Prohibition of conversion practices
On 20 August 2020, the Public Health Act 2005 (the Act) was amended to prohibit conversion practices in the context of health services delivered in Queensland.
Sexual orientation: a person’s capacity for emotional, affectional, and sexual attraction to, and intimate and sexual relations with, persons of a different gender, the same gender or more than 1 gender.
Gender identity and expression: a person’s internal and individual experience of gender, whether or not it corresponds to the sex assigned at birth. Gender identity includes:
- the person’s sense of the body
- if freely chosen, modification of the person’s bodily appearance or functions by medical, surgical or other means
- other expressions of gender, including name, dress, speech and behaviour.
An overview of the amendment
Under chapter 5B of the Act, a health practitioner in Queensland is prohibited from performing conversion practices. The Act defines conversion practices, which it referred to as ‘conversion therapy’, as any practice that attempts to change or suppress a person’s sexual orientation or gender identity or expression. Examples include:
- ‘ex-gay camps’
- shame or coercion tactics to create aversion to same-sex attractions or to encourage gender conforming behaviours
- other techniques or interventions that are based in ideology that being LGBTQA+ is a defect or disorder that needs ‘fixing’.
It does not include:
- practices that affirm or provide support or understanding to persons dealing with issues related to sexual orientation or gender identity and expression, or
- evidence-based and other reasonable clinical practices, even if these practices do not proactively affirm or support a person’s sexual orientation or gender identity and expression, including any practice that a health service provider reasonably believes will enable or promote the provision of safe and appropriate care, or is necessary to comply with the provider’s legal or professional obligation.
The prohibition applies to ‘health service providers’, which are defined under the Health Ombudsman Act 2013 to include:
- registered health practitioners, such as doctors, psychiatrists and psychologists
- unregistered health practitioners, such as counsellors, naturopaths and social workers
- businesses and other entities that provide health services.
The prohibition does not apply to religious or spiritual practices that do not involve the provision of health services. However, it is intended that prohibiting conversion practices in a health context will send a clear signal to all members of the community, including religious and spiritual communities, that these practices are unacceptable.
It’s important to understand that the prohibition only applies if a practitioner engages in a practice grounded in the ideology that being LGBTQA+ is a disorder or deviant behaviour that requires correction or suppression, and which aims to change or suppress a person’s sexual orientation or gender identity and expression.
The prohibition does not apply to treatments or practices that are evidence-based or have a reasonable clinical justification. To remove any doubt about this, the legislation includes an exemption for a health practitioner’s reasonable professional judgement that a practice:
- is part of the clinically appropriate assessment, diagnosis, or treatment of a person
- is part of the clinically appropriate support of a person
- enables or facilitates safe and appropriate care
- is necessary to comply with legal or professional obligations.
For example, the following practices are not prohibited:
- Advising a patient about the potential side effects of hormone replacement therapy or the risks of surgical intervention.
- Refusing to pursue a course of treatment, such as prescribing a hormone replacement therapy, that the provider reasonably believes would be unsafe or contra-indicated in the circumstances.
- Refusing to consider treatments to affirm a patient’s gender identity and expression until underlying mental health issues or psychological factors have been evaluated and addressed.
- Investigating or interrogating a patient’s experience of gender identity and expression as part of the clinical process of assessing the patient’s symptoms and reaching an accurate diagnosis of their mental health.
- Delaying or refusing treatment due to legal consent not being obtained or psycho-social factors that may impact on treatment efficacy, safety or recovery.
The prohibition of conversion practices does not set clinical standards or require practitioners to engage in any particular treatment or course of care. Nor does it promote any one clinical approach over another. This recognises that there are different views within the clinical community about the appropriate treatment of persons with symptoms of gender dysphoria, especially children, and that clinical standards are still evolving.
Offence and penalties
Health service providers who perform conversion practices commit an indictable offence under the Act.
The prohibition on conversion practices is limited to health service providers because they have ethical obligations to not engage in practices that are harmful and not based in evidence. Prohibiting conversion practices in health settings shows it is not an accepted health service, and that being an LGBTQA+ person is not a disorder that requires treatment.
The maximum penalty for the offence will depend on the age and vulnerability of the person subjected to the practice. Higher penalties will apply where conversion practices are performed on children and persons with diminished intellectual capacity.
12 months’ imprisonment and/or 100 penalty units ($14,375 as at July 2022)
Minors and other vulnerable persons
18 months’ imprisonment and/or 150 penalty units ($21,562 as at July 2022)