The 2026 census does not include a question asking respondents if they or household members were born with variations of sex characteristics.
Innate variations of sex characteristics are also known as intersex variations, differences of sex development, or individual diagnostic terms. People with intersex variations have any of a large number of individual traits, with more than 40 diagnoses, and around 100 genes influencing their development (Délot and Vilain 2021). The population of people with innate variations of sex characteristics is small, with a figure of up to 1.7% frequently quoted (Délot and Vilain 2021).
The census will include questions on sex registered at birth, gender, and sexual orientation but, without a separate question on innate variations of sex characteristics, it is not possible to count people with these variations.
A question on sex cannot count people with intersex variations
Each trait is associated with its own sex registration (as female or male) at birth, typical age of diagnosis, and typical treatment pathways. Traits can be identified and diagnosed prenatally, at birth, during puberty or at other times, such as when trying to conceive a child.
A 2022 endocrinology textbook describes factors influencing sex assignment – when diagnosis is made at or before birth – as follows:
Factors that influence sex assignment include the diagnosis, genital appearance, surgical options, need for lifelong replacement therapy, the potential for fertility, views of the family and sometimes, circumstances relating to cultural practices (Ahmed and Ali 2022).
The evidence available to us is that children in Australia are registered female or male, even in the small number of jurisdictions that have introduced additional classifications. This is unsurprising when sex registration is a clinically-informed process, clinicians use diagnostic language, and parents are frequently distressed (Carpenter 2018).
Importantly, sex registration does not necessarily align with sex chromosomes, SRY gene, gametes, or any other single sex characteristics. The textbook quote above shows that a set of other factors come into play: diagnosis, genital appearance, parental and cultural perspectives, and “surgical options” (Ahmed and Ali 2022).
Sex registration itself is not the main concern that intersex community controlled organisations in Australia have with this process of sex determination and classification; their main concerns are around the agency of individuals to consent to elective medical interventions (“surgical options”) that are now the subject of regulation in the ACT and Victoria.
These concerns with personal agency and consent lead to the ethical position that sex registered at birth should be respected, unless and until an individual themself seeks to change their sex marker. Individuals should not be reclassified – either as individuals or a cohort – to other categories of sex or gender.
It follows from this that is it not appropriate to add the terms intersex or indeterminate as response fields in questions about an individual’s sex.
Instead, community controlled organisations have sought precision and clear wording in asking a question that can be consistently answered irrespective of sex characteristics. A question on “sex recorded at birth” allows for this clarity and consistency.
Previous attempts to include intersex in Australian census questions on sex have failed to produce meaningful information (Australian Bureau of Statistics 2022).
A question on gender cannot count people with intersex variations
People with innate variations of sex characteristics can grow up to live in or identify with sex registered at birth (“cisgender”) or may have a different identity (“gender diverse”).
Intersex community controlled organisations in Australia take the ethical position that either outcome is acceptable and should be respected.
It follows from this that inclusion of a question on gender in the census is appropriate.
Intersex community controlled organisations do not support inclusion of intersex or indeterminate as response fields in questions on gender as people with intersex variations have as diverse a range of genders as the rest of the population.
A separate question on variations of sex characteristics is necessary
Because people with innate variations of sex characteristics have no singular way of responding to questions on sex or gender, it is necessary to ask a separate question.
The Australian Bureau of Statistics (ABS) Standard for Sex, Gender, Variations of Sex Characteristics and Sexual Orientation Variables, 2020 does this (Australian Bureau of Statistics 2021). It includes a variable “variations of sex characteristics”. All variables have been used in national surveys, including surveys used to calculate the percentage of Australians who know they have innate variations of sex characteristics (Australian Bureau of Statistics 2024b).
This variable was not recommended for inclusion in the 2026 census by the ABS. Our understanding is that:
- People with innate variations of sex characteristics who know they have a variation are able to consistently answer a question on innate variations of sex characteristics.
- The diversity of terms used to accurately describe innate variations of sex characteristics, and avoid conflation with other populations, is unfamiliar to most people.
- People without have innate variations of sex characteristics frequently don’t understand why a separate question (to questions on sex and gender) is needed.
- Adding a question is costly.
People with innate variations of sex characteristics – including Morgan Carpenter and Alastair Lawrie – were part of the ABS LGBTIQ+ Expert Advisory committee. They resigned at the point when the government ruled out inclusion of the question. It quickly became apparent that we were lobbying for inclusion of a question that the ABS had not recommended. The government also rejected further testing.
The Interconnect Health team hope that the ABS will continue to test and refine questions on innate variations of sex characteristics.
Without a specific question, we will not have adequate information on the health and well-being of this small but distinct population.
Addressing government sources of misinformation
Finally, public confusion is unsurprising when the federal government is itself a key source of misinformation. Since publication of guidelines by the then Attorney-General in 2013, the words intersex and indeterminate have been included in the definition of a third gender, X, even while the same guidelines recognise that intersex people have diverse bodies and identities.
Intersex and other organisations have been calling for change to this definition since they were published (see for example National LGBTI Health Alliance et al 2015, Carpenter 2025). The 2020 ABS Standard has not yet displaced these guidelines.
The ability to conduct research on this population would benefit from clear and consistent messaging from governments about who the population are. It follows from this that the federal government must address its own role in public confusion and misunderstanding.
Legacies of clinical non-disclosure
A history of non-disclosure of diagnosis and clinical histories to people with innate variations of sex characteristics means that many people who have intersex variations don’t know they have a variation (Carpenter 2024). This means that individuals can lack words to name their experiences; this should not be taken to imply that individuals avoid social or physical impacts due to their trait or medical history.
This cohort cannot respond affirmatively to any question on innate variations of sex characteristics, however it is worded.
Misinformation about intersex has particular adverse impacts on this population, as misinformation frames intersex as a matter of gender and identity, rather than a word for their experience of the body. Misinformation does not only impact data collection, it also impacts access to community and informed psychosocial support
How should people with intersex variations answer the census?
The Interconnect Health team recommend completion of the census, with each individual entering actual sex registered at birth and gender.
Interconnect Health team members and community partners will continue to lobby for meaningful inclusion in the future of a question that works for this population cohort.
More information
- The government statement on non-inclusion of the question (Leigh 2024)
- ABS report on testing results for the proposed question on innate variations of sex characteristics (Australian Bureau of Statistics 2024a)
References
Ahmed, S. Faisal, and Salma R. Ali. 2022. ‘Disorders of Sex Development (DSD) in the Newborn’. In Oxford Textbook of Endocrinology and Diabetes 3e, edited by John A.H. Wass, Wiebke Arlt, and Robert K. Semple, 3rd edition, 1169–85. Oxford, UK: Oxford University Press. https://doi.org/10.1093/med/9780198870197.003.0186
Attorney General’s Department. 2015 update. Australian Government Guidelines on the Recognition of Sex and Gender. http://www.ag.gov.au/Publications/Pages/AustralianGovernmentGuidelinesontheRecognitionofSexandGender.aspx
Australian Bureau of Statistics. 2021. ‘Standard for Sex, Gender, Variations of Sex Characteristics and Sexual Orientation Variables, 2020’. January 14. https://www.abs.gov.au/statistics/standards/standard-sex-gender-variations-sex-characteristics-and-sexual-orientation-variables/latest-release
Australian Bureau of Statistics. 2022. ‘Analysis of Non-Binary Sex Responses’. September 27. https://www.abs.gov.au/articles/analysis-non-binary-sex-responses
Australian Bureau of Statistics. 2024a. ‘Testing of Questions on Gender, Sexual Orientation and Variations of Sex Characteristics’. September 13. https://www.abs.gov.au/census/census-media-hub/releases-and-statements/on-the-record/testing-questions-gender-sexual-orientation-and-variations-sex-characteristics
Australian Bureau of Statistics. 2024b. ‘Estimates and Characteristics of LGBTI+ Populations in Australia, 2022’. December 19. https://www.abs.gov.au/statistics/people/people-and-communities/estimates-and-characteristics-lgbti-populations-australia/latest-release
Carpenter, Morgan. 2018. ‘Intersex Variations, Human Rights, and the International Classification of Diseases’. Health and Human Rights 20 (2): 205–14. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6293350/
Carpenter, Morgan. 2024. ‘Fixing Bodies and Shaping Narratives: Epistemic Injustice and the Responses of Medicine and Bioethics to Intersex Human Rights Demands’. Clinical Ethics 19 (1): 3–17. https://doi.org/10.1177/14777509231180412
Carpenter, Morgan, to Michelle Rowland. 2025. ‘Addressing Misinformation and Protecting the Rights of Intersex People’. InterAction. https://interaction.org.au/resource/letter-to-attorney-general-michelle-rowland/
Délot, Emmanuèle C., and Eric Vilain. 2021. ‘Towards Improved Genetic Diagnosis of Human Differences of Sex Development’. Nature Reviews Genetics, no. 22: 588–602. https://doi.org/10.1038/s41576-021-00365-5
Leigh, Andrew. 2024. ‘New Topic in the 2026 Census’. Australian Government Treasury Ministers, Treasury Ministers, September 8. https://ministers.treasury.gov.au/ministers/andrew-leigh-2022/media-releases/new-topic-2026-census
National LGBTI Health Alliance, A Gender Agenda, Organisation Intersex International Australia, Trans Formative, and Transgender Victoria. 2015. ‘RE: Commonwealth Attorney-General’s Department Review of the Australian Government Guidelines on the Recognition of Sex and Gender’. To Attorney General’s Department. September 24. https://interaction.org.au/resource/joint-submission-federal-sexgender-guidelines/