is a community advocate whose work focuses on making New Zealand more accepting and
inclusive towards both rainbow communities and people who experience mental distress.
Moira chairs the Board at rainbow peer support service OUTLine, serves on Auckland
Council’s Rainbow Communities Advisory Panel, manages advocacy for the Mental Health
Foundation and is currently undertaking Masters research focusing on rainbow community
leadership and suicide prevention.
As we wind down from Auckland Pride Festival and gear up for Wellington Pride in March,
Moira gave us an insight into why those in our rainbow communities who live with mental
distress can face dual discrimination – and how the mental health sector can help to
“It might seem obvious these days to say that there’s nothing wrong with LGBTQI+
New Zealand is increasingly accepting of people whose sexual orientations, gender
identities or sex characteristics differ from majority norms.
We have laws providing marriage equality and the right to self-identify gender, and
protecting against discrimination in most cases
(the law is due
for an update to include gender identity, gender expression and sex
characteristics as grounds for non-discrimination).
The idea that there is anything harmful or pathological about being gay, lesbian,
bisexual, transgender, intersex, takatāpui,
fa’afafine or queer is becoming less common, and less socially acceptable.
Sadly though, this is far from the full story.
Rainbow New Zealanders still face high rates of isolation, violence, bullying,
and employment discrimination.
Our healthcare system creates barriers to gender-affirming care for transgender
people, and carries out medically-unnecessary surgeries on intersex children.
These and other experiences of social exclusion and discrimination mean that rainbow New
Zealanders live with minority
stress, which leads to disproportionately high
rates of mental distress.
Lately, the Like Minds, Like Mine campaign team have been talking about intersectionality
– the idea that people who belong to more than one marginalised group face additional
burdens of discrimination, as well as particular forms of exclusion that arise from
their intersecting identities.
For example, a transgender refugee in New Zealand might face discrimination related to
their immigration status, ethnic background and gender identity. They may also face
exclusion from rainbow community spaces because of racism or misunderstanding, and may
be rejected from their diaspora community because of transphobia.
Similarly, rainbow people who experience mental distress can face intersecting
discrimination related to their identities and experiences. This can create barriers to
getting support for recovery, forming a positive sense of identity, and finding
belonging within communities. For example, within health services:
- Identity discrimination creates barriers to accessing support for recovery. Rainbow
people can face direct or unintentional discrimination from health and social
services because of inadequate policies and professionals’ attitudes or lack of
skills. Last year’s Out Loud
Aotearoa report shares a range of stories from rainbow New Zealanders about
their experiences with mental health services. For many, professionals’ judgement or
ignorance meant that effective support was not available.
- Mental distress discrimination creates barriers to accessing gender-affirming
healthcare. Too often, transgender people cannot access gender-affirming healthcare
if they are currently experiencing mental distress. For example, a diagnosis of
depression may be used as a reason to deny hormone access. This situation is
perverse: research shows that being able to access gender-affirming healthcare
significantly reduces rates of mental distress, and yet transgender people cannot
access support to affirm their identity unless they can demonstrate recovery from
- Identity is misunderstood as a mental health problem. Sexual orientation, gender
identity and diverse sex characteristics are sometimes seen by health and mental
health professionals as unhealthy, pathological, or at the root of any presenting
mental health problems. While gender and sexual diversity have historically been
classified as mental health problems (homosexuality was removed from the Diagnostic
and Statistical Manual of Mental Disorders in the 1970s, and transgender identity
from the International Classification of Diseases last year), diversity is
still often seen as a symptom of mental ill health, or as a problem that causes
distress. In some DHBs, gender-affirming healthcare is accessed through mental
health services, reinforcing the sense that people’s identities are disordered or
Last year’s Mental Health and Addictions Inquiry recognised the importance of addressing
mental health discrimination, and recognising the harms caused by intersecting
discrimination. Its report He Ara
Oranga noted “the harmful effects of discrimination on the basis of ethnicity,
culture, disability and gender identity” and recommended increased focus on social
wellbeing and a national strategy for mental health promotion, including addressing
discrimination and prejudice.
While rainbow populations have not been a specific focus of the Like Minds, Like Mine
campaign, issues of dual discrimination have been addressed at times over the last 20
The campaign has included stories about recovery, identity and rainbow peer support which
have built understanding about rainbow issues within the mental health sector.
Commissioned research on young
people’s experiences of discrimination found that mental health discrimination
cannot be seen as separate from racism, homophobia and other intersecting
The To Be Yourself project trained Youth
One Stop Shops to work effectively with rainbow young people who experience mental
In 2019, I’d love to see further action to address this.
Where to from here?
Given the specific forms of discrimination that rainbow people face when they have
experience of mental distress, I think there’s a strong argument for including them as a
priority in the next Like Mine, Like Mine strategic plan.
More generally, I’m hoping to see the Government’s response to the Mental Health and
Addictions Inquiry include a strong strand of action to address discrimination, and a
focused approach to rainbow mental health that includes national standards, consistent
training and sustained funding for the rainbow peer support sector.
Finally, I’m hoping that the Royal Commission of
Inquiry into Historical Abuse in State Care and in the Care of Faith-based
Institutions will provide a safe forum for those who faced rainbow-negative
abuse in mental health services to be heard. As a nation, acknowledging the mistakes we
made in pathologising people’s identities will allow us to move on to a future where we
all belong, and are all included for who we are.”