Switzerland (CEDAW 25-11-2016)
The Committee considered the combined fourth and fifth periodic reports of Switzerland (CEDAW/C/CHE/4-5) at its 1445th and 1446th meetings, on 2 November 2016 (see CEDAW/SR.1445 and 1446). The Committee’s list of issues and questions is contained in CEDAW/C/CHE/Q/4-5 and the responses of Switzerland are contained in CEDAW/C/CHE/Q/4-5Add.1.
D. Principal areas of concern and recommendations
- The Committee welcomes the adoption of legislative and other measures to combat harmful practices, including female genital mutilation, intersex genital mutilation, child marriage and forced marriage. Nevertheless, the Committee is concerned about:
(a) Girls living in the State party, often from migrant families, who have undergone or are at risk of being subjected to female genital mutilation and other harmful practices;
(b) Information on harmful practices not being readily available, in particular for ethnic minority and migrant women owing to language and cultural barriers, and the lack of a national comprehensive strategy, in particular to eliminate female genital mutilation, along with limited training for relevant professionals;
(c) Insufficient support for intersex persons who have undergone involuntary and medically unnecessary disfiguring surgical procedures when they were babies and children, often with irreversible consequences, resulting in significant physical and psychological suffering;
(d) The pressure placed on parents of intersex children by medical professionals, the media and society at large, which often forces them to give their consent for so-called “medical procedures”, justified by psychosocial indications; and the fact that intersex children and adults are often unaware of the procedures to which they have been subjected, while access to legal remedies for intersex persons affected by unnecessary medical procedures is extremely limited, with the statute of limitations often expiring by the time that intersex children reach adulthood;
(e) The lack of integration of intersex persons and their families into interdisciplinary working groups and the failure to consult those directly affected by these procedures in decisions that affect their lives.
- In the light of joint general recommendation No. 31 of the Committee on the Elimination of Discrimination against Women/general comment No. 18 of the Committee on the Rights of the Child on harmful practices (2014), the Committee recommends that the State party:
(a) Systematically collect disaggregated data on harmful practices in the State party and continue to strengthen preventive and protective measures to eliminate female genital mutilation, child marriage and forced marriage;
(b) Develop awareness-raising campaigns, ensure that information is readily available to victims of female genital mutilation and ensure that relevant professionals are sufficiently trained to identify potential victims and that perpetrators are brought to justice;
(c) Ensure that, in line with recommendations by the Swiss National Advisory Commission on Biomedical Ethics, no child is subjected to unnecessary medical or surgical treatment during infancy or childhood, adopt legislation to protect the bodily integrity, autonomy and self-determination of intersex persons and provide families with intersex children with adequate counselling and support;
(d) Adopt legal provisions, under the guidance of the courts, in order to provide redress to intersex persons affected by cases of surgical or other medical treatment without their free, prior and informed consent by or that of their parents;
(e) Educate and train medical professionals on the harmful impact of unnecessary surgical or other medical interventions for intersex children and ensure that the views of intersex persons are fully considered by the interdisciplinary working groups established to review these procedures.
- The Committee welcomes the measures adopted by the State party to address disparities in terms of access to health services between cantons and, in particular, between Swiss nationals and migrants. Nevertheless, the Committee remains concerned about:
(a) The language barriers and lack of awareness often preventing migrant women from accessing health-care facilities, including sexual and reproductive health services;
(b) Disparities in the teaching of age-appropriate sexual education across cantons and the resulting risk of teenage pregnancy;
(c) Disparities in the availability of cantonal support services and the lack of inclusion of lesbian, bisexual and intersex persons in health surveys and registers;
(d) The persistence of gender reassignment treatment targeting transgender persons, including involuntary medical treatment, such as hormonal or surgical sterilization, and the costs associated with such treatmen
(e) The unavailability of disaggregated information and data on cases of HIV/AIDS in the State party, and the lack of measures to limit the risk of HIV and sexually transmitted infections for women in prostitution.
- In line with its general recommendation No. 24 (1999) on women and health, the Committee recommends that the State party:
(a) Ensure that medical professionals are aware of the cultural and linguistic barriers that migrant women face when accessing health care, and ensure the availability of female medical staff if requested; and take steps to introduce awareness-raising campaigns, in relevant languages, among migrant CEDAW/C/CHE/CO/4-5 16-20858 15/19 communities on how to gain access to health-care services, including sexual and reproductive health services;
(b) Ensure that age-appropriate sexual education is included in curricula in all cantons and that training is provided to teachers;
(c) Include reference to, and documentation on, lesbian, bisexual. transgender and intersex persons in national health surveys and registers;
(d) Review the decisions taken by civil courts requiring transgender persons to undergo surgical and/or hormonal treatment before legal gender recognition can be granted, and ensure that the costs for such interventions are reimbursed;
(e) Take steps to collect data on cases of HIV/AIDS and sexually transmitted infections and ensure that age-appropriate sexual and reproductive health services and treatment, including confidential services, are accessible to all women and girls living with HIV/AIDS.