Lets talk about sex.... - Auckland District Health Board

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Discussion
In spite of New Zealand Homosexual Law Reform in 1986 which decriminalised homosexuality,
and amendments to the Human Rights Act in 1993 that made it unlawful to discriminate on
the grounds of sexual orientation*, 18 years on there are still significant inequities, including
discrimination for Rainbow people, as evidenced in this research. Much of this discrimination
in mental health and addiction services is occurring through heteronormativity and the
pathologisation of diverse gender identities. Clinicians and health professionals are generally
failing to consider the importance of sexual orientation and gender identity issues for mental
health. Further they are not supported in their professional training, or by the mental health
services they work for, to address this important service issue.
(*Gender identity was not explicitly listed as a ground of unlawful discrimination in the
Human Rights Act. The HRC and 2006 Crown Law office recommend that the Act be changed to
include discrimination based on gender identity.)
Studies show that Rainbow populations, in addition to having the same basic health needs
as the general population, experience health disparities related to S.O. and/or G.I. (Fergusson
et.al. 1999, Hass 2010, Hughes et. al. 2010, Rossen, et.al. 2009, Mayock 2009) Many however
avoid or delay care, or receive inappropriate, inferior or ineffective care because of real (or
perceived) homo/trans/biphobia and discrimination by service providers or organisations.
Unless all service users are asked about their sexual orientation and/or gender identity
by trained and skilled staff, there will continue to be a significant degree of invisibility of
our Rainbow service users. This lack of identification and acknowledgement compromises
treatment for Rainbow service users as it prevents some core mental health and addiction
issues being identified and addressed. Having said this, it is vital that service providers
understand that being stealth is very important for some trans people. This requires asking
trans people how they identify (male, female, trans, and/or using a culturally specific term)
and clarifying privacy concerns including any limitations on who can access those details.