Introduction The informed and compassionate care provided by medical healthcare professionals is key to the wellbeing of LGBTQIA+, takatāpui Māori and MVPFAFF+ Pasifika communities. Te Kāhui Tika Tangata Human Rights Commission (the Commission) is providing this guidance on conversion practices as a way to support this invaluable work. What conversion practices are not It is not a conversion practice to do any of the following providing there is no intention to change or suppress an individual’s sexual orientation, gender identity or gender expression: • a parent or guardian respectfully discussing sexuality or gender with their child – including offering advice and guidance or expressing a belief or religious principle • a medical practitioner delaying hormone treatment to allow for the development of a plan for gender affirming healthcare, or for activities, such as counselling. Practitioners need to act within legal, professional and ethical standards and exercise reasonable professional judgement • a religious leader preaching, praying for, or providing pastoral care for someone a questioning their sexuality or gender. What are conversion practices? Conversion practices are actions taken towards an individual with the intention changing or suppressing their sexual orientation, gender identity or gender expression.i They are sometimes referred to as ‘conversion therapy’. These practices are typically directed at members of the LGBTQIA+, takatāpui Māori and MVPFAFF+ Pasifika communities. They reflect a belief system, known as conversion ideology, which asserts that being part of these communities is wrong and can be changed.ii Even though conversion practices may appear to provide short term results they inevitably failiii and cause significant harm. Evidence, internationally and in Aotearoa New Zealand, shows survivors of conversion practices experience mental distress, withdrawal and isolation, negative career impacts, physical health symptoms, and suicidal thoughts, plans or attempts.iv Research published in Aotearoa in 2023 has found young people experiencing conversion practices: • had increased frequency of non-suicidal self-injury • had double the chance of planning suicide • had triple the chance of attempting suicide.v Transgender, non-binary, and gender diverse people in Aotearoa have higher exposure to conversion practices. Examples of conversion practices 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 • performing a ritual, such as an exorcism or prayerbased practice to change or suppress someone’s sexual orientation, gender expression or gender identity.vi Often conversion practices are difficult to recognise because they are disguised as non-threatening, for example as a group study, mentoring and counselling or as camps or courses. They can be formal and informal, and include practices directed by others or selfimposed.vii 22 It is also not a conversion practice to: • assist someone who is undergoing, or considering undergoing, a gender transition • assist someone to express their gender or identity • provide acceptance, support or understanding of an individual. Where conversion practices happen Medical, counselling and psychotherapy settings can be contexts for conversion practices in Aotearoa.viii For example, a medical practitioner may withhold or delay necessary gender affirming healthcare, or use counselling or psychotherapy techniques to suppress a person’s sexual orientation, gender identity or gender expression. See section Conversion practices in healthcare settings. Some people may engage in, or be pressured to engage in, conversion practices because of deeply held religious beliefs. Others may because their cultural norms prioritise heterosexual relationships and traditional gender roles. For example, in some cultures it is seen as essential to marry and have children in a heterosexual relationship to show respect to your parents. Christianity is a common context for conversion practicesix and it can be linked to cultural norms in other settings such as family and community. This is due, in part, to the historical influence of Christianity and its ongoing role in shaping community beliefs, identities and narratives about what is ‘acceptable’. Conversion Practices Guidance for medical healthcare professionals