A/HRC/44/53 57. Children and young people are particularly vulnerable to the impact of practices of “conversion therapy”. A recent study of transgender adults found that, exposure before 10 years of age “was significantly associated with increased odds of severe psychological distress … and lifetime suicide attempts”. In addition to suicidal tendencies, children also experience a pronounced loss of self-esteem and a sharp increase in depressive tendencies, which can lead to school dropout and the adoption of high-risk behaviours and substance abuse.105 58. The long-term duration of many practices of “conversion therapy”, which can last for several years to more than a decade, can be particularly harmful.106 In addition to the aforementioned effects, it creates chronic stress, which has been known to result in many negative health consequences, including stomach ulcers, gastrointestinal disorders, skin diseases, sexual and eating disorders and migraines. 107 B. 1. Applicable international human rights law Non-discrimination 59. The application of international human rights law is guided by the fundamental principles of universality, equality and non-discrimination.108 Practices of “conversion therapy” target a specific group on the exclusive basis of sexual orientation and gender identity, with the specific aim of interfering in their personal integrity and autonomy. In that sense, such practices are per se discriminatory, as has been ascertained by several United Nations treaty bodies, including the Human Rights Committee109 and the Committee on the Elimination of Discrimination against Women.110 In its general comment No. 6 (2018) on equality and non-discrimination, the Committee on the Rights of Persons with Disabilities found that discrimination occurred in brutal forms such as non-consensual and/or forced medical or hormone-based interventions, forced drugging and forced electroshocks, confinement and denial of access to health care.111 2. Right to health 60. Every person, without distinction, should be able to enjoy the highest attainable standard of physical and mental health 112 and freedom from non-consensual medical treatment.113 Furthermore, the right to sexual and reproductive health encompasses the right of persons to be fully respected for their sexual orientation and gender identity. In that regard, the Committee on Economic, Social and Cultural Rights found that regulations requiring that lesbian, gay, bisexual transgender and intersex persons be treated as mental 105 106 107 108 109 110 111 112 113 14 trfn/american-medical-association-announces-support-for-u-s-ban-on-conversion-therapyidUSKBN1XT2PJ; and www.sciencedirect.com/science/article/pii/S1752928X20300366. Jack L. Turban and others, “Association between recalled exposure to gender identity conversion efforts and psychological distress and suicide attempts among transgender adults”, JAMA Psychiatry, vol. 77, No. 1; Caitlin Ryan and others, “Parent-initiated sexual orientation change efforts with LGBT adolescents: implications for young adult mental health and adjustment”, Journal of Homosexuality, vol. 67, No. 2; and Jo Fjelstrom, “Sexual orientation change efforts and the search for authenticity”, Journal of Homosexuality, vol. 60, No. 6. See also www.sciencedirect.com/science/ article/pii/S1752928X20300366. See https://doi.org/10.1037/cou0000011; and https://doi.org/10.1080/00918369.2013.774830. See www.sciencedirect.com/science/article/pii/S1752928X20300366. Universal Declaration of Human Rights, article 1. CCPR/C/KOR/CO/4, paras. 14–15. CEDAW/C/MYS/Q/3-5, para. 21. Committee on the Rights of Persons with Disabilities, general comment No. 6 (2018) on equality and non-discrimination, para. 7. International Covenant on Economic, Social and Cultural Rights, article 12. Committee on Economic, Social and Cultural Rights, general comment No. 14 (2000) on the right to the highest attainable standard of health, para. 8.