Conversion practices in healthcare settings 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. Although not included in the legislation intersex people also experience a range of harmful practices. These can include undergoing medically deferable surgeries before they are old enough to understand or consent to them. The Darlington Statement, a joint statement by intersex organisations from Aotearoa and Australia, calls for the banning of these surgeries, alongside other measures to protect the rights and bodily autonomy of intersex people.xxii 66 In Aotearoa, clinicians are not legally allowed to coercexxiii. They must provide services that minimise the potential harm to, and optimise the quality of life of, each patientxxiv. The Royal New Zealand College of General Practitioners has publicly condemned conversion practices.xxv 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. In situations where patients have a significant sense of urgency for gender-affirming treatment, it may be appropriate to unpack the reason for the urgency, while affirming the need. Take care as ‘slowing down’ should not be used as a tactic to deny patients the care they require. If you are unable or unwilling to provide affirming care, it is vital to refer a patient to someone who can. Conversion Practices Guidance for medical healthcare professionals