The EU LGBTIQ Survey III of 2023 collects the responses of 1 920 intersex respondents in 30 countries (EU-27 plus Albania, North Macedonia and Serbia). This makes it the largest survey of its kind about intersex persons, their experiences of discrimination, victimisation and other aspects of life. It can therefore provide valuable data, insights and evidence-based findings that support rights-compliant policymaking for intersex persons. This survey informs in particular the EU LGBTIQ equality strategy 2020–2025, the assessment of its implementation and the preparation of the forthcoming EU LGBTIQ equality strategy for 2026–2030. The European Union Agency for Fundamental Rights (FRA) provides data supporting the EU and the EU Member States in assessing the situation on the ground to design and implement laws, policies and action plans promoting equality within the framework of the EU Strategy.

This report complements the FRA’s work on LGBTIQ equality groups and related laws and policies by going a step further – providing additional data and recommendations focused on the specific legal and policy needs required to ensure the protection of intersex persons’ fundamental rights. It centres on the lived experiences of intersex individuals and the safeguarding and realisation of their rights. It comes one year after the publication of the main findings report from the EU LGBTIQ survey III, LGBTIQ Equality at a Crossroads – Progress and challenges, which addressed a broad range of respondent groups and thematic areas. The present report, Being Intersex in the EU, offers more in-depth insights and expanded data concerning the experiences of intersex people, aiming to deepen understanding of the challenges they face and support the design and implementation of effective policies that guarantee their full equality and enjoyment of rights in society.

Being intersex in the EU often means facing hardships, setbacks and grave rights violations, including discrimination, violence and harassment homelessness, as well as serious health and mental health crises.

This report provides unique data and insights on the plight of an extremely marginalised group of people facing significant discrimination, whose rights are under severe threat. Their experience is important in and of itself but is also revealing of the values and priorities of entire societies by highlighting how they treat such a vulnerable minority.

The report draws on survey results and highlights the most concerning findings, in order to promote a human rights-based approach in law and policy concerning intersex persons. It aims to address significant challenges faced by intersex persons in all areas of life while ensuring the protection and respect of their fundamental rights. Through this work, FRA seeks to assist policymakers in designing and implementing laws and policies that align with European and international human rights frameworks.

The EU LGBTIQ Survey III results show that compared with both the general population and other LGBTIQ survey groups, the intersex respondents suffer disproportionately from discrimination, violence, homelessness, problems with access to healthcare and mental health issues, with many contemplating suicide.

Ten years after the first FRA report on the fundamental rights situation of intersex people examined the legal situation in the Member States in 2015, this report seeks to support rights-compliant policymaking to advance the rights of intersex persons.

This report focuses on the most notable results and trends compared with the previous survey conducted in 2019. It begins with alarming results about violence, harassment and discrimination experiences, and addresses the issues of ‘conversion’ practices, access to healthcare and mental health. It also explores homelessness, school experiences and problems in dealing with administrative authorities. Finally, it describes how intersex persons perceive the current situation, along with their views about their governments’ efforts to support and protect them.

The LGBTIQ Survey III collect the life experiences and views of respondents who identified themselves as ‘intersex’. Intersex persons are born with innate variations of sex characteristics (SC) – such as sexual anatomy, reproductive organs, hormonal structure and/or levels and/or chromosomal patterns – that do not fit the typical definition of female or male. The term ‘intersex’ is an umbrella term for the variations in sex characteristics that occur naturally; it acknowledges that sex is a spectrum and that people with variations in sex characteristics other than male or female exist.

While many intersex persons also identify with other LGBTQ identities, it is important to recognise that intersex is distinct from gender identity and expression (GIE) or sexual orientation (SO). Not all persons with innate variations of sex characteristics identify with the term ‘intersex’. The LGBTIQ Survey III collected the life experiences and views of respondents who identified themselves as intersex after they were provided with detailed information (question A8 of the survey questionnaire was developed in cooperation with Organisation Intersex International Europe (OII)):

• A8. [ASK ALL] Some persons are born with sex characteristics (like sexual anatomy, hormone levels, reproductive organs, and/or chromosome patterns) that do not fit societal and medical definitions of female or male bodies. This is known as ‘being intersex’ or ‘being a person born with variations of sex characteristics’.
• Would you describe yourself as intersex? Yes/No
• [INFO BUTTON: Innate variations of sex characteristics can present themselves prenatally and at birth but also during childhood, in puberty or in adulthood. You might have noticed a variation of your sex characteristics at a very early age or later on in life, and you may have had surgical and/or medical procedures and/or hormonal treatment to modify them.]
• This question asks about innate variations of sex characteristics, not about being trans and/or a trans identity or experience.

The survey background research aimed at setting the survey target samples estimated intersex people to be approximately 0.02 % of the general population. For more information, see the FRA Technical Report – EU LGBTIQ Survey III.

In the survey, intersex respondents were also able to select what best matches their SO and the category that best fits their current GIE. This often results in unique and intersecting identities as perceived by the individual and society, regarding gender, sexual orientation and sex characteristics. The sexual orientation, gender identity and expression and sex characteristics (SOGIESC) profiles of intersex persons often diverge from widely accepted societal norms and social expectations. As shown below, in terms of gender identity, the majority (65 %) of intersex respondents identified as trans or non-binary and gender-diverse and, in terms of sexual orientation, the majority (95 %) identified as lesbian (18 %), gay (19 %), bisexual (23 %), asexual (17 %), pansexual (9 %) or other (8 %). In this sense, the intersex respondents are representative of the wider LGBTIQ community and their life experiences are emblematic of its claim and fight for equality.

FRA data show that the SOGIESC profile, along with socioeconomic and minority identities, can lead to direct and indirect discrimination, harassment, hate speech and hate crime. This report uses an intersectional lens to present the data and disaggregate them, where possible or applicable, on the basis of the SOGIESC and the socioeconomic elements or belonging of the intersex respondents.

More about intersectionality can be found at the end of the report in the Annex Terminology - glossary.

The intersex survey respondents are presented below under their different SOGIESC profiles. As Table 1 shows, many intersex survey respondents selected ‘bisexual’ (23 %) or ‘asexual’ (17 %) as the sexual orientation best matching their own.

Table 1 – Intersex EU LGBTIQ Survey III respondents by sexual orientation

Source: EU LGBTIQ Survey III (2023), European Union Agency for Fundamental Rights.

Table 2 shows that close to half of the intersex survey respondents (41 %) selected gender identities that are grouped under ‘non-binary and gender-diverse’, thus defined in a non-binary way and distancing from the female–male dipole, such as non-binary, genderqueer, gender-fluid, agender, poly-gender or cross-dressing woman or man. Just above one third of intersex respondents (35 %) are cisgender women or men and 22 % are trans women or men.

More detailed terms are available at the end of the report in the Annex Terminology – glossary.

Table 2 – Intersex EU LGBTIQ Survey III respondents by gender identity

Source: EU LGBTIQ Survey III (2023), European Union Agency for Fundamental Rights.

The EU LGBTIQ survey III reveals a variety of SOGIESC profiles of intersex respondents. Some respondents’ SOGIESC subgroups indicate distinct life experiences and harsher realities. The most numerous SOGIESC profiles of intersex respondents were those of intersex gay men (12 %), intersex pansexual non-binary and gender-diverse (11 %) and intersex bisexual non-binary and gender-diverse (8 %). This report provides insights into these experiences, comparing the respective statistics with other LGBTIQ survey groups and the general population.

This report does not include further cross-tabulations of the intersecting SOGIE identities of intersex respondents – given that in some cases the individual SOGIESC respondent samples are too small and below a statistically acceptable threshold – in order to avoid misleading generalisations about some respondent subgroups.

However, we can safely present intersex respondent subgroups with a sufficient sample size:

• 40 % of lesbian intersex survey respondents are cisgender intersex women, while
• 37 % are non-binary and gender-diverse intersex and 18 % are trans intersex women;
• the majority (62 %) of gay intersex respondents are cisgender intersex men, while 23 % are non-binary and gender-diverse intersex;
• more than one in three (36 %) of bisexual intersex respondents are non-binary and gender-diverse intersex while 27 % are cisgender intersex women;
• non-binary and gender-diverse intersex respondents are the majority (two out of three or 65 %) of pansexual intersex respondents and 62 % of asexual respondents.

More detailed terms are available at the end of the report in the Annex Terminology – glossary.

The EU LGBTIQ Survey III constitutes a first and unique data collection, in that it achieved a large sample of intersex persons in 30 countries (1 825 intersex respondents in the EU-27 and 1 920 intersex respondents in all 30 survey countries that also include Albania, North Macedonia and Serbia). It comprises the largest amount of data gathered globally on intersex persons and their life experiences, experiences of discrimination and victimisation, and the impact on their fundamental rights.

The survey was conducted online from 2 June to 22 August 2023. The questionnaire covers a wide range of issues, such as experiences of discrimination, harassment or violence, rights awareness, openness about being LGBTIQ, positive and negative life experiences at work and in education, socioeconomic and living conditions, healthcare, mental health and well-being, as well as housing and homelessness.

The data are statistically weighted to take account of differences in the estimated size of each LGBTI group in each survey country and by age group, based on information on the LGBTI population from previous LGBTI surveys by various EU institutions and organisations. In addition, the data are weighted to account for the respondents’ affiliation with LGBTI organisations and whether they have participated in other LGBTI surveys (including FRA’s 2012 LGBT survey).

Where possible, this report compares the 2023 EU LGBTIQ Survey III results with those of the 2019 EU LGBTI Survey II. For these comparisons, FRA uses only data from respondents and countries covered in both surveys. This includes LGBTI people aged 15 and older from the EU-27, North Macedonia and Serbia. Respondents from Albania are not included as the country was not part of the 2019 LGBTIQ II Survey. The data have been adjusted using statistical methods to ensure the groups being compared are as similar as possible. As a result of the differences in the survey samples in 2019 and 2023, some percentage figures may vary slightly depending on whether they refer to the full 2023 survey results or to the specifically adjusted data used for comparison. Further details are provided in the technical report of the EU LGBTIQ Survey III.

Ten years after the publication of FRA’s report, The fundamental rights situation of intersex persons, its key conclusions still hold and are confirmed by the survey results of the most recent EU LGBTI(Q) surveys from 2019 and 2023: legal and medical professionals should be better informed of the fundamental rights of intersex persons, particularly children, and Member States should prohibit non-consensual ‘sex-normalising’ medical treatments on intersex persons.

Recent legal and policy developments in the EU reveal an increasingly comprehensive approach to the problems that still afflict intersex persons. The European Parliament resolution on the rights of intersex persons (2019) represented a milestone: it explicitly condemns intersex genital mutilation (IGM) and calls for an end to medically non-vital interventions on intersex children, urging comprehensive legal protections in the Member States. The adoption of the EU LGBTIQ equality strategy 2020–2025 confirmed the EU’s commitment to promoting intersex rights, including to bring an end to IGM and protect bodily integrity, emphasising the need for Member States to prohibit non-consensual medical interventions. More recently, the inclusion of sex characteristics in the new EU directive on minimum standards for equality bodies in 2024 reflects another relevant and significant advance in EU legislation.

While these developments signal the emergence of a human rights-based approach to intersex persons, there is much more still to be done. Several Member States have begun implementing policies to protect intersex rights, such as prohibiting IGM and providing access to specialised healthcare and support services, and five Member States have now banned non-consensual genital modification practices performed on intersex minors (Germany, Greece, Malta, Portugal and Spain). These developments augur well for more effective protection of intersex rights, ensuring the rights to self-determination and to bodily autonomy and integrity.

In recent years, sex characteristics have been acknowledged by more Member States as constituting a ground for protection against discrimination or hate crime bias motivation. Seven Member States include this ground in their anti-discrimination legislation (Belgium, Denmark, Finland, Greece, Malta, Netherlands, Spain). Eight Member States include the ground as a hate crime bias motivation (Belgium, Denmark, Germany, Greece, Ireland, Malta, Netherlands, Spain).

Eight Member States have banned ‘conversion therapies’ and/or the advertisement thereof (Belgium, Cyprus, France, Germany, Greece, Malta, Portugal, Spain), while the EU LGBTIQ equality strategy aims at fostering exchange between countries to end such harmful practices as ‘deeply harmful interventions that rely on the medically false idea that LGBT and other gender-diverse people are sick, inflicting severe pain and suffering, and resulting in long-lasting psychological and physical damage’. A European citizens’ initiative, which by May 2025 had gathered 1 245 839 signatures, calls on the European Commission to propose a binding legal ban on conversion practices targeting LGBTQ+ citizens.

More Member States now provide a path to legal gender recognition with variations in the applicable legal and administrative framework – only Bulgaria and Hungary do not provide any possible pathway.

However, several EU, regional and international institutions and bodies are urging Member States to take a stronger stance, by adopting and implementing more effective law and policy to protect the rights of intersex persons, with some evincing a human rights-based approach.

• The Parliamentary Assembly of the Council of Europe resolution ‘Promoting the human rights of and eliminating discrimination against intersex persons’ (2017), calling for the protection of intersex children and the prohibition of medically non-necessary ‘sex-normalising’ surgeries and treatments without their free, prior and fully informed consent.
• The European Commission against Racism and Intolerance (ECRI) ECRI General Policy Recommendation N°17 (2023) on preventing and combating intolerance and discrimination against LGBTI people, including a specific recommendation to ban IGM.
• The UN Human Rights Council A/HRC/55/L.9 Resolution Combating discrimination, violence and harmful practices against intersex persons (2024), expressing grave concern about the violence and harmful practices that persons with innate variations in sex characteristics, including children, face in all regions of the world, including medically unnecessary or deferrable interventions, which may be irreversible, with respect to sex characteristics, performed without the full, free and informed consent of the person and, in the case of children, without complying with the provisions of the Convention on the Rights of the Child.
• The Office of the United Nations High Commissioner for Human Rights ‘Technical Note on The Human Rights Of Intersex persons: Human Rights Standards And Good Practices’ (2023), providing an overview of the international human rights norms and standards and relevant recommendations of UN human rights mechanisms and good practices by States in relation to the human rights of intersex persons.
• The UN Special Rapporteur on torture and other cruel, inhuman or degrading treatment or punishment, Nils Melzer, report ‘Relevance of the prohibition of torture and other cruel, inhuman or degrading treatment or punishment to the context of domestic violence’ (2019), stressing that ‘conversion therapy’ can inflict severe pain or suffering, given also the absence both of a medical justification and of free and informed consent, and that it is rooted in discrimination based on sexual orientation or gender identity or expression, such practices can amount to torture or, in the absence of one or more of those constitutive elements, to other cruel, inhuman or degrading treatment or punishment.
• The Independent Expert on protection against violence and discrimination based on sexual orientation and gender identity report ‘Practices of so-called “conversion therapy”’ (2020) to the UN Human Rights Council, calling for a ban on the practices of ‘conversion therapy’ clearly establishing, through appropriate legal or administrative means, a definition of prohibited practices of ‘conversion therapy’, and ensuring that public funds are not used, directly or indirectly, to support them. Inter alia he also called for a ban on advertising of ‘conversion therapy’ and a system of sanctions for non-compliance.

The EU LGBTIQ Survey III findings presented in this report consistently reflect the human rights concerns which these measures are designed to address.