A/HRC/29/23 family member for fear of the criminal ramifications of revealing their sexual orientation. Lesbians, bisexual women and transgender persons are often especially at risk owing to gender inequalities and restrictions on autonomy in decision-making about sexuality, reproduction and family life.117 8. Recognition of relationships and related access to State and other benefits 67. While States are not required under international law to recognize same-sex marriage,118 the Committee on Economic, Social and Cultural Rights has called upon States to provide for legal recognition of same-sex couples.119 As at April 2015, 34 States offered same-sex couples either marriage or civil unions, which bestow many of the same benefits and entitlements as marriage.120 Wherever States provide benefits such as pension and inheritance entitlements for unmarried heterosexual couples, the same benefits should be available to unmarried homosexual couples. 121 68. Lack of official recognition of same-sex relationships and absence of legal prohibition on discrimination can result in same-sex partners being treated unfairly by private actors, including health-care providers and insurance companies. The United Nations Children’s Fund (UNICEF), the Committee on the Rights of the Child and the Inter-American Court of Human Rights have expressed concern at discrimination against, and the lack of legal protection of, children of same-sex couples.122 9. Gender recognition and related issues 69. In spite of recent advances in several countries, transgender persons are generally still unable to obtain legal recognition of their preferred gender, including a change in recorded sex and first name on State-issued identity documents. As a result, they face multiple rights challenges, including in employment and housing, applying for bank credit or State benefits, or when travelling abroad. 70. Regulations in States that recognize changes in gender often impose abusive requirements as a precondition of recognition – for example, by requiring that applicants be unmarried and undergo forced sterilization, forced gender reassignment and other medical procedures, in violation of international human rights standards. 123 117 118 119 120 121 122 123 18 See A/68/290, para. 38, A/HRC/20/16/Add.4, para. 20, A/HRC/22/56, para. 70, A/HRC/26/38/Add.1, para. 19. See CCPR/C/75/D/902/1999. E/C.12/BGR/CO/4-5, para17; E/C.12/SVK/CO/2, para. 10. ILGA, State-sponsored Homophobia (see footnote 70), pp. 26-28. See CCPR/C/CHN/HKG/CO/3, para. 23, CCPR/C/78/D/941/2000, para. 10.4, CEDAW/C/SRB/CO/2-3, para. 39(d); also European Court of Human Rights, applications 29381/09 and 32684/09, 7 November 2013, paras. 79-81. See CRC/C/GC/15, para.8 and CRC/C/GAM/CO/2-3, paras. 29-30; and “Eliminating discrimination against children and parents based on sexual orientation and/or gender identity”, UNICEF, position paper no.9, 2014, and Inter-American Court of Human Rights, Atala Riffo and daughters v. Chile, 24 February 2012. See CCPR/C/IRL/CO/4, para. 7, CCPR/C/UKR/CO/7, para. 10, A/HRC/22/53, para. 88; also “Eliminating forced, coercive and otherwise involuntary sterilization: an interagency statement”, OHCHR, UN-Women, UNAIDS, UNDP, UNFPA, UNICEF and WHO, 2014.