clinicians in the health sector.192 Hui participants spoke of the legacy of distrust they have towards the medical profession, and experiences of avoiding necessary healthcare.193 As noted by the World Health Organization, “[e]xcluding anyone from accessing needed health services results in preventable ill health.”194 For people with a diverse sexual orientation, gender identity and expression, or sex characteristics, health professionals are often not the trusted authorities they are supposed to be, but a source of anxiety, stress, and trauma.195 This was particularly a concern for the disabled SOGIESC-diverse people the Commission spoke with. This distrust stems from an inadequate understanding of the unique experiences and health needs of people with a diverse SOGIESC.196 Practitioners and healthcare providers may not hold accurate or contemporary knowledge about providing sensitive medical care, or may lack specific training on the needs of SOGIESC-diverse people.197 This deters these communities from seeking essential healthcare services.198 Aged care There are distinct health-related issues facing older adults with a diverse SOGIESC. During a community consultation with older adults in 2019, issues were raised with the Commission about discrimination against this group. Participants provided examples of same sex partners being separated in residential care and pressure put on older trans people to transition back.199 With a growing ageing population, New Zealand’s aged care facilities must consider diversity in their clients’ SOGIESC, including how personal care needs are met and end-of-life decisions are made.200 Privacy also plays a significant role in the wellbeing and lives of older adults with a diverse SOGIESC.201 Consistent with New Zealand research,202 the attitudes of some aged care workers can result These experiences are likely related to the fact that New Zealand’s undergraduate medical school curricula do not include compulsory SOGIESC topics. Crowded curriculums are cited as a barrier, and education directors are constantly having to triage the information taught in the syllabus. See, for example, Gloria Fraser Queer and trans experiences of accessing mental health support in Aotearoa: Summary of findings for participants and community advisors (Victoria University of Wellington, Wellington, June 2018). The 2010 Trans Pulse survey found that in Ontario, Canada, 21% of trans patients avoid accessing emergency medical services due to fear of transphobia. See Greta Bauer and Ayden Scheim Transgender people in Ontario, Canada: Statistics from the Trans PULSE Project to inform human rights policy (Trans PULSE Project, London, Ontario, 2015); see also Terryann Clark and others “Youth’12 Overview: The health and wellbeing of New Zealand secondary school students in 2012” (University of Auckland, Auckland, 2013). 193 Auckland, Wellington, and Christchurch stakeholder engagement meeting notes are publicly available. See New Zealand Human Rights Commission “Universal Periodic Review” <https://www.hrc.co.nz/international-reporting/universal-periodic-review/>. 194 World Health Organization Sexual health, human rights and the law (Geneva, 2015) at 29. 195 Gloria Fraser Supporting Aotearoa’s rainbow people: A practical guide for mental health professionals (Youth Wellbeing Study and RainbowYOUTH, Wellington, 2019) at 20; Ahi Wi-Hongi, Adeline Greig and Evan Hazenberg “Towards a model of informed consent: Trans healthcare in Aotearoa New Zealand” in Evan Hazenberg and Miriam Meyerhoff (eds) Representing Trans (Victoria University of Wellington, Wellington, 2017). 196 RainbowYOUTH and We Are Beneficiaries OutLoud Aotearoa: Sharing the stories and wishes of queer, gender diverse, intersex, takatāpui, MVPFAFF and rainbow communities around Aotearoa’s mental health and addictions services (RainbowYOUTH, Auckland, 2018); Gloria Fraser Queer and trans experiences of accessing mental health support in Aotearoa: Summary of findings for participants and community advisors (Victoria University of Wellington, Wellington, June 2018). 197 Oscar Taylor, Charlene Rapsey and Gareth Treharne “Sexuality and gender identity teaching within preclinical medical training in New Zealand: Content, attitudes and barriers” (2018) 131 New Zealand Medical Journal p35. 198 Youth’12 data showed same-sex attracted youth were less likely to be able to see a doctor when they needed, not wanted to, compared with heterosexual youth (35% versus 18%), with similar figures for trans versus non-trans youth (39% compared to 18% non-trans youth). Counting Ourselves data showed 36% of participants had avoided seeing a doctor when they needed to because they were worried about being mistreated as a trans or non-binary person. 20% of participants reported that this had happened in the past 12 months. 199 Victor Madrigal-Borloz Report to the General Assembly by the Independent Expert on protection against violence and discrimination based on sexual orientation and gender identity UN Doc A/74/181 (17 July 2019) at [46]. 200 The Royal Australian & New Zealand College of Psychiatrists “Position statement: Recognising and addressing the mental health needs of the LGBTIQ+ population” (position statement, September 2019). 201 J. Latham and C. Barrett “As we age”: An evidence-based guide to intersex inclusive aged care (Australian Research Centre in Sex, Health and Society, La Trobe University, Melbourne, October 2015). 202 Stephen Neville and others “Perceptions towards lesbian, gay and bisexual people in residential care facilities: A qualitative study” (2014) 10 International Journal of Older People Nursing p73. 192 37