healthcare and consistency of care across settings, while improving data and transparency to support further improvements to care.
What is in scope of the proposed legislation?
Different parts of the proposed legislation will apply to different people.
The proposed legislation will ensure that all people born with variations in sex characteristics and, in the case of infants and young children, their parents or guardians will be provided with accurate information about their variation and treatment options. If a person is able to give informed consent to medical treatment that modifies their sex characteristics, they will be able to do so and treatment will proceed. Individuals and families will also have access to peer, psychosocial, and decision-making supports.
Additional oversight will be required:
- where a person with a variation in sex characteristics is unable to give informed consent, most likely because they are an infant or young child, and
- where the treatment recommended will result in permanent changes to their sex characteristics, and
- where the treatment is not urgent and required to save the person's life or prevent serious, significant damage to their health.
Oversight is proposed to be provided by a new independent, expert panel. The panel's role would include setting and approving treatment plans and developing guidance for people with variations, their families, and clinicians.
There will be no change regarding urgent treatment that is required to save a person's life or prevent serious, significant pain or damage to their health. Urgent treatments will be able to proceed without additional oversight or delay.
These reforms will not apply retrospectively. Any treatment provided previously or that is already in progress at the time the legislation comes into effect will be out of scope.
What will the proposed changes mean for health practitioners providing care to people born with variations in sex characteristics?
The proposed legislation and accompanying regulations and supports will assist health practitioners to provide best practice care to people with variations and their families. It will ensure health practitioners:
- are protected from decision-making risks, including legal risks, related to treatments that permanently change a person's sex characteristics, as the oversight panel will hold decision-making risks regarding these treatments
- play a key role in developing individual and pre-approved general treatment plans, ensuring care is consistently provided in line with best practice evidence
- are supported to understand the legislation and their roles and responsibilities within it through resources, guidance, and education
- contribute to improvements in data collection to provide better visibility of variations and procedures.
How will legislation impact current practice?
There will be no change regarding urgent treatment required to save a person's life or prevent serious, significant damage to their health. Urgent treatments will be able to proceed without additional approval or delay.
Where it is safe to do so, deferrable or elective medical treatments that permanently change a person's body will not be able to be conducted until the person is old enough to consent, as assessed by their doctor. This change is intended to ensure that people born with variations in sex characteristics can make or contribute to lifelong decisions that will affect them.
Certain treatments will be pre-approved by the oversight panel and will receive minimal additional oversight, to prevent delays to care.
Is Victoria implementing the same model as the Australian Capital Territory?
The Australian Capital Territory's (ACT) Variation in Sex Characteristics (Restricted Medical Treatment) Act came into effect in June 2023. It permits irreversible treatments only when they meet specific criteria.
The proposed Victorian model has been informed by the ACT model and implementation experience. Differences in the Victorian context have also been considered, for example the higher volume of treatments and greater complexity of some cases. Drawing on these considerations, the proposed Victorian model is expected to:
- benefit from a longer, staged implementation, including developing pre-approved general treatment plans well before treatment oversight formally commences, to ensure certain treatments are not delayed and straightforward cases proceed with minimal interference
- enshrine new informed consent safeguards in the legislation itself, to ensure consistency of assessments and provide people and families with decision-making supports, aligned with the Mental Health and Wellbeing Act 2022
- outline specific transitional arrangements, ensuring treatments already in-progress are not impacted.
Next steps
Legislation is currently being drafted to establish the model developed in consultation. It is expected to be ready for Parliament’s consideration in late 2025.
If passed, the reforms will be implemented gradually, over several years. This will allow for the development of resources, guidance, and education so that people born with variations in sex characteristics and the health services that support them understand the changes.
Throughout this process, the Department of Health will continue working with community members and health practitioners on complementary improvements to the care and support of people born with variations in sex characteristics.
Resources
This information is also available as a downloadable fact sheet:
Reviewed 28 November 2025