3. However, I respectfully submit that the Bill as it stands fails to achieve its objectives and goes too far in the following respects:
a. The Bill elevates state-mandated values above those of parents. Parents or legal guardians, especially those of faith, will risk criminal liability for raising their children according to their beliefs, ethics and conscience.
b. The Bill is contrary to fundamental rights and personal autonomy.
c. The Bill presents a false dichotomy that all gender affirmation is an unqualified good and all conversion therapies an unmitigated bad.
d. The Bill will adversely and disproportionately effect those it seeks to protect.

Unwarranted state intrusion into family life

4. The Bill constitutes an unwarranted state intrusion into family life.
5. The Appendix to this submission sets out the relevant fundamental rights that the Bill infringes. These rights are enshrined in the Universal Declaration of Human Rights, the International Covenant on Civil and Political Rights, the International Covenant on Economic, Social and Cultural Rights and the United Nations Convention on the Rights of the Child.
6. These rights recognise that the family is the "natural and fundamental group unit of society" and require state signatories to "have respect for the liberty of parents [...] to ensure the religious and moral education of their children in conformity with their own convictions".
7. Domestic law requires parents be given primary responsibility to uphold a child's welfare and best interests (Care of Children Act 2004, s 5):
"(b) a child's care, development, and upbringing should be primarily the responsibility of his or her parents and guardians;
(c) a child's care, development, and upbringing should be facilitated by ongoing consultation and co-operation between his or her parents, guardians, and any other person having a role in his or her care under a parenting or guardianship order; [...]
(f) a child's identity (including, without limitation, his or her culture, language, and religious denomination and practice) should be preserved and strengthened."
8. The family is entitled to the "widest possible protection and assistance" from the State. The State is required to respect the liberty of parents and legal guardians to ensure the religious and moral education of their children in conformity with their own convictions.
9. The state must refrain from arbitrary interference with people's privacy, family, and home. Everyone has the right to freedom of thought, conscience, and religion, including the right to manifest his or her religion or belief in teaching, practice, worship and observance. No one is to be coerced in his or her freedom to have or to adopt a religion or belief of his or her choice.
10. The overwhelming majority of parents in New Zealand know what is in their children's best interests and are eager to do what is best for them. There is no justification for the state to mandate how parents are to raise their children based simply on disagreement with their religious, moral or ethical beliefs.

Contrary to fundamental rights

11. The Bill infringes fundamental rights.
12. The New Zealand Bill of Rights Act 1990 affirms the rights of thought, conscience, and religion (s 13), freedom of expression (s 14) and the manifestation of religion and belief. Included in these rights are the rights to: adopt and hold opinions without interference; seek, receive, and impart information and opinions of any kind; and manifest a person's religion or belief in worship, observance, practice, or teaching.
13. Any curbs on those rights must be "demonstrably justified" (not merely justifiable) (s 5, New Zealand Bill of Rights Act 1990). As recognised by Crown Law, the Bill constitutes "a significant limitation on freedom of expression" and "a potential chilling effect on legitimate expressions of opinion within families/whanau about sexuality and gender". The Bill denies people the freedom to express their views and prevents people from seeking and receiving whatever advice they themselves desire.
14. The Bill prevents people from living their beliefs. People of faith do not simply express their beliefs in a vacuum, divorced from their life and practice. The heart of the Christian message is about God's love and grace: reconciliation with God through Christ, God's forgiveness, and new spiritual life in Christ. In response to God's grace, all Christians are called to make changes in their lives. A Christian minister of religion must be free to pray for, and teach, counsel and support a person on any matters of conscience. Calling on one to repent of their sins should not risk criminal sanction. The same principle applies to people of other faiths.
15. People of faith must be able to speak out on issues of morality and encourage people to live in line with their principles (even if those principles are disagreed with or seem outdated). There should be restrictions on how that is done (not by force or coercion etc) but the Bill as it stands suppresses the ability to encourage people to change any part of their lives that doesn't align with the principles of their faith.
16. The Bill also risks criminalising expression of those beliefs if directed against someone under 18, even if no harm was intended or caused and, was indeed, asked for. Consider a youth pastor who cares deeply for his or her group. It would be unjust if that youth pastor ministering to youth could be imprisoned for expressing a genuinely held religious belief in love for others, even if some consider that to be misguided.
17. Perhaps, most seriously, the Bill is contrary to its own express purpose to "promote respectful and open discussions regarding sexuality and gender" (cl 3(b). Respect should be given to those who, through matters of conscience or beliefs, hold a countervailing view to that in the Bill. The current wording of the Bill would make many parents, family members, counsellors, religious leaders, and friends wary of saying or doing anything contrary to the Bill, even when they are asked by someone to give that advice, guidance, or support.

Individual's right to autonomy

18. The Bill infringes on individual autonomy. It prohibits adults of full capacity from seeking medical, pastoral or other care of their choice.
19. The rights summarised above uphold fundamental human dignity and the right to self-determination. The State should not mandate how an adult of full capacity should live his or her life or what health or pastoral care they should receive. The Bill allows (even encourages) an adult to obtain permanent and life-altering medical intervention, but does not allow that same adult the right to choose far less intrusive counselling or pastoral care.
20. The law tolerates self-harming behaviours by adults of full capacity. There must be a very strong case to criminalise self-harm -- no matter how serious that harm -- voluntarily entered into by an adult of full capacity.
21. Consenting adults should remain free to exercise their autonomy to partake in such therapy they consider best meets their needs, conscience and beliefs. To criminalise any words or actions which could be construed as "intended to change or suppress a person's sexual orientation, gender identity, or gender expression"cuts across the freedom of people of any sexuality or gender identity to seek and receive any assistance and support they may want.

False dichotomy

22. The Bill also sets up a false dichotomy. The presumption is that all gender and sexual orientation affirmation is an unqualified positive to be upheld and all conversion therapies are irredeemably negative.
23. In a survey of 70 ex-LGBT people, all respondents were helped by the kinds of support that the Bill seeks to ban. The authors of the survey condemned the "gross distortion" of conversion therapy as being from "the dark ages". Rather, therapies involved regular talking, prayer, and counselling in which the individual decided what issues he or she wanted to address, what to discuss and disclose, and what goals he or she wanted to achieve. The respondents obtained extensive professional and religious counselling to their benefit.
24. Not one participant mentioned any abuses or harmful impact from the counselling and support they received. Conversely, a number claimed harm from counsellors who discounted their wishes and even berated them for wanting to change their lives.
25. In similar vein, D'Angelo et al refer to flawed research often used to justify the "misguided notion that anything other than 'affirmative' psychotherapy for gender dysphoria (GD) is harmful and should be banned". They say:
"The notion that all therapy interventions for GD can be categorically classified into this simplistic binary ['affirmation' v 'conversion'] betrays a misunderstanding of the complexity of psychotherapy. At best, this blunt classification overlooks a wide range of ethical and essential forms of agenda-free psychotherapy that do not fit into such a binary; at worst, it effectively mis-categorizes ethical psychotherapies that do not fit the "affirmation" descriptor as conversion therapies. Stigmatizing non-"affirmative" psychotherapy for GD as "conversion" will reduce access to treatment alternatives for patients seeking non-biomedical solutions to their distress. Our aim is to put the spotlight on the more problematic areas of Turban et al.'s analysis and to illustrate how heeding their recommendations will limit access to ethical psychotherapy for individuals suffering from GD, further disadvantaging this already highly vulnerable population."
26. The authors conclude that a singular endorsement of "affirmative" therapies "contributes to the alarming trend to frame any non-'affirming' approaches as harmful":
"We are deeply concerned that this false dichotomy, reinforced by Turban et al.'s unproven claims of the harms of GIVE [conversion practices], will have a chilling effect on the ethical psychotherapists' willingness to take on complex GD patients, which will make it much harder for GD individuals to access quality mental health care. We maintain that availability of a broad range of non-coercive, ethical psychotherapies for individuals with GD is essential to meaningful informed consent, which requires consideration of the full range of treatment options, from highly invasive to non-invasive. Further, given the potential of agenda-free psychotherapy to ameliorate GD non-invasively among young people with GD, withholding this type of intervention, while promoting "affirmation" approaches that pave the way to medical transition, is ethically questionable.

Unintended consequences

27. The Bill will have disproportionate adverse effects on those it seeks to protect. Those with gender dysphoria or struggling with their sexuality would be unable to access the care they need.
28. As the above survey of ex-LGBT people demonstrates, those who seek input from others around them or from professionals (including counsellors, mental health practitioners, religious leaders, youth workers) should have the freedom to seek advice or support from anyone they choose, with all options open for discussion and exploration. The Bill would prevent people from freely accessing the help and support they voluntarily seek and would magnify the stigma of people's choice to live the way they see fit.
29. Evidence also reveals that transitioning not only sometimes fails to improve psychological outcomes in patients, it can be detrimental. The largest dataset on sex-reassignment procedures--both hormonal and surgical -- concluded that individuals diagnosed with gender incongruence who had received gender-affirming surgery were more likely to be treated for anxiety disorders compared with individuals diagnosed with gender incongruence who had not received gender-affirming surgery.
30. There is growing professional concern about gender transitioning, especially in children. In most cases, gender dysphoria or incongruence in children does not persist into adolescence.
a. Of nearly a dozen studies (including three large scale follow-up studies), only very few children with gender dysphoria still wanted to transition by the time they were adults. The number varied by study, ranging from 60 to 90% of gender dysphoric children no longer remaining that way by adulthood.
b. Finland's Ministry of Social Affairs and Health recommends postponing interventions on minors with gender variance until they reach adulthood. The guidance points out that gender reassignment of minors is an "experimental practice" and the lack of quality evidence to support using hormonal interventions in adolescents with gender dysphoria. The guidance warns that young people do not have the ability to assess the consequences of their decisions on their future selves, noting that brain development continues until about age 25. The Ministry also recognises that cross-sex identification in childhood, even in "extreme cases", generally disappears during puberty.
c. Similarly, the United Kingdom National Health Service's guidance on the treatment of gender dysphoria also recognises that many cases of gender variant behaviour or feelings disappear. The Guidance notes that: "Little is known about the long-term side effects of hormone or puberty blockers in children with gender dysphoria. It's also not known whether hormone blockers affect the development of the teenage brain or children's bones".
d. The National Association of Practising Psychiatrists in Australia also points out that scientific knowledge about the nature and cause of gender dysphoria and the effectiveness and dangers of treatment are not well known. Areas of concern to NAPP include children's capacity for informed consent, and the medical risks, known and unknown, of treatment with puberty blockings drugs, sex hormones and surgery before the age of 18 years. The NAAP also questions the level of maturity required by a child to make a competent decision about this type of medical treatment. The NAAP notes that many physicians avoid facilitating interventions in children due to long-lasting harmful effects which are not fully reversible.
e. The Royal College of Psychiatrists (the professional medical body responsible for psychiatrists in the United Kingdom) says this:
"[There is] the need for better evidence on the outcomes of pre-pubertal children who present as transgender or gender-diverse, whether or not they enter treatment. Until that evidence is available, the College believes that a watch and wait policy, which does not place any pressure on children to live or behave in accordance with their sex assigned at birth or to move rapidly to gender transition, may be an appropriate course of action when young people first present".
f. This growing professional concern about gender transitioning, including the risks of such treatment and uncertainties about long-term benefits and detriments, led the High Court in England to intervene by restricting prescription of puberty blockers. The claimant in that case, who had transitioned from female to male in her teens, claimed doctors should have challenged her more about the decision to transition before starting medical treatment. The claimant reports that:
"I was an unhappy girl who needed help. Instead, I was treated like an experiment."
"As I matured, I recognized that gender dysphoria was a symptom of my overall misery, not its cause."
g. Abigail Shrier attributes the "sudden surge of adolescents claiming to have gender dysphoria and self-identifying as transgender" to social contagion among "high-anxiety, depressive" girls who, "in previous decades, fell prey to anorexia and bulimia or multiple personality disorder". Explaining why she set out to investigate this phenomenon, Shrier says she became "haunted" by one question: "What's ailing these girls? [...] Their distress is real, but their self-diagnosis is flawed -- more the result of encouragement and suggestion than psychological necessity".
h. Historically, gender dysphoria afflicted about 0.01 per cent of the population, and almost exclusively boys. Shrier points out that, before 2012, there was no scientific literature on girls aged 11 to 21 ever having developed gender dysphoria. In Britain, Canada, Sweden and Finland, clinicians and gender therapists began reporting a dramatic shift in the demographics of those presenting with gender dysphoria, from predominately pre-school-aged boys to predominately adolescent girls (e.g. Britain saw a 4,400 per cent rise in teenage girls seeking gender treatments in the decade to 2018).
i. Shrier is not alone in her observations. Dr Christopher Gillberg, a professor of child and adolescent psychiatry at Gothenburg University in Sweden and a specialist in autism, was an expert witness in the High Court case referred to above. Dr Gillberg told the court that over 45 years of treating children with autism, it was rare to have patients with gender dysphoria, but their numbers started exploding in 2013, and most were biological girls.
j. Shrier delivers this sobering message:

"Nearly all of these detransitioners blame the adults in their lives, especially the medical professionals, for encouraging and facilitating their transitions rather than questioning them."

31. The approach proposed by the Bill is inconsistent with the practices recommended by psychiatrists. The only acceptable treatment option in the Bill is affirmation and support to transition. The Bill creates a chilling effect on providing therapy while supporting affirmation approaches that have gender transition as their end point. The law should not deter mental and other medical health professionals from providing appropriate treatment to children and young people who may be uncertain about their gender identity or counselling being provided from a range of trusted advisors.
32. The Bill also unintentionally marginalises people of faith who express a personal struggle with gender or sexuality by removing their right to seek and give consent to faith-based counselling, advice and support, and by potentially criminalising anyone who gives that support.
33. In the survey of ex-LGBT people referred to above, the authors found that although anti-conversion laws purport to help the LGBT community, the potential for the laws to harm them was "abundantly clear" and that "LGBT people will be uniquely disadvantaged by reduced access to therapies which, according to the 70 respondents to our survey, were not only beneficial but, in many cases, life-saving. [...] To legislate new social norms and enforce acceptance of these ideas is to ignore the lived experience of those who have found change both possible and beneficial".
34. Anti-conversion laws, in the authors' view, would effectively declare a "no-go" zone in conversations LGBT people can have with their friends, pastors and therapists. Therapists who wish to escape criminal prosecution will avoid any issues that touch on gender identity or sexuality or simply refuse to take on LGBT clients.

Proposed amendments

35. "Conversion Therapy" should be defined so that strongly held opinions, teaching and discussions on conscientious beliefs or opinions, whether they are moral, religious, scientific, or otherwise are not criminalised. No practice performed on a consenting adult of full capacity should be criminalised.
36. Clause 5(2) should be amended by adding the following new subclauses (g), (h) and (i):
(g) any practice performed on an individual of 18 years or older who has consented to the performance of that practice; or
(h) any practice performance by, or on behalf of, a parent or legal guardian on the child of that parent or legal guardian unless that practice constitutes an offence under any other Act; or
(i) discussions regarding sexuality, identity and gender, and advice, guidance, prayer, or support given to anyone by anyone else including parents, family members, friends, counsellors, religious leaders, or health professionals.
37. Clause 10 should be amended as follows:

10 Consent

(1) Consent of the parent or guardian of a child on whom the conversion practice was performed is not a defence to a charge under section 8(1)(a) or section 9 if section 5(2)(h) applies.
(2) It is not a defence to a charge under section 8(1)(b) or section 9 that an individual who lacks, wholly or partly, the capacity to understand the nature, and to foresee the consequences, of decisions in respect of matters relating to their health or welfare consented to the conversion practice performed on them.

Conclusion

38. The Diocese (Church of Confessing Anglicans Aotearoa New Zealand) repudiates any pastoral practice which is coercive, disrespectful, or harmful. This submission is not made to allow in any way for such practices. Pastoral counselling and interaction should always be compassionate, gentle, and respectful of everyone's personal worth, dignity, and freewill. It should be undertaken out of a love for people and aimed at the best outcome for them. We disavow any pastoral or counselling practices regarding LGBT people that are unloving, uninvited, coercive, harsh, or disrespecting of people's freedoms. We desire a Bill that provides the best advice and care for vulnerable people and assert that the proposed Bill currently fails to achieve this.
39. If it is helpful, I am happy to speak to this submission.

APPENDIX -- New Zealand's International Human Rights Obligations

Universal Declaration of Human Rights

Article 12: No one shall be subjected to arbitrary interference with his privacy, family, [or] home [...].
Article 16(3): The family is the natural and fundamental group unit of society and is entitled to protection by society and the State.
Article 18: Everyone has the right to freedom of thought, conscience and religion; this right includes freedom to change his religion or belief, and freedom, either alone or in community with others and in public or private, to manifest his religion or belief in teaching, practice, worship and observance.
Article 19: Everyone has the right to freedom of opinion and expression; this right includes freedom to hold opinions without interference and to seek, receive and impart information and ideas through any media and regardless of frontiers.
International Covenant on Civil and Political Rights.
Article 1
(1) All peoples have the right of self-determination. By virtue of that right they freely determine their political status and freely pursue their economic, social and cultural development.

Article 17

(1) No one shall be subjected to arbitrary or unlawful interference with his privacy, family, [or] home [...].

Article 18

(1) Everyone shall have the right to freedom of thought, conscience and religion. This right shall include freedom to have or to adopt a religion or belief of his choice, and freedom, either individually or in community with others and in public or private, to manifest his religion or belief in worship, observance, practice and teaching.

(2) No one shall be subject to coercion which would impair his freedom to have or to adopt a religion or belief of his choice.

(3) Freedom to manifest one's religion or beliefs may be subject only to such limitations as are prescribed by law and are necessary to protect public safety, order, health, or morals or the fundamental rights and freedoms of others.

(4) The States Parties to the present Covenant undertake to have respect for the liberty of parents and, when applicable, legal guardians to ensure the religious and moral education of their children in conformity with their own convictions.

Article 19

(1) Everyone shall have the right to hold opinions without interference.
(2) Everyone shall have the right to freedom of expression; this right shall include freedom to seek, receive and impart information and ideas of all kinds, regardless of frontiers [...].
Article 23
(1) The family is the natural and fundamental group unit of society and is entitled to protection by society and the State.

International Covenant on Economic, Social and Cultural Rights

Article 1(1): All peoples have the right of self-determination. By virtue of that right they freely determine their political status and freely pursue their economic, social and cultural development.
Article 10: The States Parties to the present Covenant recognize that:
(1) The widest possible protection and assistance should be accorded to the family, which is the natural and fundamental group unit of society, particularly for its establishment and while it is responsible for the care and education of dependent children.
Article 12(3): The States Parties to the present Covenant undertake to have respect for the liberty of parents and, when applicable, legal guardians to choose for their children schools, other than those established by the public authorities, which conform to such minimum educational standards as may be laid down or approved by the State and to ensure the religious and moral education of their children in conformity with their own convictions.
United Nations Convention on the Rights of the Child
Preamble
"[...] Convinced that the family, as the fundamental group of society and the natural environment for the growth and well-being of all its members and particularly children, should be afforded the necessary protection and assistance so that it can fully assume its responsibilities within the community [...]",

Article 2

1. States Parties shall respect and ensure the rights set forth in the present Convention to each child within their jurisdiction without discrimination of any kind, irrespective of the child's or his or her parent's or legal guardian's race, colour, sex, language, religion, political or other opinion, national, ethnic or social origin, property, disability, birth or other status.

2. States Parties shall take all appropriate measures to ensure that the child is protected against all forms of discrimination or punishment on the basis of the status, activities, expressed opinions, or beliefs of the child's parents, legal guardians, or family members.

Article 3

2. States Parties undertake to ensure the child such protection and care as is necessary for his or her well-being, taking into account the rights and duties of his or her parents, legal guardians, or other individuals legally responsible for him or her, and, to this end, shall take all appropriate legislative and administrative measures.

Article 5

States Parties shall respect the responsibilities, rights and duties of parents or, where applicable, the members of the extended family or community as provided for by local custom, legal guardians or other persons legally responsible for the child, to provide, in a manner consistent with the evolving capacities of the child, appropriate direction and guidance in the exercise by the child of the rights recognized in the present Convention.

Article 14

2. States Parties shall respect the rights and duties of the parents and, when applicable, legal guardians, to provide direction to the child in the exercise of his or her right in a manner consistent with the evolving capacities of the child.

Article 16

1. No child shall be subjected to arbitrary or unlawful interference with his or her privacy, family, home or correspondence, nor to unlawful attacks on his or her honour and reputation.

2. The child has the right to the protection of the law against such interference or attacks.

Article 18

1. States Parties shall use their best efforts to ensure recognition of the principle that both parents have common responsibilities for the upbringing and development of the child. Parents or, as the case may be, legal guardians, have the primary responsibility for the upbringing and development of the child. The best interests of the child will be their basic concern.
2. For the purpose of guaranteeing and promoting the rights set forth in the present Convention, States Parties shall render appropriate assistance to parents and legal guardians in the performance of their child-rearing responsibilities and shall ensure the development of institutions, facilities and services for the care of children.
Article 27

2. The parent(s) or others responsible for the child have the primary responsibility to secure, within their abilities and financial capacities, the conditions of living necessary for the child's development.

FOOTNOTES

Report at https://www.freetochange.org/wp-content/uploads/Free-To-Change-2020-Conversion-Therapy-Report-V4E.pdf.
R D'Angelo, E Syrulnik, S Ayad, L Marchiano, D Kenny & P Clarke, "One Size Does Not Fit All: In Support of Psychotherapy for Gender Dysphoria" Archives of Sexual Behavior 50 (2021) 7-16.
"'Transitioning' Procedures Don't Help Mental Health, Largest Dataset Shows": https://www.heritage.org/gender/commentary/transitioning-procedures-dont-help-mental-health-largest-dataset-shows; "New Data Show 'Gender-Affirming' Surgery Doesn't Really Improve Mental Health. So Why Are the Study's Authors Saying It Does?": https://www.thepublicdiscourse.com/2019/11/58371/; "Sex Change: Physically Impossible, Psychosocially Unhelpful, and Philosophically Misguided" https://www.thepublicdiscourse.com/2018/03/21151/. "Does Conversion Therapy" Hurt People Who Identify as Transgender? The New JAMA Psychiatry Study Cannot Tell Us": https://www.thepublicdiscourse.com/2019/09/57145/.
Citations to these studies can be found at http://www.sexologytoday.org/2016/01/do-trans-kids-stay-trans-when-they-grow_99.html. See, for example, Steensma TD, Kreukels BP, de Vries AL, Cohen-Kettenis PT, "Gender identity development in adolescence", Hormones and Behavior (2013); 64(2):288--297, who found that 85% of prepubertal children with a childhood diagnosis did not remain gender dysphoric or gender incongruent in adolescence.
Recommendation of the Council for Choices in Health Care in Finland (PALKO / COHERE Finland): Medical Treatment Methods for Dysphoria Related to Gender Variance In Minors (file:///C:/Users/si565282/Desktop/New%20folder/Done/Finland_Guidelines_Gender_Variance_In_Minors.pdf).
https://www.nhs.uk/conditions/gender-dysphoria/treatment/.
https://napp.org.au/2019/10/gender-dysphoria-national-enquiry/.
https://www.rcpsych.ac.uk/pdf/PS02_18.pdf.