Turei Metiria: Care of Children Bill — Instruction to Committee Procedure In Committee 
Turei Metiria: Care of Children Bill — Instruction to Committee Procedure In Committee 
[Volume:621;Page:16648] 
METIRIA TUREI (Green) 
: 
 The Green Party has put forward an amendment to clause 35 in Part 2 under the name of my colleague Sue Bradford. The amendment concerns the situation where young women are unable to give informed consent to their own sterilisation and puts in place legal protection for them. The amendment states that where a girl is unable to give informed consent a health professional must apply to the Family Court with supporting information from a second health professional identifying clearly that the procedure is medically necessary. The amendment also ensures that the girl has a lawyer to advocate for her interests and her views. This issue was raised by CCS in the select committee and has been of concern to a great number of people for a very long time. 
The fact is that sterilisation of young disabled girls is occurring in this country on non-medical grounds without their informed consent. There are many reasons for this such as families being very concerned because they are unsure how to manage the temperamental issues that arise when a girl gets her period or just general menstrual management issues. Those are serious problems for families but there is no way that we in this country would allow the non-medical sterilisation of non-disabled children yet we do at this time allow non-medical sterilisation of disabled children. In fact that is a discriminatory process and it cannot be justified. 
The New Zealand Disability Strategy 2001 identifies those concerns and its list of actions includes supporting disabled people in making their own choices about their relationships sexuality and reproductive potential; looking at ways to ensure that disabled young people are involved in decision making to give them greater control over their lives; and ensuring that the criteria and considerations in terms of the health and reproductive-related treatment of disabled women are the same as those for non-disabled women. 
The Ministry of Health report from 2002 analysed the prevalence of hysterectomies in young women with intellectual disabilities. In the period between 1997 and 2000 24 patients with intellectual disabilities had a hysterectomy. Eight of those hysterectomies were performed for reasons such as genital abnormalities and cancer. Sixteen had hysterectomies for control of excessive and frequent menstruation. The report does note that in only one of those cases was the girl able to change her own sanitary protection. Those 16 cases were reviewed and in 14 of them the average age for the hysterectomy was 15 years 7 months. The range of ages of the girls at the time of those hysterectomies was 13 years 5 months to 20 years. Of those patients 12 were unable to participate in the decision-making consent process at all two did have limited ability to participate in the consent in only one case was contraception seen as a necessary secondary function and in 11 cases the use of contraception was not mentioned. 
Starship Children’s Hospital has produced a pamphlet on this issue and it notes that most girls and young women with intellectual disabilities can be taught how to manage their own menstrual hygiene perfectly well. One of the difficulties is that most problems with irregular and sometimes heavy periods occur in the first year or two of menstruation. We see hysterectomies being performed on young women in the early years of their menstrual cycle. In fact in cases such as  
Re X 
 in 1990 the courts have allowed hysterectomies of girls before they begin menstruation as a means to control and prevent menstruation in the future. 
Those young disabled women are told that menstruation is a problem that it is a negative thing and a difficulty that has to be fixed. In fact they have a right to control over their own fertility and over their own bodies and the right to be able to engage in their natural reproductive processes if they choose. Menstruation is not a problem and not a negative; it is something that should be understood and recognised as natural to the species.