A 2016 Family Court case authorising a gonadectomy and consequential surgery on a young child[2] has attracted public commentary for disclosing those medical interventions, their rationales, and a prior clitorectomy and labiaplasty.

[15][16] Alex MacFarlane is believed to be amongst the first people worldwide to legally secure a birth certificate and passport recording sex as indeterminate, reported in January 2003.

[6][26][27][28][29] Intersex infants are often subjected to medical operations to their genitalia and other sex characteristics to make them conform to a male or female appearance or nature.

[11] In October 2013, the Australian Senate Community Affairs References Committee published a report entitled Involuntary or coerced sterilisation of intersex people in Australia.

The surgery is intended to deconstruct an intersex physiology and, in turn, construct an identity that conforms with stereotypical male and female gender categories...

The evidence suggests that a human rights consistent framework ... must necessarily operate from a presumption in favour of maintaining the status quo for as long as possible...

In December 2016, The Australian and SBS reported on a Family Court of Australia case published in January 2016, Re Carla (Medical procedure),[2] where the parents were able to authorize the sterilization of their 5-year child with 17-beta-hydroxysteroid dehydrogenase III deficiency.

The child had previously been subjected to intersex medical interventions including a clitorectomy and labiaplasty, without requiring Court oversight.

Bernadette Richards wrote that it stretched the bounds of parental authority by removing "external review of invasive treatment".

[45] Fiona Kelly and Malcolm Smith have written that the evidence put to the Court was incomplete, and its reasoning lacked rigor.

[49] In December 2016, the United Nations Committee Against Torture asked the Australian government to confirm the availability of civil and criminal remedies for irreversible medical interventions as children, including the applicability of statutes of limitations.

[49] In March 2017, an Australian and Aotearoa/New Zealand community statement called for acknowledgement, an apology, and compensation for intersex people who have been subjected to "involuntary or coercive medical interventions".

[6][26] In June 2017, and in response to a joint submission by almost 50 non-governmental organizations, the UN Committee on Economic Social and Cultural Rights stated concern that "children born with intersex variations are subject to early surgeries and medical interventions before they are able to provide full and informed consent", calling for implementation of the 2013 Senate report.

[52] In July 2018, the UN Committee on the Elimination of Discrimination against Women issued concluding observations on harmful practices, recommending that Australia adopt "Adopt clear legislative provisions explicitly prohibiting the performance of unnecessary surgical or other medical treatment on intersex children before they reach the legal age of consent".

[66] Australian research has shown that 19% of people born with atypical sex characteristics selected an "X" or "other" classification, while 52% are women and 23% men and 6% unsure.

[76] Alex MacFarlane is also believed to be the first person in Australia to obtain a birth certificate recording sex as indeterminate, reported in January 2003.

[80] The organisations have also expressed concern about pregnancy termination rates of up to 88% in 47,XXY in circumstances where the World Health Organization describes the intersex trait as "compatible with normal life expectancy", and "often undiagnosed".