Els Leye and Ino Kehrer 119 ments”54. The Special Rapporteur affirmed that non-therapeutic, intrusive, and irreversible treat­ ment might constitute torture or ill-treatment when enforced without the free and informed consent of the person concerned55. Indeed, informed consent is, as the Special Rapporteur states, “a fundamental feature to guarantee the respect of individual’s autonomy, self-determination and human dignity”56. In particular, informed consent has to be guaranteed to avoid torture or ill-treat­ ment where the situation presupposes powerlessness of the victim, which is the case when a per­ son is controlled by another. This situation can occur in health care settings, were patients rely on the judgment and skills of health care professionals, and in the case of FGM performed on minors, consent is given by parents. However, in countries where FGM is common practice, health pro­ fessionals might adhere to the same social norms that perpetuate FGM, and as such, might not question its performance. Furthermore, in line with a 2011 report by the United Nations High Commissioner for Human Rights57, in which concerns were raised about health care practices and violence based on sexual orientation and gender identity, the Special Rapporteur on Torture, stated that informed consent has to be prioritized in order to guarantee the right to health of vulnerable groups such as lesbi­ ans, gay, transsexuals, and intersex persons. The Special Rapporteur recommends repealing any law allowing intrusive and irreversible treatments, including forced genital-normalizing surgery, involuntary sterilization, unethical experimentation, medical display, and “reparative therapies” or “conversion therapies”, when enforced or administered without the free and informed consent of the person concerned. Moreover, to ensure a gender-sensitive approach toward the torture pro­ tection framework, he identified some reproductive-rights practices in health care settings that amount to torture or ill-treatment, including FGM. In the report, the Special Rapporteur recalled that States have the obligation to regulate, control, and supervise health care practices with a view to preventing mistreatment under any pretext. The Committee against Torture and the InterAmerican Court of Human Rights have confirmed that States have the particular obligation to ensure special protection of minorities as well as marginalized groups and individuals from tor­ ture, as such persons are generally more at risk of experiencing torture and ill-treatment. An example of how a State could act with regard to such obligations is Italy’s law against FGM. Law no. 7/200658introduced article 583 bis and 583 ter into Italy’s criminal code,59 and serve to prevent and prohibit FGM. Article 583 bis establishes FGM as a specific crime. The first paragraph of this article provides for imprisonment from four to twelve years for perpetrators who cause the mutilation of a female genital organ for no therapeutic reason. The second paragraph provides for imprisonment from three to six years for those who, without therapeutic reason, cause injuries to female genital organs, other than those referred to in the first paragraph, with the purpose to impair females’ sexual functions. In both cases, the sanction increases by one-third if the victim is 54 A/HRC/22/53, Report of the Special Rapporteur on torture and other cruel, inhuman or degrading treatment or punishment, Juan E. Méndez, 2013. 55 A/HRC/22/53, Report of the Special Rapporteur on torture and other cruel, inhuman or degrading treatment or punishment, Juan E. Méndez, 2013. 56 A/HRC/22/53, Report of the Special Rapporteur on torture and other cruel, inhuman or degrading treatment or punishment, Juan E. Méndez, 2013. 57 A/HRC/19/41. 58 Law 7/ 2006, 9 January 2006, Provisions concerning the prevention and prohibition of female genital mutilation (Legge 9 Gennaio 2006, n.7, Disposizioni concernenti la prevenzione e il divieto delle pratiche di mutilazioni). 59 Italian Criminal Code (approved by Royal Decree No. 1398 19 October, 1930).