Role of medical healthcare professionals in recovery Evidence shows that access to medical healthcare professionals who are educated about conversion practices and how they harmfully affect survivors’ can be key to recovering from conversion practices.xviii In healthcare settings, transgender people who have more experiences of supportive and affirming primary care doctors have lower psychological distress and are less likely to attempt suicide.xix Conversion practices and their effects may show as someone disclosing conversion practices either in the health care setting or happening elsewhere. Disclosures of conversion practices During the course of a consultation or conversation, someone may disclose they are trying to change their sexual orientation or gender identity, or that someone else is trying to change, to conform to cisgender and heterosexual norms even though they are LGBTQIA+. If so, it’s important to listen actively and provide validation and support for their LGBTQIA identity. Give them the information that conversion practices don’t work, are harmful and are now unlawful. Some survivors have difficulty trusting medical healthcare professionals, particularly if their experience with conversion practices occurred in a similar setting. Moreover, where there may be relationships between medical practitioners and a survivor’s whānau or parents, maintaining a client’s confidentiality is of the utmost importance. Addressing this directly and reassuring your client can help to build trust. Feelings of shame can be a barrier to sharing information about the practices so it can be easy for a professional, or assessment, to overlook or misattribute indicators of conversion practices.xx 55 Talking about what happened Know that your patient may struggle to articulate their experience. They might not know they are experiencing or have experienced a conversion practice. References to their community having homophobic or transphobic beliefs, or being pressured to change, is a signal to ask more. Be guided by values of aroha and whanaungatanga. If your patient discloses that they are experiencing or have experienced a conversion practice, let them know you’re there for them. People in conversion practices are generally experiencing control and surveillance, and the misuse of authority. Encourage your patient to do their own research. Especially in the case where they are seeking out a conversion practice for themselves it is crucial they are aware of affirming alternatives. A good place to start is the Born Perfect website or the Human Rights Commission’s Conversion Practices webpage for more links. Referral to mental health support Recovery from conversion practices is seldom linear and will likely continue throughout an individual’s life. Trauma-informed practice is key and evidence shows that access to mental health support from practitioners educated about the harm they cause is critical.xxi People who have experienced conversion practices have often faced, and will likely continue to face, abusive relationships within their community, PTSD, major traumatic incidents and accumulated microtrauma, and the burden of repetitive coming out. Survivors may not want to disrupt relationships even when they are causing harm. In some cases, leaving a religious setting may not be possible due to financial or living arrangements. Conversion Practices Guidance for medical healthcare professionals