INSIGHTS: WA Tribunal refuses to consent to the sterilisation of an intellectually disabled 23-year old male on the basis that fathering a child is not a present and actual risk

The Full State Administrative Tribunal of Western Australia, (the Tribunal)[1], in its Guardianship Division, has refused to consent to the sterilisation (by way of a vasectomy) of JC — a 23-year-old male living with a rare genetic condition which resulted in him living with an intellectual disability, and problems with gross and fine motor skills, among other things.[2] Consent to sterilisation was sought by JC’s parents, LC and NC (as his joint limited guardians with authority for medical decisions), under s 59(1) of the Guardianship and Administration Act 1990 (WA) (GA Act). This was supported by his larger family and treating health practitioners — including his behavioural support practitioner, psychologist, general practitioner and two laparoscopic surgeons. All of these health practitioners gave evidence that the vasectomy would be in JC’s best interests.[3]

The Tribunal accepted that it was a universal and genuinely held belief[4] of those close to JC that sterilisation was in his best interests, but determined that it was not warranted at this time as the prospect of him fathering a child was not a real one.[5] The Tribunal made plain that the consideration of “best interests” is solely focused on the represented person (RP)[6] — in this case JC, and not ancillary interests, such as any child that may be born to JC or to the interests of JC’s family members who may be called upon to care for the child (and JC given the accepted position that fatherhood would be detrimental to JC’s own wellbeing).[7]

The judicial discussion deals with moral questions regarding bodily autonomy, reproductive rights and sexual enjoyment, as well as darker concerns in a contemporary society about known sexual abuse of intellectually disabled or otherwise impaired persons.

Factual background

JC’s disability was only diagnosed in 2023 (at the age of 20 years)[8] and while his development was known to have been divergent (in the sense that he was greatly delayed) from his peers, it had been hoped to have a less significant aetiology. It was accepted that his condition, including his physical abilities and cognition (which is said by his mother to be “that of young child”),[9] are permanent.

JC is a member of a loving and supportive family[10] and receives significant attendant care.[11] He is likely to require 24-hour care for the remainder of his life and the family is presently applying for disability funding, which is hoped will allow him to live in supported independent living accommodation (SIL accommodation).[12] JC recognises that he is different from his siblings, which has caused him distress. He has autism and is unsettled when his routine changes.[13] He is traumatised by operations based on his past experience of medical procedures.[14] This was so severe that JC’s parents asked that he not be involved in the proceedings and if he had to attend, that the Tribunal refrain from using the word “operation” (instead using the words “procedure” and/or “vasectomy”) when speaking with JC directly so as to not trigger his medical anxiety.[15] The Tribunal was not prepared to forego use of the key word “operation”, however used that term consciously and for the focused purpose of ascertaining from JC his views and wishes with respect to the proposed sterilisation in terms that he was more likely to understand.[16] JC attended the hearing by audio-visual link only for as long as was required and was otherwise excused from the remainder of the proceedings so as to lessen any trauma.

The Tribunal noted that JC is at an age where sexual activity is typically engaged in or desired by young men.[17] The evidence indicated that, while he has not expressed any intention of that type,[18] he does engage in sexual self-gratification in a modified way as his gross and fine skills do not allow sufficient command of his hands.[19] The Tribunal also noted that JC’s intellectual disability means that he does not understand the meaning of sexual intercourse,[20] biological reproductive functions,[21] parenthood[22] nor the purpose of a vasectomy (or the risks and complications arising from same).[23]

For these reasons, JC’s parents considered sterilisation to be in their son’s best interests to future proof his life[24] including guarding against the risk that he may be sexually abused in care and father a child.[25] That risk was demonstrated by JC’s parents to the public advocate investigator[26] by way of contemporaneous media reports of widespread sexual misconduct within the disability community.[27] The investigator equated their desire to sterilise their son as akin to making an Enduring Power of Attorney, Enduring Power of Guardianship or an advanced health directive[28] — all being legal instruments directed to future planning. To do so would mean that JC can enter into a sexual relationship in the future, which the Investigator acknowledged he may wish to do. The investigator’s report concluded that JC’s parents “are, and always have been, acting in [JC’s] best interests”.[29]

What are “best interests”

The procedural framework

The legal framework for sterilisation is strict given its seriousness and permanency. Section 57 of the GA Act makes it an offence for a person to carry out a “procedure for the sterilisation” of a RP unless:

• the Tribunal (by its full constitution) first consents to sterilisation in writing[30] which it can only do if it is satisfied that sterilisation is in the “best interests” of the RP[31]
• the guardian has provided secondary consent to sterilisation (also in writing)
• all rights of appeal have been lapsed or been exhausted[32] and
• the sterilisation is performed in accordance with any conditions imposed under the Act

A “procedure for the sterilisation” of a RP does not include a procedure that is carried out for a lawful purpose other than sterilisation but incidentally results or may result in sterilisation.[33]

While “sterilisation” is not itself defined (despite being a central term), courts have applied the ordinary meaning of the word “sterilise” to mean a procedure that is for the purpose of depriving a RP of the ability to produce children (unless that is an incidental result).[34] An RP, their guardian or the public advocate can apply to the Tribunal for its consent to carry out a procedure for the sterilisation of a RP.[35] Any person with a sufficient interest in the proceedings must be notified of the hearing.[36]

The decision-making framework

While the Tribunal pointed to inconsistencies in the GA Act[37] and having been satisfied that the application met the threshold procedural requirements,[38] it was without question that the serious matter to which they were tasked related solely to JC — that is, what is in JC’s best interests.[39] That is a question which requires a judgement informed by all of the circumstances[40] and is not a precise science.[41] It will always be dependent on the specific facts of each represented person.

The other central term that is not legislatively defined is “best interests” — that being an expression that is “multifaceted and complex. It is susceptible to very different conclusions being drawn by different people of equal compassion, sincerity and integrity”.[42]

The Tribunal drew from relevant cases (while also recognising the lack of any published decisions relating to sterilisation of a male RP)[43] to elucidate factors which can guide their considerations as to best interests generally.

In doing so, the Tribunal endorsed that the starting point for determining what was in the child’s best interests is that sterilisation is a step of last resort, to be undertaken only when alternative and less invasive procedures have failed.[44] That is, because it is a significant thing to render a person unable to reproduce it must only be approved if there is compelling justification[45] (least restrictive approach).

The Tribunal recognised the particular difficulty that arises when a parent is appointed guardian of the RP, as the Tribunal recognised that their views are of considerable importance in assessing the RP’s best interests in light of their involvement in that person’s life. However, that same positioning can make it extremely difficult for family members to disentangle what might be in their best interests from the best interests of the RP. It is for that reason that the legislature confers the decision to consent to sterilisation on the full Tribunal in recognition of the seriousness of the decision.[46]

In this application, the Tribunal noted and adopted[47] prior emphasis on the views of a child’s parents as to what was in their child’s best interests, these views being given “considerable weight” in their own right because of the unique relationship and knowledge a parent has of their child.[48] This is even more so when the guardian’s position clearly embodies the positive guardian factors in s 51 of the GA Act and are clearly embodied in the position expressed by the child’s parents.[49] Those factors include acting as an advocate for the RP; encouraging the RP to live and participate in the general community, encouraging and assisting the RP to become capable of caring for themselves and making reasonable judgements and protecting the RP person from neglect, abuse and exploitation.

Consistent with the basic human rights of all persons regardless of capacity,[50] the approach to “best interests” should always be one that is the least restrictive to the RP’s personal freedom of decision and action (personal autonomy).[51]

The Tribunal also considered precedent factors from earlier sterilisation cases[52] including whether the person had considered having children, the likelihood of the person changing their mind, whether the person engages (or may do in the future) in sexual activity that could result in a pregnancy, whether there are less evasive contraceptive measures, the extent of physical invasion and effect on the person’s mind and self-perception of the proposed procedure, and whether sterilisation is sought in good faith or for the applicant’s own personal interests or public convenience.[53]

What is in JC’s best interests

The Tribunal found on the evidence that JC did not have the capacity to make a reasonable decision about whether to have a vasectomy. That was largely because he did not understand what that procedure was for, what it involved, or what consequences flow from it.[54]

Further, JC was unable to express a fixed view on critical points, such as his wishes with respect to parenthood and his willingness to undergo the vasectomy if that was found to be in his best interests. The Tribunal decided those questions on his behalf from the evidence — namely that JC did not wish to be a father, and would be opposed to having even a simple operation.[55]

The two surgeons who gave evidence as to the risks and complications of vasectomy, indicated that these risks were small[56] and could be well managed given JC’s specific care needs. JC’s family submitted that they are supportive of him having a full life experience, including engaging in sexual relationships but say that is “not possible” without a vasectomy.[57] JC’s parents (and others who gave evidence) emphasised the detrimental impact on his wellbeing should he become a father. The unavoidable change to his routine, leading to dysregulation and paired with the physical, emotional and financial responsibilities of parenthood, would likely cause him to “flip out” and would be devastating to his mental health.[58]

Given a past history of sexual abuse in care,[59] his ongoing risk of exploitation (flowing from his vulnerability to go along with the wishes of others)[60] and a perceived future risk of pregnancy resulting in him fathering a child (either voluntarily or by exploitation, coercion or abuse), JC’s parents expressed the view that they were not willing to move him into SIL accommodation unless and until he has a vasectomy.[61] Despite the focus on JC’s sexual activity, the accepted fact was that he was not engaging (and was not intending to engage) in a sexual relationship with any person.[62]

The Tribunal determined the real question to be:

… whether there is currently, or [is] in the reasonably foreseeable future, any realistic possibility that JC will engage in sexual relations that might result in the conception of a child that needs to be guarded against by the performing of a vasectomy at this time [emphasis added].[63]

The Tribunal determined the answer to be no because the submissions as to JC’s “best interests” were contemplative of a future scenario and not a real or present risk (of avoiding fathering a child). If such a risk existed, the Tribunal accepted that it would be in JC’s best interest to undergo a vasectomy for the purposes of avoiding a pregnancy.[64]

In reaching that position, the Tribunal recognised that it is a very significant step to consent to the sterilisation of any person who cannot themselves consent, particularly a young man of 23 years. The Tribunal simply was not “positively persuaded” that sterilisation was in JC’s best interests at this time[65] and so did not consent to sterilisation and ordered the application initiated by his parents be dismissed.

Sterilisation decisions

JC’s case is an example of diligent parents motivated by an interest in their child’s wellbeing, and their views were given great weight by the Tribunal.[66] That is not, however, synonymous with the best interests of the RP, but may be a factor that the decision-maker gives considerable weight to,[67] amongst other factors. It is also not sufficient to try to guard against future risks, even if the concerns are genuinely held.

The decision affirms the primary principles elucidated in Dept of Health and Community Services (NT) v JWB and SMB (Marion’s case)[68] (Marion’s Case), being Australia’s leading authority on sterilisation (albeit the gendered issue of managing menstruation) — namely that:

• Non-therapeutic sterilisation of a child or young person, (including an RP that does not have decision-making capacity) is a special case requiring court (or Tribunal) authorisation.
• The test for involuntary sterilisation should be a consideration of what is in the “best interests of the child/RP, noting that it is treatment of last resort” (best interests but last resort).[69]

Subsequent cases[70] to Marion’s Case in Australia have concluded (albeit under different legislative regimes) as follows:

• In Re P & P; Legal Aid Commission of NSW,[71] the Family Court of Australia in its welfare jurisdiction, decided that it can approve sterilisation procedures for children, even if a Tribunal had determined otherwise.[72] However, it must be a “step of last resort” when there is no alternative (such as contraception or training) that is appropriate. A child’s future right to sexual activity should not be deprived — to do so would be discrimination on the grounds of a disability.[73]
• In Re Katie,[74] the Family Court of Australia determined that sterilisation of an intellectually disabled 17-year-old was supported on the onset of menstruation because of the “appreciable easing of the burden” on the parents as primary carers.
• In Re HGL (No 2),[75] it was determined that sterilisation (by hysterectomy) of an 18-year-old with severe intellectual disability (requiring 24-hour care and confined to a wheelchair) was approved for menstrual management on the evidence of her parents that it had caused her “distress” and hormone treatment may fail over time.
• EW and CD,[76] the Western Australian State Administrative Tribunal endorsed the approach in Re Jane[77] which identified 9 factors of relevance to determining whether sterilisation was in the best interests of a person, specifically a female child, which require consideration of:

—the factual possibility of pregnancy, either by voluntary sexual activity or rape

—the inability of the person to understand (and whether that inability is permanent) reproduction or contraception

—the feasibility of less drastic contraception, and whether medical or scientific advances may occur in the foreseeable future which may affect either the persons condition or the drasticness of current sterilisation

—the persons ability to care for a child

—the possibility that the person would experience trauma or psychological damage if she either became pregnant, gave birth, or as a result of the sterilisation procedure

—the bona fides of the applicant seeking sterilisation is the represented person’s interests, and not their own

The recent cases appear to move away from what was (and should be) judicial acceptance that involuntary sterilisation requires “compelling justification for it is a serious invasion of that child’s personal integrity and a grave impairment of that child’s human dignity”.[78] The leading US case of Re Grady suggested the starting point for any consideration of sterilisation must be the acknowledgment that the right to procreate is fundamental to the very existence and survival of the race.[79]

It is hard to rationalise these aspirational principles with the published cases, especially those that focus on menstrual management. This dilemma is likely explained by the fact that, even in the 20th and 21st centuries, there are negative social attitudes and pressures on both menstruation (as uncomfortable, debilitating and unclean) and intellectual disability (as being hard to understand or difficult to teach). Putting those two factors together, there is a perception of a problem requiring extreme management.[80] However, menstruation can, of course, be seen as an important manifestation of identity and womanhood.[81]

By contrast, men do not generally face the same level of bodily moralisation[82] and opposition to autonomy at a societal level.[83] This is perhaps not surprising since women, as the primary bearers, carers and rearers of children, have historically been more vulnerable to incursions upon their sexual and reproductive rights. Where women with intellectual disabilities are concerned, this is further complicated by domestic[84] and international[85] research suggesting that they face significantly higher prejudices and complications, and as such are considered a risk group.[86]

The Tribunal in JC’s case recognised that involuntary sterilisation cases are gendered.[87] Judicial consideration of male sterilisation is relatively new. In the UK, the first[88] judicially-approved vasectomy occurred in 2013 (Re DE)[89] in relation to an intellectually disabled 36-year-old man when it was found to be in his best interests to prevent fathering further children as a way to mitigate relationship strain and allow him to re-establish as normal a life as soon as possible. DE was found to have capacity to give sexual consent, but did not have capacity to make decisions about contraception.[90]

The framework

Legal requirements for consent differ significantly between jurisdictions. The age[91] (and capacity) of the person who is the subject of proposed treatment matters, as does the proposed procedure. Guardianship Tribunals in Australia were introduced in the 1980s to manage capacity, guardianship and administration issues, including with respect to “special” medical treatment/procedures.[92] However those forums related to adults with disabilities.

It is only in the post-Marion’s Case era (being after 1992) that children, young persons and adults had some measure of equal protection in the sense that sterilisation of a minor/young person was a “special” case and outside of the ordinary scope of parental power to be able to consent on their behalf, and rather, required approval by a court or tribunal with relevant jurisdiction. To date, those protections have been routinely and exclusively applied to girls and young women with a disability.[93]

Now (and since 2001), the Family Court[94] (in its welfare jurisdiction)[95] has concurrent jurisdiction[96] with all state and territory guardianship tribunals to hear applications for the sterilisation of children. Since 2009, the Australian Guardianship and Administration Council (AGAC) released its Protocol for Special Medical Procedures (Sterilisation) (AGAC protocol)[97] to streamline the states and territories with a consistent regime.[98] The Protocol sets out decision-making principles[99] and a two-part test.[100]

Concluding comments

Despite the High Court in Marion’s Case stating the operative test to be “best interests but last resort”, research conducted by the Australian Human Rights Commission suggests that the legal trend in decision-making in Australia is not towards a more restrictive approach to the sterilisation of children but a more relaxed one.[101] That is wholly at odds with the fact that forced sterilisation has been identified as an act of violence, a form of social control and a form of torture.[102]

Any person involved in an application for involuntary sterilisation (or any permanent procedure affecting an incapacitated person) should always be guided by the fact that the decision is not just a medical one, but a moral decision of a fundamental sort arising within the broader context of societal values and norms. These decisions are about the rights and dignities of people with disabilities more generally.[103]

Despite the efforts at unifying and streamlining decision-making, there is appreciable disparity between jurisdictions. Research[104] reveals that the Federal Court of Australia has approved proposed hysterectomies in 17 out of 19 cases and in the case of guardianship tribunals, 10 out of 10 cases.

What does seem evident from the decided cases discussed in this article is that, when it comes to the “best interests” of males, the court quarantines the interests of the represented person (to the exclusion of others such as parents) but when females are being considered, the interests of others appear to have an elevated relevance. As Brennan J acknowledged when dissenting to Marion’s Case:

… in the absence of legal rules or a hierarchy of values, the best interests approach depends upon the value system of the decision-maker. Absent any rule or guideline, that approach simply creates an unexaminable discretion in the repository of the power [emphasis added]. …[105]

The balance is a fine and imperfect one.

[1] Section 3 of the Guardianship and Administration Act 1990 (WA) (GA Act) defines the “Full Tribunal” as being constituted of the President or a Deputy President and at least two other members — which is said to evince the seriousness of the question to be considered.

[2] Re JC [2026] WASAT 13; BC202602365 at [1].

[3] Above, at [81]–[82].

[4] Above n 2, at [83].

[5] Above n 2, at [89].

[6] “Represented person” (RP) is legislatively defined in s 56 of the GA Act as a person in respect of whom a guardianship order is in force.

[7] Above n 2, at [25].

[8] Above n 2, at [43].

[9] Above n 2, at [44].

[10] Above n 2, at [3].

[11] Above n 2, at [44].

[12] Above n 2, at [45].

[13] Above n 2, at [44].

[14] Above n 2, at [49] and [76].

[15] Above n 2, at [16].

[16] Above n 2, at [17].

[17] Above n 2, at [51].

[18] Above n 2, at [52] and [72].

[19] Above n 2, at [53].

[20] Above n 2, at [54].

[21] Above n 2, at [50].

[22] Above n 2, at [56].

[23] Above n 2, at [48].

[24] Above n 2, at [75].

[25] Above n 2, at [74].

[26] Investigator, being a professional from the Office of the Public Advocate who investigates the welfare of adults with decision-making disabilities, acting as an independent advisor to the Tribunal — often by way of written report.

[27] Above n 2, at [74].

[28] Above n 2, at [75].

[29] Above.

[30] GA Act, s 58(1).

[31] Above n 2, at [7] referencing GA Act, s 63.

[32] GA Act, ss 57(1)(c) and 57(3).

[33] Above n 2, at [10(b)] referencing GA Act, s 56.

[34] Above n 2, at [10(b)] citing EW and CD [2021] WASAT 111; BC202107906 at [14] and [15] (EW).

[35] Above n 2, at [9] referring to GA Act, s 59(1). Most curiously, the legislative section employs the gendered term “his” despite the process being available to any RP, and in circumstances where no decision has been made about male sterilisation in Australia prior to above n 2.

[36] GA Act, s 60(1).

[37] See the discussion in above n 2, at [23] regarding presumed personal autonomy and [24] regarding the requirement of a person to be under a guardianship order in order to have jurisdiction to apply for a sterilisation order.

[38] Above n 2, at [13] and [14].

[39] Above n 2, at [25].

[40] Above n 2, at [26] citing EW, above n 34, at [23].

[41] Above n 1, at [28] citing O’Brien J in Re Director Clinical Services, Child & Adolescent Health Services and Kiszko (2016) 312 FLR 319; [2016] FCWA 75; BC201651300 at [101] (Kiszko).

[42] Above n 2, at [28] citing Kiszko, above, at [101].

[43] Above n 2, at [30].

[44] Above n 2, at [31], citing Dept of Health and Community Services (NT) v JWB and SMB (Marion’s case) (1992) 175 CLR 218; 106 ALR 385; [1992] HCA 15 (Marion’s Case) at 259 and 260 per Mason CJ, Dawson, Toohey and Gaudron JJ.

[45] Above n 2, at [32] citing Marion’s Case, above, at 269 per Brennan J; see also Re Jane (1988) 85 ALR 409; 94 FLR 1; at [19]–[21].

[46] Above n 2, at [27].

[47] Above n 2, at [29].

[48] Above n 2, at [29], citing Kiszko, above n 41, at [67]–[69].

[49] Which are set out in above n 2, at [33].

[50] Above n 2, at [36] citing EW, above n 34, and also referring to JS v CS (2009) 63 SR (WA) 23; [2009] WASAT 90 (JS).

[51] Above n 2, at [35].

[52] Above n 2, at [37].

[53] Above; see also S Brady The sterilisation of girls and young women with intellectual disabilities in Australia: An audit of Family Court and Guardianship Tribunal cases between 1992– 1998 (2001) (Brady, Sterilisation case Audit) https://humanrights.gov.au/resource-hub/by-resource-type/books/sterilisation — a paper that was presented at International Conference Disability With Attitude: Critical Issues 20 years After International Year of Disabled Persons on 16th–17th February 2001 Parramatta Campus, University of Western Sydney, Australia — specifically the “central assertion is that non-consensual sterilisation continues to be framed as a medical problem to be ‘cured’ for family and social reasons”. This theme is also explored in R Graycar, “The Gender of Judgements: An Introduction” in Public and Private: Feminist Legal Debates M Thornton (ed), Oxford University Press, South Melbourne pp 262–305.

[54] Above n 2, at [78].

[55] Above n 2, at [80].

[56] Above n 2, at [57]–[66].

[57] Above n 2, at [67].

[58] Above n 2, at [68].

[59] Above n 2, at [70], which is said to have given rise to a diagnosis of post-traumatic stress disorder (PTSD).

[60] Above n 2, at [69].

[61] Above n 2, at [73].

[62] Above n 2, at [72].

[63] Above n 2, at [86].

[64] Above n 2, at [87].

[65] Above n 2, at [94].

[66] Above n 2, at [92].

[67] Above n 2, at [29] referring to Kiszko, above n 41, at [67]–[69].

[68] Marion’s parents had asked the court to either consent to her having a hysterectomy, or declare it lawful that they could make that decision in circumstances where her intellectual disability rendered her unable to give valid and effective consent to treatment.

[69] Above n 2, at [31] referring to Marion’s Case, above n 44.

[70] For a comprehensive overview of judicial determinations pre- and post-Marion’s Case, above n 44, see C Frohmader Dehumanised: The Forced Sterilisation of Women and Girls with Disabilities in Australia (2013) (Dehumanised, WWDA) — submissions on behalf of Women with Disabilities Australia to the Senate Inquiry into the involuntary or coerced sterilisation of people with disabilities in Australia https://assets.wwda.org.au/uploads/2020/05/WWDA_Sub_SenateInquiry_Sterilisation_March2013.pdf.

[71] Re P & P; Legal Aid Commission of NSW (1995) 126 FLR 245; 19 Fam LR 1 — regarding a 17 year old female (Lessli).

[72] Above, at [575].

[73] That point having been made by the Australian Human Rights Commission (AHRC) who have made submissions on the case, see AHRC, Commission submissions: P v P, 14 December 2012, accessed 26 May 2026, https://humanrights.gov.au/about-us/about-the-commission/submission-court-intervener-and-amicus-curiae/commission-submissions-p-v-p.

[74] Re Katie (1995) 128 FLR 194; (1996) FLC 92-659 at 82817 per Warwick J (Re Katie).

[75] Re HGL (No 2) [2011] QCATA 259; BC201112366 at [7], [18], [26] and [29].

[76] EW, above n 34, concerning a 41-year-old woman diagnosed as suffering from treatment refractory schizophrenia, a chronic condition that causes her to be very seriously unwell with affect to her cognitive ability. At the time of the application, EW was pregnant and wished for sterilisation at the time of planned caesarean, which was supported by her medical practitioners and others supporting her.

[77] Re Jane (1988) 85 ALR 409; 94 FLR 1 per Nicholson CJ. The case predates Marion’s Case, above n 44, but is often talked about together, as Re Jane rejected unqualified trust in a medical professional and instead held that court consent was required.

[78] Marion’s Case, above n 44, at [267] per Brennan J.

[79] Re Grady 426 A 2d 474 (1981) at [472].

[80] N O’Neill “Sterilisation of Children with Intellectual Disabilities” (1996) 2(2) Australian Journal of Human Rights 267.

[81] See generally E Handsley “‘Sterilisation’ of Young Intellectually Disabled Women” (1994) 20(2) Monash University Law Review 272–99 for a feminist perspective to involuntary sterilisation.

[82] In Re Katie, above n 74 the Family Court of Australia considered the girl to be at higher risk of abuse and/or exploitation because she was “quite an attractive girl”.

[83] See T Morgenroth and others “The Moralization of Women’s Bodies” (2025) 55 European Journal of Social Psychology 227–39.

[84] See C Smithson “Perinatal outcomes of women with a disability who received pregnancy care through a specialised disability clinic in Melbourne Australia” (2021) 61(4) Australian and New Zealand Journal of Obstetrics and Gynaecology 489–633.

[85] See B Hoglund, P Lindgren and M Larsson, “Pregnancy and birth outcomes for women with intellectual disability in Sweden: a national register study” (2012) 91(12) Acta Obstetrica et Gynecologica Scandinavica 1381–87.

[86] Above n 85, at 1386.

[87] Above n 2, at [30] in that the Tribunal was not able to identify any published decision in Australia which dealt with a male represented person; see also S Brady and Dr S Grover The Sterilisation of Girls and Young Women in Australia: A legal, medical and social context (1997) Table 4.1: The Number of Authorisations of Girls by Australian Courts and Tribunals https://humanrights.gov.au/resource-hub/search-all-our-publications/reports-and-projects/projects2/sterilisation-girls-and-young-women-australia-1997-report.

[88] An earlier (unrelated) application in respect of a man was sought in 1999 but refused.

[89] A NHS Trust v DE [2013] EWHC 2562.

[90] Above, at [4].

[91] Generally speaking, persons under 16 years are considered children, persons aged 16 or 17 are considered “young persons” or minors and over 18 considered “adults”. Any person with an intellectual disability regardless of age may have an incapacity requiring additional management.

[92] See Australian Guardianship and Administration Council (AGAC) Protocol for Special Medical Procedures (Sterilisation) (2009) Sch 1 for a comparative definitions of sterilisation across Australian jurisdictions.

[93] See further Brady, Sterilisation case Audit, above n 53.

[94] Family Court (Federal Circuit and Family Court of Australia).

[95] Family Law Act 1975 (Cth), s 67ZC.

[96] Affirmed in above n 71.

[97] Made pursuant to the approval of the AGAC 6 May 2009: see above n 92.

[98] And was considered in EW, above n 34, at 82 and JS, above n 50, at 52.

[99] Above n 92, Pt 4 — including but not limited to equal human rights, individual value and autonomy, maximum participation, least restrictive alternatives and the maintenance of supports.

[100] Above n 92, Pt 5, Phase 2 — as to whether the application meets the threshold criteria:

• Does the person have capacity?

• Is sterilisation required?

[101] See Brady, Sterilisation case Audit, above n at 53.

[102] See C Woods — Law Society Journal Online, “State-sanctioned torture”: women with disability continue to suffer forced sterilisation, 21 January 2025, accessed 26 May 2026, https://lsj.com.au/articles/state-sanctioned-torture-omen-with-disability-continue-to-suffer-forced-sterilisation/ quoting the United Nations Committee on the Rights of the Child.

[103] Brady, Sterilisation case Audit, above n 53.

[104] Above.

[105] Marion’s Case, above n 44, at 270–71.