There are further guidelines and limitations in place for providing gender affirming treatments that might carry a higher risk. For example, to access a first specialist assessment for publicly funded gender affirming surgery that is either complex or requires anaesthetic, a patient must be at least 18 years of age and medically fit, including having any mental health conditions managed and stable. Timeliness is vital for gender-affirming healthcare for young people. In 2021 a New Zealand study showed 73% of transgender and diverse gender participants had started to identify as transgender or gender diverse before the age of 14.xliii In that same study: • 57% of transgender and gender diverse participants reported significant depressive symptoms • 57% had self-harmed in the past year • 26% had attempted suicide in the past year. This suggests that prompt intervention is crucial for young people who may already need family, school and healthcare support around them. For more information on informed consent, see the Guidelines for Gender Affirming Healthcare. Next steps as a medical health professional Know the process Educate yourself Have a clear written policy and procedure to follow in instances of client disclosure. These are key to ensuring everyone’s safety and can be easily referred to when professional knowledge is limited. Creating these policies and procedures collaboratively can also build professional capability in this area. Having a solid understanding of conversion practices and related information is vital for medical healthcare professionals to be able to identify and effectively address issues and to provide informed and affirming care. Stay up-to-date with research, guidelines, and resources from reputable sources to ensure your practice is evidence-based and aligned with ethical and professional standards. Reflect on your practice space Consider the physical, emotional and cultural aspects of your practice space. Are there visible signs of inclusivity, such posters or literature affirming of LGBTQIA+, takatāpui Māori and MVPFAFF+ Pasifika identities? Are your policies and procedures supportive of clients in these communities? Are your intake forms inclusive of diverse gender identities and sexual orientations? It is crucial for a client to be able to recognise your practice space as “safe” for them. The Practice Guide: Developing Rainbow Inclusive Practice at www.rainbowmentalhealth.com offers useful considerations and suggestions. 88 It’s also important to stay updated with issues affecting LGBTQIA+, takatāpui Māori and MVPFAFF+ Pasifika communities. More Aotearoa-based studies and research projects on conversion practices are now being conducted. Share your knowledge Discussing this issue in a compassionate and non-judgmental manner can foster a supportive environment for learning and growth. Share resources, articles or research findings with your colleagues to increase their understanding of conversion practices, their harmful effects and what the law says about conversion practices. Encourage colleagues to seek further education or training on affirmative care and conversion practices. Conversion Practices Guidance for medical healthcare professionals

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