A/HRC/20/5 violence, in particular sexual violence, can result in significant, long-standing physical and mental health consequences, including permanent injuries, for survivors.37 According to a study published in the Journal of the American Medical Association, among a nationally representative sample of Australian women, gender-based violence was significantly associated with mental health disorder and intellectual disability.38 Harmful practices, such as female genital mutilation and cutting, may also result in a wide range of physical and psychological impairments. IV. Measures to address violence against women and girls with disabilities A. Legislation to address violence against women and girls with disabilities, and risk factors 28. States have clear obligations under international human rights law to enact legislation prohibiting all acts of violence 39 against women and girls with disabilities, including those to which they are more vulnerable, such as forced sterilization, forced institutionalisation and forced abortion. This is important not only to ensure legal protection but also to promote a culture where no form of violence against women and girls with disabilities is tolerated. 29. The Committee on the Rights of Persons with Disabilities has expressed concern about involuntary treatment and involuntary confinement and has recommended States to incorporate into the law the abolition of surgery and treatment without the full and informed consent of the patient, and to ensure that national law respects women’s rights under articles 23 and 25 of the Convention on the Rights of Persons with Disabilities. 40 Other international human rights standards also prohibit forced and coerced treatment of people suffering from intellectual disabilities, regardless of arguments of their “best interests��. The Human Rights Committee has affirmed that special protection is necessary in the case of persons not capable of giving valid consent, and that such persons should not be subjected to any medical or scientific experimentation that may be detrimental to their health.41 Compulsory or forced treatment of persons with disabilities, including women, may amount to ill-treatment and torture.42 The Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health has also stressed that consent to treatment is one of the most important human rights issues relating 37 38 39 40 41 42 10 See Persephone , “Violence against women with a disability”, Antwerp, January 2002, updated in May 2008; and Amnesty International, Democratic Republic of Congo: Mass rape - time for remedies, 25 October 2004. Available fromhttp://www.amnesty.org/en/library/info/AFR62/018/2004. “Lifetime Prevalence of Gender-Based Violence in Women and the Relationship with Mental Disorders and Psychosocial Function”, 2011, pp. 513-521. International law and human rights jurisprudence sets out States responsibilities to exercise due diligence in taking steps to end violence against women. See E/CN.4/2006/61. CRPD/C/TUN/CO/1,, paras. 28-29. General comment No. 20 (1992) on prohibition of torture and cruel treatment or punishment, para. 7. In 2008, the Special Rapporteur on torture and other cruel, inhuman or degrading treatment or punishment articulated in his interim report (A/63/175) that prolonged segregation of people with disabilities from society in institutions, including prisons, social care centres, orphanages and mental health institutions could amount to torture. He also noted that the vulnerability of persons with disabilities means their access to judicial remedies is severely restricted, and that involuntary treatment and involuntary confinement run counter to the provisions of the Convention on the Rights of Persons with Disabilities.