Trans Rights Archives - Gender Minorities Aotearoa

Conversion Practices Guidance for medical healthcare professionals

The New Zealand Human Rights Commission (HRC) has published clear guidance about which medical practices will be considered conversion practices.

The law says that medical practices are only legal if they are BOTH 1.) according to a medical practitioner’s “reasonable professional judgement” and 2.) in compliance with all legal, professional, and ethical standards. Otherwise they are punishable.

The guidance from the HRC clarifies ethical standards, which will help HRC and the courts clearly determine which medical practices are unethical, unreasonable, and not up to professional standards.

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Conversion practices

“Conversion practices in healthcare settings are typically non-affirming practices directed towards an individual because of their sexual orientation, gender identity or gender expression. These could look like:

• using shame or coercion to discourage someone from seeking gender-affirming care

• expressing the belief that being transgender is an illness and suggesting counselling to ‘fix it’

• creating delays to obstruct access to genderaffirming healthcare

• knowingly referring someone to a non-affirming healthcare provider.”

(The last point would include being knowingly referred to a non-affirming counsellor or therapist).

“If the provision of treatment is hindered by a belief that having a minority sexual orientation, gender identity or gender expression is wrong and needs ‘healing’ it is likely to be a conversion practice.”

“If you are unable or unwilling to provide affirming care, it is vital to refer a patient to someone who can.”

“In Aotearoa, patients have the right “to services of an appropriate standard”. This means that all people seeking gender affirming healthcare should be able to access it. Guidelines for gender affirming healthcare in Aotearoa, and internationally, show that timeliness is vital and deliberate delays such as the ‘watchful waiting’ approach exacerbate gender dysphoria, mental health problems and other negative and avoidable outcomes.”

“People aged 16 and over are considered old enough to provide medical consent for themselves under the Care of Children Act 2004.”

This document does also mention “readiness assessments,” in the context of readiness assessments being required for “any medical procedure.”

Another complexity is that the document mentions that counselling can be a conversion practice, but also says that delaying hormone treatment for “activities, such as counselling” is not a conversion practice. However, there are also clear guidelines for mental health professionals.

Mental health professionals

“Conversion practices include but are not limited to:

• using shame, coercion or other tactics to give someone an aversion to same-sex attractions or to encourage gender-conforming behaviour

• encouraging someone to believe their sexuality or gender is defective or disordered”

“When conversion practices occur in mental healthcare settings they typically do not support an individual in their sexual orientation, gender identity or gender expression. These could look like:

• counselling to try and change or suppress sexuality or gender expression

• hypnotherapy to attempt to reorient sexuality

• deliberate referral to non-affirming healthcare providers”

“Conversion practices also occur in medical, counselling and psychotherapy settings, for example a practitioner may withhold necessary gender affirming healthcare or use counselling to suppress a person’s sexual orientation, gender identity or gender expression.”

“Q. How should I deal with differences of opinion between a young client and their parent or caregiver when it comes to conversion practices?

A: Conversion practices cause significant harm to the person experiencing them and are unlawful. Treat this as a situation where the risk of harm – and the law – requires appropriate escalation.”