{"id":"sl-2023-35","name":"Variation in Sex Characteristics (Restricted Medical Treatment) Regulation 2023","slug":"variation-in-sex-characteristics-restricted-medical-treatment-regulation-2023","collection":"regulation","jurisdiction":"act","status":"in_force","isInForce":true,"actNumber":"35 of 2023","makingDate":null,"administeringDepartment":null,"currentVersion":{"id":173917,"registerId":"act-sl-2023-35-current","compilationNumber":null,"startDate":"2026-04-05","status":"InForce","reasons":null,"registeredAt":null},"sections":[{"sectionNumber":"1","sectionType":"section","heading":"Variation in Sex Characteristics (Restricted Medical Treatment) Regulation 2023","content":"Authorised by the ACT Parliamentary Counsel—also accessible at www.legislation.act.gov.au\nAustralian Capital Territory\nVariation in Sex Characteristics\n(Restricted Medical Treatment)\nRegulation 2023\nSL2023-35\nmade under the\nVariation in Sex Characteristics (Restricted Medical Treatment)\nAct 2023\nRepublication No 2\nEffective: 23 December 2024\nRepublication date: 23 December 2024\nRegulation not amended\n(republication for commenced provision)\n\nAuthorised by the ACT Parliamentary Counsel—also accessible at www.legislation.act.gov.au\nAbout this republication\nThe republished law\nThis is a republication of the Variation in Sex Characteristics (Restricted Medical Treatment)\nRegulation 2023, made under the Variation in Sex Characteristics (Restricted Medical\nTreatment) Act 2023 (including any amendment made under the Legislation Act 2001, part 11.3\n(Editorial changes)) as in force on 23 December 2024. It also includes any commencement,\nrepeal or expiry affecting this republished law.\nThe legislation history and amendment history of the republished law are set out in endnotes 3\nand 4.\nKinds of republications\nThe Parliamentary Counsel’s Office prepares 2 kinds of republications of ACT laws (see the ACT\nlegislation register at www.legislation.act.gov.au):\n• authorised republications to which the Legislation Act 2001 applies\n• unauthorised republications.\nThe status of this republication appears on the bottom of each page.\nEditorial amendments\nThe Legislation Act 2001, part 11.3 authorises the Parliamentary Counsel to make editorial\namendments and other changes of a formal nature when preparing a law for republication.\nEditorial changes do not change the effect of the law, but have effect as if they had been made by\nan Act commencing on the republication date (see Legislation Act 2001, s 115 and s 117). The\nchanges are made if the Parliamentary Counsel considers they are desirable to bring the law into\nline, or more closely into line, with current legislative drafting practice.\nThis republication does not include amendments made under part 11.3 (see endnote 1).\nUncommenced provisions and amendments\nIf a provision of the republished law has not commenced, the symbol U appears immediately\nbefore the provision heading. Any uncommenced amendments that affect this republished law\nare accessible on the ACT legislation register (www.legislation.act.gov.au). For more\ninformation, see the home page for this law on the register.\nModifications\nIf a provision of the republished law is affected by a current modification, the\nsymbol M appears immediately before the provision heading. The text of the modifying\nprovision appears in the endnotes. For the legal status of modifications, see the Legislation\nAct 2001, section 95.\nPenalties\nAt the republication date, the value of a penalty unit for an offence against this law is $160 for an\nindividual and $810 for a corporation (see Legislation Act 2001, s 133).\n\nR2\n23/12/24\nVariation in Sex Characteristics (Restricted Medical\nTreatment) Regulation 2023\nEffective: 23/12/24\ncontents 1\nAuthorised by the ACT Parliamentary Counsel—also accessible at www.legislation.act.gov.au\nAustralian Capital Territory\nVariation in Sex Characteristics\n(Restricted Medical Treatment)\nRegulation 2023\nmade under the\nVariation in Sex Characteristics (Restricted Medical Treatment)\nAct 2023\nContents\nPage\n1 Name of regulation 2\n3 Excluded conditions—Act, s 7 (1), def variation in sex characteristics,\npar (c) 2\n4 Temporary restricted medical treatment—Act, s 8 (1), def restricted\nmedical treatment, par (b) 2\n5 Operation of assessment committee—additional requirements—Act,\ns 18 (4) 2\n\nContents\nPage\ncontents 2 Variation in Sex Characteristics (Restricted Medical\nTreatment) Regulation 2023\nEffective: 23/12/24\nR2\n23/12/24\nAuthorised by the ACT Parliamentary Counsel—also accessible at www.legislation.act.gov.au\n6 Membership of assessment board—criteria for medicine category—\nAct, s 31 (6) 2\n7 Membership of assessment board—criteria for variation in sex\ncharacteristics category—Act, s 31 (6) 3\n8 Membership of assessment board—criteria for provision of\npsychosocial support category—Act, s 31 (6) 3\n9 Reporting treatment in relation to sex characteristics—\nAct, s 43 (1) (b) (iv) 4\n10 Reportable treatment—Act, s 43 (2), def reportable treatment, par (c) 4\nEndnotes\n1 About the endnotes 5\n2 Abbreviation key 5\n3 Legislation history 6\n4 Amendment history 6\n5 Earlier republications 6\n\nR2\n23/12/24\nVariation in Sex Characteristics (Restricted Medical\nTreatment) Regulation 2023\nEffective: 23/12/24\npage 1\nAuthorised by the ACT Parliamentary Counsel—also accessible at www.legislation.act.gov.au\nAustralian Capital Territory\nVariation in Sex Characteristics\n(Restricted Medical Treatment)\nRegulation 2023\nmade under the\nVariation in Sex Characteristics (Restricted Medical Treatment)\nAct 2023\n\nSection 1\npage 2 Variation in Sex Characteristics (Restricted Medical\nTreatment) Regulation 2023\nEffective: 23/12/24\nR2\n23/12/24\nAuthorised by the ACT Parliamentary Counsel—also accessible at www.legislation.act.gov.au\n1 Name of regulation\nThis regulation is the Variation in Sex Characteristics (Restricted\nMedical Treatment) Regulation 2023.\n3 Excluded conditions—Act, s 7 (1), def variation in sex\ncharacteristics, par (c)\nThe following conditions are prescribed:\n(a) bladder exstrophy;\n(b) epispadias;\n(c) hypospadias, other than proximal hypospadias with\ncryptorchidism;\n(d) polycystic ovary syndrome;\n(e) undescended testis.\n4 Temporary restricted medical treatment—Act, s 8 (1),\ndef restricted medical treatment, par (b)\nVaginal dilation is prescribed.\n5 Operation of assessment committee—additional\nrequirements—Act, s 18 (4)\nAn assessment committee must keep minutes of its meetings.\n6 Membership of assessment board—criteria for medicine\ncategory—Act, s 31 (6)\nA person appointed for the category mentioned in the Act,\nsection 31 (1) (b) (ii) must have qualifications or expertise in at least\n1 of the following areas:\n(a) adolescent and young adult medicine;\n(b) clinical genetics;\n\nSection 7\nR2\n23/12/24\nVariation in Sex Characteristics (Restricted Medical\nTreatment) Regulation 2023\nEffective: 23/12/24\npage 3\nAuthorised by the ACT Parliamentary Counsel—also accessible at www.legislation.act.gov.au\n(c) general paediatrics;\n(d) neonatology;\n(e) paediatric endocrinology;\n(f) paediatric or adolescent gynaecology;\n(g) paediatric urology.\n7 Membership of assessment board—criteria for variation\nin sex characteristics category—Act, s 31 (6)\nA person appointed for the category mentioned in the Act,\nsection 31 (1) (b) (iv) must have lived experience of a variation in sex\ncharacteristics.\nExamples\n1 a person with a variation in sex characteristics\n2 a parent of, or carer for, a person with a variation in sex characteristics\n8 Membership of assessment board—criteria for provision\nof psychosocial support category—Act, s 31 (6)\nA person appointed for the category mentioned in the Act,\nsection 31 (1) (b) (v) must have qualifications or experience in\nproviding—\n(a) psychological support; or\n(b) social work services; or\n(c) counselling, including genetic counselling, services; or\n(d) support or care for the psychosocial needs of people with a\nvariation in sex characteristics.\n\nSection 9\npage 4 Variation in Sex Characteristics (Restricted Medical\nTreatment) Regulation 2023\nEffective: 23/12/24\nR2\n23/12/24\nAuthorised by the ACT Parliamentary Counsel—also accessible at www.legislation.act.gov.au\n9 Reporting treatment in relation to sex characteristics—\nAct, s 43 (1) (b) (iv)\n(1) The following information is prescribed:\n(a) details of each reportable treatment undertaken;\n(b) the date the reportable treatment started.\n(2) In this section:\nreportable treatment—see the Act, section 43 (2).\n10 Reportable treatment—Act, s 43 (2), def reportable\ntreatment, par (c)\nThe following conditions are prescribed:\n(a) bladder exstrophy;\n(b) epispadias;\n(c) hypospadias, other than proximal hypospadias with\ncryptorchidism;\n(d) polycystic ovary syndrome;\n(e) undescended testis.\nNote This section prescribes conditions that are excluded under s 3 from the\ngeneral application of the Act but which are still subject to reporting\nrequirements in the Act, s 43 and s 44.\n\nEndnotes\nAbout the endnotes 1\nR2\n23/12/24\nVariation in Sex Characteristics (Restricted Medical\nTreatment) Regulation 2023\nEffective: 23/12/24\npage 5\nAuthorised by the ACT Parliamentary Counsel—also accessible at www.legislation.act.gov.au\nEndnotes\n1 About the endnotes\nAmending and modifying laws are annotated in the legislation history and the\namendment history. Current modifications are not included in the republished law\nbut are set out in the endnotes.\nNot all editorial amendments made under the Legislation Act 2001, part 11.3 are\nannotated in the amendment history. Full details of any amendments can be\nobtained from the Parliamentary Counsel’s Office.\nUncommenced amending laws are not included in the republished law. The details\nof these laws are underlined in the legislation history. Uncommenced expiries are\nunderlined in the legislation history and amendment history.\nIf all the provisions of the law have been renumbered, a table of renumbered\nprovisions gives details of previous and current numbering.\nThe endnotes also include a table of earlier republications.\n2 Abbreviation key\nA = Act NI = Notifiable instrument\nAF = Approved form o = order\nam = amended om = omitted/repealed\namdt = amendment ord = ordinance\nAR = Assembly resolution orig = original\nch = chapter par = paragraph/subparagraph\nCN = Commencement notice pres = present\ndef = definition prev = previous\nDI = Disallowable instrument (prev...) = previously\ndict = dictionary pt = part\ndisallowed = disallowed by the Legislative r = rule/subrule\nAssembly reloc = relocated\ndiv = division renum = renumbered\nexp = expires/expired R[X] = Republication No\nGaz = gazette RI = reissue\nhdg = heading s = section/subsection\nIA = Interpretation Act 1967 sch = schedule\nins = inserted/added sdiv = subdivision\nLA = Legislation Act 2001 SL = Subordinate law\nLR = legislation register sub = substituted\nLRA = Legislation (Republication) Act 1996 underlining = whole or part not commenced\nmod = modified/modification or to be expired\n\nEndnotes\n3 Legislation history\npage 6 Variation in Sex Characteristics (Restricted Medical\nTreatment) Regulation 2023\nEffective: 23/12/24\nR2\n23/12/24\nAuthorised by the ACT Parliamentary Counsel—also accessible at www.legislation.act.gov.au\n3 Legislation history\nVariation in Sex Characteristics (Restricted Medical Treatment)\nRegulation 2023 SL2023-35\nnotified LR 14 December 2023\ns 1, s 2 commenced 14 December 2023 (LA s 75 (1))\ns 9 commenced 23 December 2024 (s 2 (2))\nremainder commenced 23 December 2023 (s 2 (1))\n4 Amendment history\nCommencement\ns 2 om LA s 89 (4)\n5 Earlier republications\nSome earlier republications were not numbered. The number in column 1 refers to\nthe publication order.\nSince 12 September 2001 every authorised republication has been published in\nelectronic pdf format on the ACT legislation register. A selection of authorised\nrepublications have also been published in printed format. These republications are\nmarked with an asterisk (*) in column 1. Electronic and printed versions of an\nauthorised republication are identical.\nRepublication\nNo and date\nEffective Last\namendment\nmade by\nRepublication\nfor\nR1\n23 Dec 2023\n23 Dec 2023–\n22 Dec 2024\nnot amended new regulation\n© Australian Capital Territory 2024","sortOrder":0}],"analysis":{"issue_detection":{"absurdities":[],"contradictions":[]},"flash_summary_failed":{"failed":true,"reason":"A positive credit balance is required for all requests, including BYOK, so fallback providers remain available. Add credits at https://vercel.com/d?to=%2F%5Bteam%5D%2F%7E%2Fai%3Fmodal%3Dtop-up to continue.","source":"analysis-cron"},"kimi_summary":{"content_quality":"ok","complexity_score":2,"scope_assessment":{"changed":false,"description":"This regulation remains tightly scoped to its original purpose of operationalising the parent Act. It does not expand beyond the Act's framework of restricting certain medical treatments and establishing oversight mechanisms. The content is purely subsidiary—prescribing excluded conditions, qualifications for board membership, and reporting requirements exactly as anticipated by the enabling Act."},"complexity_factors":["Very short document—only 10 substantive sections across 6 pages","Minimal defined terms (only 1 explicit definition in section 9(2))","No nested conditional logic or exceptions to exceptions","Straightforward cross-references to parent Act sections (simple 'see the Act' citations)","Prescriptive lists rather than discretionary criteria (sections 3, 6, 7, 8, 10 are essentially bullet-point lists)","No complex temporal provisions or transitional arrangements","Single purpose instrument that merely 'fleshes out' the parent Act without creating new regulatory schemes"],"plain_english_summary":"This regulation operationalises the ACT’s 2023 law limiting certain medical treatments for children with variations in sex characteristics. It clarifies which conditions are excluded from the strict approval pathway, adds vaginal dilation to restricted procedures, sets membership and record‑keeping rules for assessment bodies (including representation with lived experience), and specifies what clinicians must report. It affects intersex children, their families, treating clinicians and board members by tightening scrutiny of irreversible, cosmetic interventions while allowing legitimate medical care to proceed."},"flash_summary":{"complexity_score":3,"scope_assessment":{"changed":false,"description":"This regulation refines and limits the operational scope of the underlying Act rather than expanding it. It narrows the Act’s general application by excluding five named conditions from the Act’s definition of 'variation in sex characteristics' (Reg 3) while keeping those conditions within the Act’s reporting framework (Regs 9–10). It also clarifies procedures and membership criteria for assessment bodies and prescribes that vaginal dilation be treated as a temporary restricted medical treatment (Reg 4). Those are implementation details and scope clarifications rather than an expansion beyond the Act’s stated purpose."},"complexity_factors":["Short instrument (10 substantive provisions: regs 1, 3–10)","5 specifically prescribed conditions listed twice (Regs 3 and 10)","Cross-references to multiple Act provisions (s7, s8, s18, s31, s43) requiring readers to consult the parent Act for full effect","Three membership categories with sub-criteria (Regs 6–8) including 7 clinical specialties in Reg 6","Simple reporting prescription (only 2 data fields) limiting complexity","One procedural administrative requirement (minutes) with minimal conditional logic"],"plain_english_summary":"**What this regulation does, in plain English**\n\n- Mechanically, the regulation tells officials and health providers three things: which medical conditions are *excluded* from the Act’s general definition of “variation in sex characteristics” (but remain reportable), which procedure counts as a *temporary restricted medical treatment*, and what administrative and membership rules apply to the assessment bodies and reporting required by the Act. (See Regs 3, 4, 5, 6–8, 9–10.)\n\n- The regulation prescribes five specific conditions as excluded from the Act’s general application: bladder exstrophy; epispadias; hypospadias (except proximal hypospadias with cryptorchidism); polycystic ovary syndrome; and undescended testis. Those same five conditions are nevertheless subject to the Act’s reporting rules (Regs 3 and 10; note to s10). \n\n- The regulation specifies that vaginal dilation is a “temporary restricted medical treatment” for the purposes of the Act (Reg 4). That means vaginal dilation is treated under the Act’s rules on restricted treatments (the Act’s mechanics — e.g. assessment, consent, reporting — apply insofar as the Act defines for temporary restricted medical treatment).\n\n- The regulation imposes simple administrative requirements on assessment committees: they must keep minutes of meetings (Reg 5). It also sets minimum qualifications/experience for members of the assessment board in three categories (Regs 6–8):\n  - Medicine category: appointment must have qualifications or expertise in at least one of a listed set of specialties (adolescent/young-adult medicine, clinical genetics, general paediatrics, neonatology, paediatric endocrinology, paediatric/adolescent gynaecology or paediatric urology) (Reg 6).\n  - Variation-in-sex-characteristics category: the appointee must have lived experience of a variation in sex characteristics; examples include a person with such a variation or a parent/carer (Reg 7).\n  - Psychosocial-support category: the appointee must have qualifications or experience in providing psychological support, social work, counselling (including genetic counselling) or analogous psychosocial support for people with variations (Reg 8).\n\n- Reporting requirements are narrowed to two prescribed items: the details of each reportable treatment and the date the treatment started (Reg 9). The regulation defines which conditions count as “reportable treatment” for the purposes of the Act by listing the five conditions noted above (Reg 10).\n\nWhy it matters (claimed purpose, and practical effects)\n\n- Purpose claimed by the instrument: to clarify which conditions and treatments fall inside or outside the Act’s general reach, to set membership standards for assessment bodies, and to specify the minimum data that must be reported so the jurisdiction can monitor restricted treatments. (See Regs 3–10.)\n\n- Concrete practical effects and incentives:\n  - Clinicians and health services who treat the listed conditions must still report specified information (Reg 9–10), so there is an ongoing administrative/data-collection obligation even though those conditions are excluded from the Act’s general application (Reg 3; note to s10).\n  - Assessment committees must record minutes (Reg 5), which raises administrative and record-keeping obligations and creates an audit trail for decision-making.\n  - The membership rules (Regs 6–8) steer who can be appointed to assessment boards. That affects who decides on applications and the mix of clinical, lived-experience and psychosocial perspectives on panels; appointment decisions therefore shape gatekeeping and oversight.\n  - Classifying vaginal dilation as a temporary restricted medical treatment (Reg 4) brings that procedure within the Act’s restricted-treatment framework (and its associated procedural requirements).\n\nCosts, trade-offs and implementation risks (mechanical, not political)\n\n- Compliance burdens: reporting (Reg 9–10) and minute-keeping (Reg 5) create time and record-keeping costs for providers and committees. Those costs fall on public and private providers who carry out or arrange reportable treatments.\n\n- Potential effects on clinical timing and choice: adding assessment-board involvement, reporting and classification as a restricted treatment can lengthen decision timelines for some procedures and may change provider behaviour (e.g., more cautious thresholds to proceed, or substitution to unregulated alternatives) depending on how the Act implements assessments.\n\n- Concentration of decision power and capture risk: the regulation narrows membership to specified clinical specialties and to a lived-experience representative for one category (Regs 6–8). This clarifies expertise but also concentrates selection choices in appointments; who appoints members (per the Act) and how appointments are made will determine whether the board’s composition is broadly representative.\n\n- Data limitations and trade-offs: the regulation prescribes only two reporting fields (details of each treatment and start date) (Reg 9). That lowers reporting burden but limits the depth of monitoring data available to evaluate outcomes or trends.\n\nWho pays and who decides (mechanics)\n\n- Who pays: health providers and assessment committees absorb the compliance and administrative costs (reporting, minute-taking, meeting time); any supervisory entity set up under the Act bears costs to recruit and maintain board membership per the criteria in Regs 6–8.\n\n- Who decides: appointments to assessment boards are made under powers in the Act (the regulation sets eligibility criteria) and assessment committees apply the Act’s decision rules; the regulation prescribes what kinds of members those decision-makers must include (Regs 6–8) and that committees must keep minutes (Reg 5).\n\nSummary in one sentence\n\n- The regulation narrows the Act’s general scope by excluding five specified conditions from being treated as variations in sex characteristics (while still requiring reporting for those conditions), designates vaginal dilation as a temporary restricted treatment, requires minutes from assessment committees, prescribes minimum qualifications and lived-experience membership for assessment boards, and limits required reporting to the treatment details and start date (Regs 3–10)."}},"importantCases":[],"_links":{"self":"/api/acts/variation-in-sex-characteristics-restricted-medical-treatment-regulation-2023","history":"/api/acts/variation-in-sex-characteristics-restricted-medical-treatment-regulation-2023/history","analysis":"/api/acts/variation-in-sex-characteristics-restricted-medical-treatment-regulation-2023/analysis","conflicts":"/api/acts/variation-in-sex-characteristics-restricted-medical-treatment-regulation-2023/conflicts","importantCases":"/api/acts/variation-in-sex-characteristics-restricted-medical-treatment-regulation-2023/important-cases","documents":"/api/acts/variation-in-sex-characteristics-restricted-medical-treatment-regulation-2023/documents"}}