A/HRC/44/53 VI. Effective State measures A. Legislation 75. The Independent Expert has identified a recent trend towards banning practices of “conversion therapy” in certain parts of the world. In a few countries, such as Ecuador and Malta,134 it is considered a criminal practice. In several others, such as Canada, 135 Spain136 and the United States,137 bans have been introduced at local levels. 76. Specific legislation follows different models: (a) Wide-reaching bans. The most comprehensive approach is to prohibit all practices of “conversion therapy”, including faith-based organization-based counselling, by any person for any reason. Whereas there is no such nationwide law yet, there are a few examples at the state or local level. In 2019, Edmonton, Canada, approved a by-law that prohibited “any business” from offering or providing counselling or behaviour modification techniques, the administration or prescription of medication, or any other purported treatment, service or tactic used for the objective of changing a person’s sexual orientation, gender identity, gender expression or gender preference, or eliminating or reducing sexual attraction or sexual behaviour between persons of the same sex. 138 Similar examples can be found in autonomous regions in Spain.139 (b) Recipient-based restrictions. Some States prohibit practices of “conversion therapy” for any individuals, regardless of age, whereas others only prohibit them for children or individuals particularly susceptible to coercion or family pressure.140 Several bans in force in the United States protect children from practices performed by mental health professionals only, 141 whereas in bans in Europe, all providers are included. In the regions of Aragon and Valencia, Spain, practices cannot be validated upon consent. 142 Malta, however, excludes adults who freely consent from the ban, although the ban has a specific subsection under the definition of “vulnerable adult”, which opens the door for consent given by an adult to be invalidated on grounds that are broader than the usual coercion-based grounds required to annul consent.143 In several countries, the scope of bans has been extended over time. In Brazil, the first resolution restricting those practices, in 1999, referred only to “homosexuality”;144 gender identity and expression were added in 2018. 145 Ecuador and Malta, among others, also prohibit practices regarding gender identity, but the latter expressly excludes from the restriction: (a) any services related to the exploration, free development and/or affirmation of one’s identity with regard to one or more of the characteristics being affirmed by the act, through counselling, psychotherapeutic services and/or similar services; or (b) any health-care service related to the free development and/or affirmation of one’s gender identity and/or gender expression.146 134 135 136 137 138 139 140 141 142 143 144 145 146 18 Malta, Affirmation of Sexual Orientation, Gender Identity and Gender Expression Act , 2016; and Ecuador, Comprehensive Organic Penal Code, article 151 (3). For a critique on actual implementation, see Martina Guglielmone, “Fight against “reparative sexual therapy” in Ecuador”, Council on Hemispheric Affairs, 2017. Ontario, Nova Scotia, Prince Edward Island, Vancouver and Edmonton. Submission by Egale Canada. See ilga.org/Conversion-therapy-global-research-ILGA-World. Twenty states, the District of Columbia and Puerto Rico. Canada, City of Edmonton Bylaw 19061: Prohibited Businesses Bylaw (2019), Schedule A Prohibited Businesses. Submission by G37 Despacho Internacional. Submission by Human Rights Watch. See ilga.org/Conversion-therapy-global-research-ILGA-World. Submission by G37 Despacho Internacional. Submission by Malta. Submission by Brazil. See ilga.org/Conversion-therapy-global-research-ILGA-World. Submission by Malta.