For older people and frail people, the long-term benefit of medicines reduces and the potential for harm from adverse effects increases. When the benefit–risk balance changes in this way, medicine review and optimisation are important to simplify the therapeutic regimen, reduce inappropriate medicines and minimise risks. In this article, pharmacist prescriber Linda Bryant uses two case studies to illustrate important considerations during medicine reviews
NZ First’s gender definition bill will harm mental health, counsellors warn
NZ First’s gender definition bill will harm mental health, counsellors warn

The New Zealand Association of Counsellors (NZAC) is deeply concerned by New Zealand First’s proposed Member’s Bill, which seeks to legally define “man” and “woman” solely based on biological sex.
NZAC warns the Bill risks increasing psychological harm among trans, non-binary and rainbow communities.
The Bill represents an unacceptable step backward for human rights and mental health in Aotearoa New Zealand, President Sarah Maindonald says.
“This is not just a political issue, it is a mental health issue,” she says.
“Legislation that restricts someone’s ability to self-identify attacks a person’s dignity and sense of belonging.
“It compounds the distress already faced by many in the rainbow community, who are disproportionately affected by bullying, discrimination, and marginalisation.”
Evidence paints a stark picture. The landmark Counting Ourselves survey of trans and non-binary Kiwis found 77% experienced high or very high psychological distress, compared to 12% of the general population.
Similarly, the Youth19 survey revealed rainbow youth fare significantly worse on measures such as mental distress, self-harm, and suicidality, with even higher disparities for takatāpui/Māori and Pacific rainbow young people.
“As counsellors, we support people navigating their identities and experiences,” Maindonald says.
“When political decisions invalidate or erase those identities, the trauma can run deep.
“This Bill will only further marginalise people already at heightened risk of mental health challenges.”
The role of government should be to reduce harm and foster inclusion, not legislate exclusion, Maindonald says.
“Our message to MPs across all parties is clear: focus on building a more inclusive society where everyone, regardless of gender identity, feels safe and supported.”