Submission to NSW Parliamentary Inquiry into Youth Suicide

 

The NSW Parliamentary Committee on Children and Young People is currently holding an inquiry into the prevention of youth suicide. Full details can be found here. The following is my personal submission:

 

c/- childrenyoungpeople@parliament.nsw.gov.au

Sunday 27 August 2017

 

Dear Committee

 

Submission to Inquiry into Youth Suicide in NSW

 

Thank you for the opportunity to provide a submission to this important inquiry.

 

In this submission, I will be focusing on items (g) and (h) from the inquiry’s terms of reference: ‘Approaches taken by primary and secondary schools’ and ‘Any other related matters’ respectively.

 

Specifically, I will be discussing these terms of reference and how they relate to one of the groups that is disproportionately affected by mental health issues, depression and suicide: young lesbian, gay, bisexual, transgender and intersex people.

 

The National LGBTI Health Alliance confirms that LGBTI people, and especially young LGBTI people, are at much higher risk of suicide than non-LGBTI people. From the Alliance’s July 2016 ‘Snapshot of Mental Health and Suicide Prevention Statistics for LGBTI People’:

 

“Compared to the general population, LGBTI people are more likely to attempt suicide in their lifetime, specifically:

 

  • LGBTI young people aged 16 to 27 are five times more likely
  • Transgender people aged 18 and over are nearly eleven times more likely
  • People with an intersex variation aged 16 and over are nearly six times more likely
  • LGBT young people who experience abuse and harassment are even more likely to attempt suicide.

 

Statistics for LGBTI Population:

 

  • 16% of LGBTI young people aged 16 to 27 reported that they had attempted suicide
  • 35% of Transgender people aged 18 and over have attempted suicide in their lifetime
  • 19% of people with an Intersex variation aged 16 and over had attempted suicide on the basis of issues related [to] their Intersex status
  • 8% of Same-Gender Attracted and Gender Diverse young people aged between 14 and 21 years had attempted suicide, 18% had experienced verbal abuse, and 37% of those who experienced physical abuse.

 

Statistics for General Population:

 

  • 2% of people (4.4% females; 2.1% males) aged 16 and over have attempted suicide in their lifetime; 0.4% of general population (0.5% females; 0.3% males) in the last 12 months
  • 1% of people (1.7% females; 0.5% males) aged 16 to 24 have attempted suicide in the past 12 months.”

 

These statistics are obviously incredibly alarming, and reveal the scale of the challenge of mental health issues experienced by LGBTI people, and especially young LGBTI people.

 

What should not be forgotten is that there is nothing inherently ‘wrong’ with LGBTI people, and LGBTI young people – their disproportionate rates of suicide are in response to external factors, including a lack of acceptance (or feared lack of acceptance) from parents, other family members and friends, as well as society-wide homophobia, biphobia, transphobia and intersexphobia.

 

Another contributing factor to high rates of LGBTI youth suicide – and perhaps most relevantly to this inquiry – is the school environment. While some schools are welcoming to all young people, including those of diverse sexual orientations, gender identities and sex characteristics, other schools are far less welcoming – and some are even outright hostile.

 

For the purposes of this submission, I would nominate two key factors that help determine whether a school is welcoming of LGBTI young people:

 

  • Whether it has an explicit program addressing anti-LGBTI bullying (such as Safe Schools), and
  • Whether it has an inclusive curriculum for LGBTI students, with content that is relevant to their needs.

 

The importance of these two factors is confirmed by the 2010 Writing Themselves In 3 Report (by La Trobe University), which found that:

 

  • “61% of young people reported verbal abuse because of homophobia.
  • 18% of young people reported physical abuse because of homophobia.
  • School was the most likely place of abuse – 80% of those who were abused” (p39).

 

This last statistic is perhaps the most disturbing. Instead of being a place of learning, for far too many LGBTI young people, school is a place of intimidation, intolerance, and fear.

 

Although even more worrying is the fact that the proportion of students nominating school as a site of abuse increased from 1998 to 2004, and then again from 2004 to 2010 (p45) – rather than being more welcoming today, the schoolyard and the classroom is becoming more abusive.

 

Similarly, the Writing Themselves In 3 Report demonstrated that, in far too many schools, LGBTI students are not being included in the curriculum, both generally and specifically in relation to Health & Physical Education (including sex education).

 

From page 79: “10% of young people reported that their school did not provide any form of Sexuality Education at all.”

 

Even where some sexuality education was provided, it was primarily targeted at cisgender and heterosexual students. While almost 60% of students reported that the school provided information about heterosexual relationships, less than 20% received education about gay or lesbian relationships (p81).

 

And, while approximately 70% reported education about safe heterosexual sex, less than a quarter were instructed about safe gay sex and less than 20% about safe lesbian sex (p82).

 

Finally, roughly 1 in 10 reported learning that ‘homophobia is wrong’ as part of their sexuality education (p83), meaning that almost 90% of students were not receiving this important message.

 

Unfortunately, on both of these issues (anti-bullying programs, and an inclusive curriculum) NSW is clearly failing in its obligations to LGBTI young people.

 

First, in terms of Safe Schools, it was incredibly disappointing that the NSW Government abandoned this vital LGBTI anti-bullying program in April 2017.

 

Yes, there were some significant problems with this program – although not the ones that religious fundamentalists lied about in their dishonest campaign to undermine and destroy it.

 

Chief among the actual shortcomings of Safe Schools was the fact that it was an entirely optional program, meaning only a small proportion of schools had even begun to implement it by the time it was axed. Further, the schools that chose to implement it were likely the same schools that were already LGBTI-inclusive, while those that were less inclusive were far less likely to adopt the program.

 

Instead of abolishing Safe Schools, the NSW Government should have been working to ensure that it was rolled-out more widely, and ultimately to reach every school in the state (following the lead of Victoria) – because LGBTI students and young people exist in every school in the state.

 

Perhaps even worse than axing this program is the fact it has been replaced with a ‘general’ anti-bullying program and one that, based on media reports, does not include appropriate materials and resources to address the specific needs of LGBTI students and young people.

 

As reported in the Star Observer (Experts Slam NSW Anti-Bullying Resource as ‘Missed Opportunity for LGBTI Youth’, 21 July 2017:

 

“Leading health organisation ACON has expressed concern over the lack of LGBTI-specific tools and information in the new [anti-bullying] resource, despite liaising with the government in the months leading up to its launch.

 

Chief Executive of ACON Nicolas Parkhill said the new resource failed to meaningfully address the bullying, abuse, and discrimination faced by young LGBTI people.

 

“Bullying is an acute problem for young LGBTI people and this resources does not respond to their unique needs,” he said.

 

“Of concern is the absence of tools and resources that specifically address LGBTI bullying in schools – especially when we know it affects a significant proportion of young people.

 

“The government’s own report released earlier this month stated that 16.8 per cent of secondary school students in Australia are attracted to people of the same sex. That’s one in six students…

 

“We believe this resource falls short in responding to LGBTI bullying and there needs to be more emphasis placed on the needs of young LGBTI people.”

 

Based on this critique, it appears that the NSW Government has axed a program that was specifically designed to address anti-LGBTI bullying – which, as we saw earlier, is a contributing factor to LGBTI youth suicide – and replaced it with a ‘generalist’ anti-bullying program that does little to reduce this behaviour.

 

That is clearly not good enough.

 

Recommendation 1: The NSW Government should roll-out the Safe Schools program, or a similar program that specifically and explicitly deals with anti-LGBTI bullying, in every school across the state.

 

The Personal Development, Health and Physical Education (PDHPE) Syllabus is also not good enough in terms of how it includes – or, in many cases, excludes – LGBTI students and information that is relevant to their needs.

 

Earlier this year, the NSW Education Standards Authority (NESA) released a new draft PDHPE K-10 Syllabus for public consultation. Unfortunately, it fell far short of what is necessary to educate LGBTI students across the state, or to contribute to a reduction in youth suicide among this group.

 

As I outlined in my submission to NESA about the draft Syllabus (see Every Student. Every School. Submission on Draft NSW Personal Development, Health and Physical Education (PDHPE) Syllabus K-10), its problems include that:

 

  • It does not define the terms lesbian, gay, bisexual, transgender or intersex
  • It does not guarantee that all students in all schools will learn about these sexual orientations, gender identities or sex characteristics
  • It does not include sufficient LGBTI anti-bullying content, and
  • It does not offer appropriate, or adequate, sexual health education for students who are not cisgender and heterosexual, including a lack of information about sexually transmissible infections and diverse sexual practices.

 

If the PDHPE K-10 Syllabus is implemented without significant and substantive changes to the draft that was released, another generation of LGBTI young people will grow up without being told in the classroom that who they are is okay, and without learning vital information on how to keep themselves safe.

 

That would represent a failure of the NSW Government to exercise the duty of care that it owes to all students across the state.

 

Recommendation 2: The NSW Government should ensure that the PDHPE K-10 Syllabus is inclusive of LGBTI students, and provides content that is relevant to their needs, including comprehensive sexual health education.

 

The previous two issues – anti-bullying programs, and an inclusive curriculum – relate to term of reference (g) (Approaches taken by primary and secondary schools).

 

However, there is one final, non-school related matter that I would like to raise in this submission (under term of reference (h) – ‘Any other related matters’).

 

That is the issue of ‘ex-gay therapy’ or ‘gay conversion therapy’. As the name suggests, this practice aims to convince LGBT people that who they are is wrong, and that they should try to stop being who they are and instead attempt to be cisgender and heterosexual.

 

Let us be clear – ‘ex-gay therapy’ or ‘gay conversion therapy’ is not therapy, and does not offer anything ‘therapeutic’ to the people who are subjected to it. It is not counselling, nor does it have any basis in medical or scientific fact.

 

It is fundamentally harmful, and preys upon vulnerable people, exploiting their fears, their isolation and their insecurities. It leaves the vast majority of people feeling far worse, and can cause, or exacerbate, depression and other mental health issues, including leading to suicide.

 

Ex-gay therapy is psychological abuse, and the people who continue to ‘offer’ this practice are psychological abusers.

 

The NSW Government should outlaw this practice both because it is wrong, and because it is inherently harmful. This should be implemented by a criminal penalty for anyone conducting ex-gay therapy, with a separate penalty for advertising such services.

 

The imposition of ex-gay therapy on young LGBT people is particularly heinous, given they are especially vulnerable. Therefore, the fact that a person being subjected to ex-gay therapy is under 18 should be an aggravating factor for these criminal offences, attracting an increased penalty.

 

The prohibition of ex-gay therapy, and the protection of vulnerable LGBT people – and especially young LGBT people – from this practice is urgently required to help remove another cause of mental health issues, including possible suicide, of LGBTI youth in NSW.

 

Recommendation 3: The NSW Government should ban the practice of ‘ex-gay therapy’ or ‘gay conversion therapy’, making both conducting this practice, and advertising it, criminal offences. Offering these services to LGBT people under the age of 18 should be considered aggravating factors, attracting increased penalties.

 

Thank you for taking this submission into consideration. Please do not hesitate to contact me at the details provided should you require additional information, or to clarify any of the above.

 

Sincerely

Alastair Lawrie

 

There's no place for discrimination in the classroom-7

NSW schools have an important role to play in preventing LGBTI youth suicide – one that they are currently failing to fulfil.

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No 3 Senate Report on Involuntary or Coerced Sterilisation of Intersex People in Australia

Another development during 2013 which was, frankly, far more important than anything related to marriage equality was the Senate Standing Committee on Community Affairs’ Report on Involuntary or Coerced Sterilisation of Intersex People in Australia, handed down on 25 October (link here: http://www.aph.gov.au/Parliamentary_Business/Committees/Senate/Community_Affairs/Involuntary_Sterilisation/Sec_Report/~/media/Committees/Senate/committee/clac_ctte/involuntary_sterilisation/second_report/report.ashx).

For people unaware (as, being perfectly honest, I was until around this time last year), the vast majority of intersex children are subjected to involuntary surgeries shortly after birth, designed to ‘normalise’ them according to the expectations of either their parents, their doctors, or society at large (or, more likely, a combination of all three) that they should conform to a man/woman binary model of sex.

These surgeries, obviously performed without the infant/child’s consent, can involve sterilisation, as well as other ‘cosmetic’ (ie unnecessary), largely irreversible surgery on genitalia to make it fit within the idea of what a man or woman ‘should’ be (completely ignoring the fact that the infant doesn’t fit into that model, nor should that model be imposed upon them, and certainly not without their informed consent).

The fact that these surgeries continue to the present day is a major human rights scandal. The idea that people are having such major, lifelong decisions made for them by doctors and parents (who are often persuaded by the views of the medical profession) is a horrifying one.

It is something that groups like Organisation Intersex International Australia (OII Australia), and others have been campaigning on for some time. And in 2013 the members of the Senate Standing Committee on Community Affairs were listening.

They commenced an inquiry on September 20 2012, looking at the general topic of involuntary or coerced sterilisation of people with disabilities in Australia. Through the course of this inquiry, and the advocacy of groups like OII Australia, they came to see the significance of the continuing violation of the rights, including the bodily integrity, of young intersex people.

So much so, that they separated out the issues surrounding intersex people and, after handing down their general report on 17 July 2013, devoted a second report entirely to these issues. In their conclusion, they made some very encouraging observations about the need to break down the barriers of thinking around sex. In particular, they noted:

“ 6.29      Least well understood is the challenge that intersex variation presents to the rest of society. It is the challenge involved in recognising that genetic diversity is not a problem in itself; that we should not try to ‘normalise’ people who look different, if there is no medical necessity. It is the challenge of understanding that everyone does not have to fit into fixed binary models of sex and gender, and that nature certainly does not do so.

6.30      A key example of our lack of understanding of how to respond to intersex diversity can be seen in the clinical research on sex and gender of intersex people. The medical understanding of intersex is so strongly focussed on binary sex and gender that, even though its subjects have some sort of sex or gender ambiguity, the committee is unaware of any evidence to show that there are poor clinical or social outcomes from not assigning a sex to intersex infants.[19] Why? Because it appears never to have even been considered or researched. Enormous effort has gone into assigning and ‘normalising’ sex: none has gone into asking whether this is necessary or beneficial. Given the extremely complex and risky medical treatments that are sometimes involved, this appears extremely unfortunate. [emphasis added]”

 

Which is a pretty radical sentiment for a cross-party group of Senators to put their names to. The Committee also made recommendations designed to at least reduce the incidence of coerced sterilization (and surgery on genitalia), as well as increasing the support available to parents of intersex children. Specifically:

3.130    The committee recommends that all medical treatment of intersex people take place under guidelines that ensure treatment is managed by multidisciplinary teams within a human rights framework. The guidelines should favour deferral of normalising treatment until the person can give fully informed consent, and seek to minimise surgical intervention on infants undertaken for primarily psychosocial reasons. [emphasis added]

 

Recommendation 11

5.70    The committee recommends that the provision of information about intersex support groups to both parents/families and the patient be a mandatory part of the health care management of intersex cases.

Recommendation 12

5.72    The committee recommends that intersex support groups be core funded to provide support and information to patients, parents, families and health professionals in all intersex cases.”

These recommendations, and the Report more broadly, have been received positively by the National LGBTI Health Alliance, and by OII Australia, who released a statement responding to the report on 29 October (link here: http://oii.org.au/24058/statement-senate-report-involuntary-or-coerced-sterilisation-intersex-people/). OII President Morgan Carpenter said:

“This report represents the first opportunity, after many years of campaigning, to place our most serious human rights concerns before Parliament. Medical interventions on intersex infants, children and adolescents have been taking place in Australia with insufficient medical evidence, and insufficient emphasis placed on the human rights of the child and future adult. Genital surgeries and sterilisations create lifelong patients and there’s significant evidence of trauma.

At a first view, many of the headline conclusions and recommendations are positive – accepting our recommendations on minimising genital surgery, concern over the lack of adequate data, insufficient psychosocial support, and concern that decision making on cancer risk is insufficiently disentangled from wider concerns about a person’s intersex status itself; we also broadly welcome the recommendations relating to the prenatal use of Dexamethasone” and, went on to say:

 

“OII Australia warmly welcomes this crucial report. It addresses the main concerns of the intersex community. We welcome that this is a joint report with cross-party support, and we would like to thank the Committee members and staff for their hard work.

We also give particular thanks to our friends in the Androgen Insensitivity Syndrome Support Group Australia (AISSGA), the National LGBTI Health Alliance, and the other people and organisations who took time to make relevant submissions to the inquiry, or who participated in the hearing on intersex issues.

We look forward to working with clinicians, Commonwealth and State and Territory Health Departments, and the Commonwealth Attorney General’s Department, to improve health outcomes for intersex infants, children, adolescents and adults.”

Which is I guess the crucial point – it is up to multiple levels of Government, and the health profession, to implement the Committee’s recommendations, and make substantial (and long overdue) improvements in this area. And it is up to groups like OII Australia – together with support from their allies throughout the LGBTI, and wider, community – to make sure that they do.