HIV stigma and discrimination and official indifference?
Outrage Magazine takes a closer look at alleged discrimination experienced by some Filipinos living with HIV at some government agencies. This begs the question of whether it is time to re-visit “official” policies to ensure that they do not violate the rights of PLHIVs, and even end up promoting stigma and discrimination of those living with HIV.
Time to revisit ‘official’ approaches to HIV?
The Bureau of Quarantine’s (BOQ) form specifically states that it “encourages” those who will get the yellow fever (YF) vaccination (to get their “yellow card”, which is needed by those traveling to/from select Latin American and African countries, among others) to be “honest” to “avoid possible medical complications”. But honesty, in this case – and as relayed by a Filipino living with HIV, Xander* – came at a price.
“The first step is to fill in a form that expects one to detail his/her medical condition. This form is then checked by a nurse (the second step), who will decide if you can proceed to the third step, which is the actual vaccination. If he/she has doubts about your entries in the form, you will be sent to one of the doctors on duty; he/she will determine if you can get vaccinated,” Xander relayed to Outrage Magazine.
The problem, said Xander, is in the handling of HIV-related cases.
When he went to the BOQ in the City of Manila, first, “my filled-in form was handled by at least three people who passed it around before I was forwarded to the doctor on duty (that day).” And because this section of the BOQ did not have partitions that could have afforded him privacy, Xander deemed what happened to him as “invasive, as it failed to respect my right to privacy,” he said. “In fact, by the time I was forwarded to the doctor on duty, even the other people who were also only there to get vaccinated already knew of my HIV status.”
And then the doctor on duty “was not even familiar with HIV-related cases,” Xander alleged, basing his assumption/observation on this doctor’s “lack of knowledge about CD4 and ARV (antiretroviral medicines) – he kept saying ‘Kailangan ko yung CD-CD ba ‘yun (I think I need that CD thing)?’ and ‘Dalhin mo lahat ng gamot mo sa akin. Hindi ko masyado alam ano yang Lamivudine-Tenofovir-Efavirenz (You have to show me all your medicines. I’m not very familiar with Lamivudine-Tenofovir-Efavirenz).” The doctor’s table was, by the way, right beside the waiting area (where people who were already vaccinated were awaiting their yellow card) and the cashier (where those who get vaccinated pay for the services received), so that everything discussed was done in public.
Xander – with head hanging low – left the BOQ sans knowing that the vaccination he desired; but also shamed because of his HIV status.
HIV AND YF VACC
The doctor on duty when Xander went to the BOQ was – in a way – right to be cautious when he asked for more information about Xander’s health condition.
In a study titled “Yellow fever vaccination in HIV-infected patients”, published in HIV Therapy, Olivia Veit, Christoph Hatz, Matthias Niedrig and Hansjakob Furrer stated that “millions of HIV-infected individuals are at risk to YF, a severe hemorrhagic disease which is endemic in tropical areas of Africa and Latin America.” To deal with this, “the 17D YF vaccine (17DV) is the most effective preventive strategy.” The World Health Organization (WHO), in fact, recommends that all people aged ≥9 months living or travelling in areas where there is a risk of YF transmission to be vaccinated.
Particularly in relation to HIV, there are some things worth stressing here.
First, “data regarding safety and immunogenicity of 17DV in HIV-infected individuals are limited to small studies, mainly in travelers with CD4 cell counts above 200 cells/mm”.
Second, even with sparse information, “according to current recommendations, 17DV should only be given to asymptomatic HIV-infected individuals with a CD4 cell count above 200 cell/mm” since “rare serious adverse events cannot be excluded”. As per WHO, “the vaccine is contraindicated for people who are severely immunocompromised”.
And third, at least according to some studies, “yellow fever vaccine did not result in any serious adverse events in HIV-positive individuals. However, people with HIV responded less well to the vaccine than their HIV-negative counterparts, and the protective effects of the vaccine wore off more quickly.”
All in all, though, there is still “a special need for further studies to investigate the safety and efficacy of 17DV in HIV-infected individuals”.
LAW OF THE LAND
But again, as Xander stressed, YF vaccination isn’t his issue, per se; instead, it is the handling of his situation by a government office as a Filipino living with HIV.
Republic Act 8504 (or the Philippine AIDS Prevention and Control Act of 1998, otherwise known as the AIDS Law) states (in Section 3b): “The State shall extend full protection of human rights and civil liberties to persons living with HIV.” Part of the protection clause of the existing law is ensuring that “the right to privacy of individuals with HIV shall be guaranteed.”
Section 41 of the IRR (implementing rules and regulations) of the RA 8504 states:
“Medical confidentiality shall protect and uphold the right to privacy of an individual who undergoes HIV testing or is diagnosed to have HIV. It includes safeguarding all medical records obtained by health professionals, health instructors, co-workers, employers, recruitment agencies, insurance companies, data encoders, and other custodians of said record, file, or data.
“Confidentiality shall encompass all forms of communication that directly or indirectly lead to the disclosure of information on the identity or health status of any person who undergoes HIV testing or is diagnosed to have HIV. This information may include but is not limited to the name, address, picture, physical description or any other characteristic of a person which may lead to his/her identification.
“To safeguard the confidentiality of a person’s HIV/AIDS record, protocols and policies shall be adopted by concerned officials, agencies and institutions.”
Section 44 of the IRR, in fact, details the sanctions against violators, i.e.:
“Penalties for violating medical confidentiality, as provided in Sec.s 30 and 32 of RA 8504, include imprisonment for six (6) months to four (4) years. Administrative sanctions may likewise be imposed…”
FAILURES OF THE SYSTEM
YF vaccine can only be had in three BOQ offices in the Philippines – i.e. BOQ – Manila, 25th Street, Port Area, Manila (Monday to Friday, 8am to 2pm); BOQ – Cebu, General Maxilom Avenue (Wednesday and Thursday, 8am-9am); and BOQ – Davao, Chavez St. (Fridays 8-9am).
Xander went to BOQ – Manila.
(Outrage Magazine sent on two separate dates two representatives to observe the processes of BOQ – Manila; and we can verify the same – Ed)
The BOQ “system” is somewhat different in Cebu City, still another place where the YF vaccine can be had; though there, forced HIV disclosure could still happen.
(Outrage Magazine also sent a representative to observe the processes of BOQ – Cebu; and we can verify the same – Ed)
In Cebu, people who intend to get the YF vaccine are first asked to “register”. Then those who will be given the vaccination for the first time are ushered into a private room where they are given a mini-lecture by the resident doctor re YF (and in our undercover representative’s case, sermon re HIV). During this mini-lecture, the resident doctor also asked the group if any one of them is HIV-positive. Not surprisingly, none openly admitted his (as there were only males in that batch) HIV status.
Emails were sent by Outrage Magazine to Dr. Janette L. Garin, Secretary of the Department of Health (since BOQ is under DOH), and to Dr. Ferdinand S. Salcedo, Director of the BOQ.
Specifically, Outrage Magazine sought for more information on:
- The intake forms of BOQ – e.g. if these rely on self-disclosure of HIV status, and who handles these forms since (as was reported to Outrage Magazine, these were just left on tables so that everyone could see them; and
- The set-up of BOQ – e.g. if the doctors on duty were trained to handle HIV-related scenarios, and if people living with HIV are allowed to get more private consultation (instead of discussing the cases in public).
As of press time, however, NO RESPONSES WERE RECEIVED FROM BOTH GARIN AND SALCEDO.
On May 30, however, Ferchito L. Avelino, M.D. of the BOQ responded to Outrage Magazine, stating the bureau’s appreciation of “your effort to communicate to us your concerns. These information is important to us as we continue to improve client-to-doctor engagement (to) make sure that such engagement is within the bounds of medical confidentiality.”
Specific to the first concern raised by Outrage Magazine, Avelino stated that, “yes, the answer to the query on HIV status is based on self-disclosure of the client… although we strongly encourage client to disclose their status as this information is vital prior to the administration of any antigen. Also, our doctor may request the client to secure a certification from their attending physician on the needed for vaccination.”
(The HIV status is based on self-disclosure because of the confidentiality clause in the law – Ed)
Pertaining the possible breach in confidentiality that Xander noted in BOQ, Avelino stated that “aside from the doctor, (the) nurse on duty handles the information that are inputted in the BOQ form.” He added that “actions are made and continuously being updated to put in place systems and processes to make sure that other clients and service providers will have no access to this information.”
Avelino also stated that “the Bureau has medical doctors trained in internal medicine and in public health”, and that “to be updated on clinical practices, we conduct sessions in handling medical cases. In the past, we had sessions on HIV with representatives from the positive community.”
Avelino is hopeful that stakeholders “work together and disseminate information on HIV and correct myths that breed unnecessary fear that results to stigma and discrimination.”
While the BOQ is used here as a sample government office, it is – incidentally – not the only office (and a government office, particularly) that has issues when dealing with HIV-related cases.
Humphrey Gorriceta, a Filipino living with HIV, once recalled how he was “forced” to disclose his HIV status in the Land Transportation Office (LTO). Upon renewing his license in the LTO in Rosario, Cavite, Gorriceta had to take a drug test (a requirement).
“I just took my ARV about an hour or two before the testing (before giving my urine specimen), and the drug test result turned out positive. They asked me the routine questions if I have consumed alcohol recently or have taken any prohibited drugs. I said no. I asked why, and they said that they will have to send it to the DOH for confirmatory (drug test). I told them no need for that. I confessed that I am on ARV, and possibly the false-negative result is due to my ARV. I showed them my ARV caplets. They asked what ARVs are. I was surprised they didn’t know. I told them I have a lifetime condition that required me to take ARV, and that ARVs are like very strong antibiotics for a specific infection. They still didn’t get it and continued to ask about the meds. So I told them that ARVs are maintenance medication for HIV. I had to make the disclosure. I ended up explaining about HIV and ARV,” Gorriceta said.
Gorriceta added that he “felt it was uncalled for. I felt I was pushed against the wall to do the disclosure. For them to have a drug testing service means that they should be educated or at least be oriented of the possible scenarios why a person would come out (false) positive to drug testing.”
The mandatory drug testing for driver’s license applicants was scrapped after the Republic Act 10586 (Anti-Drunk and Drugged Driving Act) took effect in June 2013.
In another case, this time in Cagayan de Oro City (CDO), a person living with HIV (PLHIV) was given a PWD (person with disability) card by the City Social Welfare and Development (CSWD) that identified the bearer as a “PLHIV”. After a complaint was filed, the card was replaced; though the replacement now stated that the bearer of the ID is “mentally ill”.
NorMAA now helps provide support to the CDO PLHIV.
“While we say that there is no shame in being HIV-positive, as it is supposed to be only a medical condition, we remain cognizant of the fact that society as a whole continues to not be accepting of PLHIV, who are often stigmatized and discriminated. Care should therefore be given in handling HIV-related cases; and this is not always provided even by those in government offices,” Quilacio said.
According to Ico Rodulfo, president and CEO of Project Red Ribbon, “discrimination among PLHIVs in government offices is still rampant. Project Red Ribbon has encountered a lot of reports and from personal experiences in the PLHIV community, where PLHIVs were bullied, not given chances to be promotion or are talked into quitting their posts. The Foundation also had an experience with one government agency which has an HIV program, but where the staff didn’t respect the confidentiality of the PLHIV and disclosed the status of the client to the neighborhood where she resides. This eventually caused her to be bullied and pressured to move out as her neighbors feared that her HIV might infect the entire barangay.”
CONFRONTING STIGMA AND DISCRIMINATION
Yet another example happened back in Cebu City, with the handling of the cadaver of a PLHIV who passed on. There, after the demise of the PLHIV, his family was allegedly told to “ilubong dayun ang patay kay basin makatakod (immediately bury the dead as it could infect others)”. His casket was also tightly wrapped in layers of plastic.
Outrage Magazine contacted the office of Dr. Ilya Tac-an, head of Cebu City’s Epidemiology Center and STD Detection Center, who said she will refer the publication to the one in charge with the cadaver section. Tac-an, nonetheless, stated that as far as she knows, the City Health Department is following the provision on the proper disposal of dead persons as mandated in the Presidential Decree 856, s. 1975, or the Code on Sanitation of the Philippines.
IRR of Chapter XXI (Disposal of Dead Persons) of PD 856, s. 1975, states that when the death due to “dangerous communicable diseases”, including HIV, the following are the requirements:
- The remains shall be buried within 12 hours after death;
- The remains shall not be taken to any place of public assembly;
- Only the adult members of the family of the deceased shall be permitted to attend the funeral;
- The remains shall be placed in a durable, air tight and sealed casket; and
- No permit shall be granted for the transfer of such remains.
As of press time, Outrage Magazine did not receive the referral from Tac-an.
However, according to Nenet Ortega, R.N., a licensed embalmer who is with the International Development Leadership and Learning Corporation now as one of its technical experts on health system strengthening/health sector reforms, as long as Universal Precautions (standard infection control guidelines) are followed, the risk of infection from a dead body is very low.
“Hindi naman gaya ng Scarlet Fever or diphtheria ang AIDS para ilibing (AIDS is not like Scarlet Fever or Diphtheria that requires for the body to be buried) within 24 hours. It also does not require hermetically sealed coffin,” Ortega said.
Ortega added that “TB, polio, hepatitis and HIV can effectively be killed by formaldehyde and other embalming chemicals. Also, embalmers are trained to protect themselves from getting any infection during embalming process. You know what, as long as there are no microorganism that is resistant to formaldehyde and other embalming fluids and chemicals, and as long as embalmers have the means to protect themselves, embalmers can and will always be able to serve the public.”
The fear of the dead PLHIV infecting others is also baseless, Ortega said. “Remember that the virus need a living cell as its host in order to replicate. When the body dies, all the cells die, so therefore the virus dies as well kasi patay na din ang mga white cells (because the white cells also die) within 24 hours. And by exposing it to formaldehyde earlier than 24 hours, the faster the cells are preserved, but the virus dies.”
Ortega added: “That incident in Cebu exposed the immediate family of the person who died to further stigma and discrimination. That action indirectly tells people na namatay ang taong nasa loob ng ataul na nakabalot pa ng plastic sa isang nakakahawa, nakakadiri at (that the person inside the coffin that is wrapped in plastic died from a contagious, disgusting and) fatal kind of disease.”
For Ortega, “that incident in Cebu is a gross discrimination. As if balutin ng plastic ang coffin (by wrapping the coffin in plastic) would be a protection enough to keep HIV. That is bullshit! Ignorance spreads stigmatization and discrimination, including ignorance of the simple Universal Precaution. And Universal Precaution is basic. It is practiced in all clinics, lying in, hospitals of all levels, in schools with anatomy, physiology, clinical and chemistry laboratories, in morgues, in all places where exposure to bodily fluids may happen.”
For Dr. Jose Narciso Melchor Sescon of the AIDS Society of the Philippines, “the City Health Office is handling and tracking these cases through the death certificate filed by relatives prior to the burial. Hospitals are required by DOH to report the types of infections borne as part of surveillance (PIDSR, or the Philippine Infectious Disease Surveillance Response). Take note what is discriminating is what you put in the death certificate and not necessarily the process or handling as there are funeral parlors highly competent to handle such cases (e.g. Funeraria Oro).”
For Sescon, “the reality is that not all funeral parlors are trained or are competent to handle bodies with infectious diseases. Yes, I agree that standard precautions must apply, but the reality is, not all abide by this. Add to this the reservations of the owners of embalming establishments if they are not trained to deal with such cases.”
In cases where there are no experts that can handle the cadaver of PLHIVs, “there are DOH memorandum or administrative orders that the city must follow that within 24 hours, the body should already be cremated or be buried. If only there are a lot of trained embalmers to handle highly infectious diseases, not only HIV but also the likes of meningococcemia and chicken pox, then it will not be a problem.”
Sescon added that “this may be why a PLHIV’s body had to be cremated or buried within 24 hours, particularly if there are no trained embalmers around, most especially in far-flung areas.”
He added, nonetheless, that “the manner of relaying the correct information is also important so that the situation is better understood.”
Both Ortega and Sescon advocate the further professionalization of the funeral industry for the people in it to know how to properly handle sensitive cases, such as when involving a dead PLHIV.
“I agree with the need to professionalize the profession for only then will this issue be somehow resolved. Professionalizing increases the quality standards of operations, provision of licenses and permit will depend now on meeting the quality standards in embalming bodies and or running a funeral parlor,” Sescon said.
RAMPANT STIGMA AND DISCRIMINATION
HIV-related stigma and discrimination has long been reported in the Philippines by the likes of Remedios AIDS Foundation and Pinoy Plus Association in a study called Exploring the Realities of HIV/AIDS Related Discrimination in Manila Philippines, published in 2005; APN+, Pinoy Plus Association and UNAIDS in AIDS Discrimination in Asia: From the Perspective of Persons Living with HIV/AIDS,
Published in 2002; and GNP+, Pinoy Plus Association and UNAIDS in The People Living with HIV Stigma Index in the Philippines, published in 2010.
These studies, in fact, note that the area where PLHIVs experience most discrimination is the healthcare setting (both public and private), with instances cited including: refusal to treat on the grounds of HIV status, different treatment on grounds of HIV status, testing for HIV without the knowledge of the individual, breach of confidentiality and denied of health insurance.
Eddy N. Razon of the Pinoy Plus Association, in his report AIDS Related Stigma and Discrimination in the Philippines, also noted the “non-availment of redress mechanisms” of PLHIVs. Among the reasons provided include: lack of understanding on what constitute human rights violations; lack of knowledge on available redress mechanism; unwillingness to come out and be identified in public in the course of seeking redress; and the cost of legal action.
And so – back to the access to the YF vaccine at the BOQ – Xander said it is a “Catch 22 situation. We’re damned if we disclose, and damned if we don’t disclose.”
In his case, Xander is first to admit the good of knowing how he may react to what will be injected into his body. He is now seeking medical clearance from his personal doctor, just so he can present some documentation to the BOQ.
But Xander said that he isn’t a “special case – there are others like me who also had YF vaccination, and who opted not to admit their HIV status just to be done and over with with the YF vaccination”.
And Xander said he understands the other PLHIVs, stressing that “unless protections are given to those who openly admit their HIV status, then expect PLHIVs to lie instead to protect themselves from stigma and discrimination.”
In CDO, NorMAA’s Quilacio believes in the need to revisit the approaches in the delivery of services of government offices, among others; though this time, “these need to be informed by the very people they claim to serve. Otherwise, if they persist as if it’s all business as usual, then they’re just going to continue doing things insensitively, and maybe even against the laws that ought to be upheld.”
Rodulfo said that “the challenges are aplenty. First, we need to educate the government offices and agencies about HIV and the law. Second, we need to implement the HIV in the workplace policy as required by RA 8504 and the DOLE mandate, so all government offices educate the workforce re respect of the rights of the workers with HIV. And third, we need to continue to push for anti-discrimination ordinances and policies.”
Rodulfo is, nonetheless, hopeful that change will come soon. “As change is coming with the next President, we are hopeful that reforms will be implemented to finally stop stigma and discrimination of members of the PLHIV community,” he said.
“We may still have a very long way to go when dealing with HIV-related issues,” admitted Xander. “But we’d have an even longer way to go if the very institutions that swore to uphold our rights – i.e. the government – are the very ones that violate them.” And so, “change needs to happen. And they need to happen fast.”
*THE INTERVIEWEE REQUESTED FOR HIS REAL NAME NOT TO BE USED TO PROTECT HIS PRIVACY
THIS IS A DEVELOPING STORY, AND OUTRAGE MAGAZINE WILL CONTINUE PURSUING LEADS THAT HIGHLIGHT NOT ONLY ERRONEOUS PRACTICES BUT BEST PRACTICES WHEN DEALING WITH HIV IN VARIOUS OFFICES
5 LGBTQIA ‘markers’ in Phl for 2018
With an eye to doing more to achieve more in 2019 (and the coming years), here is a short list of some of the markers for LGBTQIA Philippines’ 2018.
2018 has been busy for the LGBTQIA community in the Philippines, with numerous happenings marking either backward or onward movements for the local LGBTQIA struggle.
With an eye to doing more to achieve more in 2019 (and the coming years), here is a short list of some of the markers for LGBTQIA Philippines’ 2018.
1. Gathering of 20,000+ pax for Metro Manila’s one-day Pride parade
Particularly if the “measurement” is the Western perspective, 2018’s Metro Manila Pride parade proved that LGBTQIA Filipinos may already be woke.
Perhaps showing growing widespread popularity of everything LGBT-related in the Philippines, Metro Manila’s annual LGBT gathering patterned after Western Pride celebration/s was attended by an estimated 25,000 people. Even if figures are wrong, this still easily topped 2017’s 8,000 participants in the event that was held in Marikina City for two years now.
Here’s the thing, though: While the number is impressive as a show of force and as advertising magnet for those targeting the pink market, it – nonetheless – does not necessarily equate to promotion of LGBT causes in the Philippines. The challenge is still how to convert this number to attend not just one-day partying, but – say – joining rallies to push for the passage of the Anti-Discrimination Bill (ADB).
2. Inability of the LGBTQIA community to gather as many to promote Anti-Discrimination Bill (ADB)
The SOGIE Equality Bill was already passed by the likes of Reps. Geraldine Roman and Kaka Bag-ao in the House of Representatives in 2017, the first time it went this far in 11 years. And yet the Senate version – that is in the hands of Liberal Party-aligned Akbayan partylist helmed by Sen. Risa Hontiveros – is not gaining grounds.
Linked to, and stressed by #1 above, actual participation by LGBTQIA people to promote the ADB continues to be very limited. Various LGBTQIA organizations have attempted to hold events to push for ADB to be passed in the Senate; but these were – without mixing words – basically flops, failing to get the “numbers game” of the one-day Pride party.
The elitist and very “exclusive” approach to the ADB is also not helping.
Still, some of these efforts are worth highlighting, e.g.:
In May, student leaders asked the new Senate leadership of Sen. Tito Sotto to prove that it is better. Over 500 students – including lesbian, gay, bisexual, transgender, queer and intersex (LGBTQI) Filipinos and their supporters – to the new Senate President Tito Sotto and Majority Floor Leader Juan Miguel “Migz” Zubiri. The call is to end the debates and eventually pass the SOGIE Equality Bill to protect the LGBTQI Filipinos from discrimination based on their sexual orientation, gender identity and expression (SOGIE).
In July, the Commission on Human Rights (CHR) and the United Nations Development Programme (UNDP) called for the speedy passing of bills that could help better the plight of LGBTQIA people in the Philippines.
3. Inadvertently “killing” ADB for this Congress
Perhaps not surprisingly – with anti-LGBTQIA politicians (e.g. Sens. Sotto, Manny Pacquiao and Joel Villanueva) – the Senate version of the anti-discrimination bill (ADB) – the Senate Bill No. 1271 – remains stalled in the Philippine Senate.
Worse, the ADB has become political football; with even supposed ADB supporters ending up backing those opposing it.
For instance, in March, politicians supposed to interpellate the ADB sponsor, Sen. Risa Hontiveros, either balked or walked out. The Senate agenda for March 21 (as an example) reflected Sen. Sherwin Gatchalian as the person who will interpellate (instead of Sen. Villanueva). The switcheroo is bad enough; but Gatchalian left the halls of Senate before his chance to interpellate, thereby effectively stalling the ADB. And for as long as there are senators still wanting to interpellate, the ADB – or any bill – can’t progress to the next steps, so that this is effectively a delaying tactic.
No progress has happened since then.
And with the May 2019 elections in the corner, passing the ADB in the Senate now seems improbable.
4. Growing number of LGBTQIA-related efforts – e.g. Pride parades, ADOs and private initiatives
Still sans a national law protecting the human rights of LGBTQIA Filipinos, many of LGBTQIA-related efforts are going local.
There are educational institutions hosting Pride-related events.
In March, for instance, the LGBTQIA community of the Polytechnic University of the Philippines (PUP) in Sta. Mesa in the City of Manila stressed the importance of “real diversity” as it celebrated its 4th Pride. The hosting of Pride in PUP has actually been inconsistent, with the first one held in the 1990s, and only followed by the second one in 2015. It was only in the last two years when Pride was held consistently. Themed “Putting we in diversity”, the gathering that was helmed by Kasarianlan, the only LGBTQIA organization in PUP, “eyed to emphasize that we can’t truly claim pride if this is not inclusive of all of us,” said Jan Melchor Rosellon, the student organization’s former inang reyna/head.
Various local government units (LGUs) also still have Pride events.
Themed “This is Pride”, the 12th Baguio LGBT Pride Parade 2018 on November 24 “acknowledged that the community is still facing a lot of issues, so that we are coming out on the streets to continue the struggle for LGBT rights not yet won,” said Archie Montevirgen, chairperson of Amianan Pride Council.
And just as the year was about to close, the City of San Juan held its second LGBTQIA Pride parade. This is part of the mandate of City Ordinance No. 55, or the anti-discrimination ordinance (ADO) of the City of San Juan, which was passed in the third quarter of 2017 to protect the human rights of its LGBTQIA constituents.
Re localized anti-discrimination policies (via anti-discrimination ordinances, or ADOs), a handful of LGUs took the leap to advocate for their LGBTQIA constituents.
In May, the city of Mandaluyong passed Ordinance 698, S-2018, which seeks to “uphold the rights of all Filipinos especially those discriminated against based on their sexual orientation, gender identity and expression (SOGIE).” With this, it is now “the policy of the Mandaluyong City government to afford equal protection to LGBTQI people as guaranteed by our Constitution and to craft legal legislative measures in support of this aim.”
In June, the city of Iloilo joined the ranks of local government units (LGUs) with LGBTQI anti-discrimination ordinances (ADOs), with the Sangguniang Panlungsod (SP) unanimously approving its ADO mandating non-discrimination of members of minority sectors including the LGBTQI community. The ADO was sponsored by Councilor Liezl Joy Zulueta-Salazar, chair of the SP Committee on Women and Family Relations. Councilor Love Baronda helped with the content/provisions of the ordinance.
And in October, Malabon City passed an anti-discrimination ordinance (ADO) that prohibits: discrimination in schools and the workplace, delivery of goods or services, accommodation, restaurants, movie houses and malls. It also prohibits ridiculing a person based on gender and/or sexual orientation. Penalties for discriminatory act/s include imprisonment for one month to one year, a fine of P1,000 to P5,000, or both.
Meanwhile, companies are finally, finally joining the rainbow bandwagon – whether as a PR initiative (we’re looking at you, Bench!) or to change internal policies – e.g.: As an attempt to ramp up its responses to a diverse workforce, Unilever now offers a 20-day paid leave for fathers, healthcare benefits for same-sex partners and paid absences for adoptive parents. According to Unilever Philippines chairman and CEO Benjie Yap, “diversity is an essential requirement in the today’s workforce, as it lends to new ideas, energies, and solutions.”)
5. New HIV infections now reach 32 cases per day
October highlighted the continuing disturbing worsening HIV situation in the Philippines, with an estimated 32 new HIV cases now happening in the country every day. For October, there were 1,072 new HIV cases reported to the HIV/AIDS & ART Registry of the Philippines (HARP).
It was in September when this number (i.e. 32 new HIV cases per day) was first reported. Prior to that, the country “only” had 31 new HIV cases reported daily, though even this figure was already considered high compared to figures from past years. In 2009, the country only had two new HIV cases per day. By 2015, the number increased to 22; and in the early part of 2018, the number was 31.
From January 1984 (when the first HIV case was reported in the country) to October 2018 (when the latest figures were belatedly – as usual – released by the HARP), the Philippines already had a total of 60,207 HIV cases. It is worth noting that 9,605 of that figure was reported from January to October 2018 alone.
The deaths related to HIV are also getting worrying.
The DOH reported that for August, there were 159 HIV-related deaths; in July, there were “only” 30. The figure may even be higher because of under- or non-reporting.
The worsening HIV situation is perhaps not surprising considering the foot-dragging and wrong priorities of bodies dealing with HIV in the Philippines.
NGOs, CBOs or CSOs aren’t always better, with issues similarly affecting them – from profiteering to abusing positions of power to the detriment of people living with HIV and Filipinos in general.
Relevance of public & private sectors’ support highlighted in Quezon City’s 2018 Pride parade
Highlighting the importance of the participation of all stakeholders, not just the LGBTQIA community but also including the public and the private sectors, Quezon City in Metro Manila held one of the last Pride parades in the Philippines for 2018.
Highlighting the importance of the participation of all stakeholders, not just the LGBTQIA community but also including the public (including government) and the private sectors, Quezon City in Metro Manila held one of the last Pride parades in the Philippines for 2018.
Hanz Defensor, who helms Quezon City Pride Council (QCPC), the organizer of the annual gathering, told Outrage Magazine in an exclusive interview that Quezon City is “quite fortunate” that it now has an anti-discrimination ordinance (ADO) that protects LGBTQIA people from discrimination.
Signed by mayor Herbert Bautista (whose term ends in May 2019), City Ordinance 2357-2014, otherwise known as The Quezon City Gender-Fair Ordinance, eyes to “to actively work for the elimination of all forms of discrimination that violate the equal protection clause of the Bill of Rights enshrined in the Constitution, existing laws, and The Yogyakarta Principles; and to value the dignity of every person, guarantee full respect for human rights and give the highest priority to measures that protect and enhance the right of all people; regardless of sexual orientation, gender identity and expression (SOGIE).”
But Defensor said that, “admittedly, kulang pa rin (this is still lacking).” This is because – even if they already have the ADO and its implementing rules and regulations (IRR), the actual implementation continues to be challenging.
Quezon City, Defensor noted as an example, has “a lot of business establishments, and while they know that discriminating against LGBTQIA people in the city is prohibited by law, not all of them actually have a copy of the ADO and the IRR to know the small details.”
As he encouraged particularly those affected by the ADO to “download (the same) from Quezon City’s official website”, he is also encouraging other local government units to already take steps to also protect their LGBTQIA constituents, perhaps learning from Quezon City’s example.
The same sentiment was expressed in a letter sent to QCPC by Pres. Rodrigo Duterte, who remarked that Quezon City’s ADO – which also mandates the annual holding of the Pride parade – “has become a source of inspiration for advocates of gay rights in the Philippines and the rest of the world” because “it has institutionalized the city’s progressive and inclusive policy that eliminates discrimination on the basis of SOGIE.”
Though criticized for pinkwashing, Duterte still expressed hope that Pride further strengthens “the solidarity of (the) community so you may inspire the entire nation with the diversity and dynamism of your talents and skills.”
To contextualize, past administrations did not openly support Pride-related events.
Also, even if Akbayan partylist – which is aligned with Liberal Party that helmed the country under Pres. Benigno Aquino III prior to Duterte’s term – has been sponsoring the anti-discrimination bill for almost 20 years now, it still fails to gain traction, including during Aquino’s administration when it was largely ignored.
As an FYI, Quezon City actually hosted the largely accepted first Pride March in Asia.
On June 26, 1994, ProGay Philippines and Metropolitan Community Church helmed a march in Quezon City. Dubbed as “Stonewall Manila” or as “Pride Revolution”, it was held in remembrance of the Stonewall Inn Riots and coincided with a bigger march against the imposition of the Value Added Tax (VAT).
Defensor stressed the need to be pro-active when confronting LGBTQIA-related discrimination. While the ADO is there, he said that should LGBTQIA people from Quezon City experience discrimination, “seek help” and know that “QCPC is here, and the LGU will back you.”
San Juan hosts 2nd Pride parade to stress city’s support for ‘equality in diversity’
The City of San Juan held its second LGBTQIA Pride parade. According to San Juan City Vice Mayor Janella Ejercito Estrada: “San Juan Pride is about people recognizing individuality, diversity and equality. We are all equal…”
Rainbow explosion in the City of San Juan.
Just as the year is about to close, the City of San Juan held its second LGBTQIA Pride parade. This is part of the mandate of City Ordinance No. 55, or the anti-discrimination ordinance (ADO) of the City of San Juan, which was passed in the third quarter of 2017 to protect the human rights of its LGBTQIA constituents.
Exclusively interviewed by Outrage Magazine, San Juan City Vice Mayor Janella Ejercito Estrada – who backed the ADO when it was still being proposed by Councilor Mary Joy Ibuna-Leoy – said that “San Juan Pride is about people recognizing individuality, diversity and equality. Lahat naman tayo ay pantay-pantay (we are all equal)… and (so) I’m an advocate for equality.”
Estrada added: “We acknowledge that LGBT rights are human rights; and we protect (those) rights here in San Juan.”
Pride – including Metro Manila’s – is admittedly fast be becoming a commercial endeavor. But Faustino “Bubsie” L. Sabarez III, national chairman of LGBT Pilipinas, said that “we still need Pride because it highlights individuality and the celebration of diversity.” He added that “safe spaces are still needed to celebrate being LGBTQIA, and (Pride) is one such space.”
Dindi Tan, Secretary-General of LGBT Pilipinas, added that Pride – such as San Juan’s – shows “where we are now.”
The city, for instance, has its ADO. This ADO, by the way, is not exclusive to LGBTQI people, but is also for those who may experience discrimination based on: race, disability, ethnicity and religious affiliation.
San Juan’s ADO prohibits, among others: employment-related discrimination; discrimination in education; discrimination in delivery of goods and services; discrimination in accommodation; verbal/non-verbal ridicule and vilification; harassment, unjust detention and involuntary confinement; disallowance from entry or refusal to serve; and the promotion of LGBT discrimination. Any person held liable under the ordinance may be penalized with imprisonment for 60 days to a year or fined up to P3,000, or both, depending on the discretion of a court.
Tan is also realistic in saying that the anti-discrimination bill (ADB) being pushed in the Senate by Sen. Rosa Hontiveros of Akbayan is basically dead. Its counterpart in the House of Representatives was passed with the big help of trans Rep. Geraldine Roman of the First District of Bataan; but the version in the Upper House failed to gain traction not only because of the opposition of select senators particularly Tito Sotto, Manny Pacquiao and Joel Villanueva, but also because of the exclusivist approach in the pushing for the ADB.
“Until an ADB is passed, we need ADOs,” Tan said. And local government units with ADOs “should be commended.”
Tan is also pushing for the election (in the 2019 May elections) of “politicians who will deliver,” she said, particularly “the promise for an ADB.”
Moving forward, Vice Mayor Estrada said that they are already eyeing other LGBTQIA-related efforts – e.g. broadening the city’s anti-HIV efforts to “ensure that testing, and then treatment, care and support are widely rendered in the city.”
People now embrace different forms of intimate relationships that flout cultural norms
Social media and the internet empowered individuals with diverse identities and relationship practices to find each other, raising awareness of connections that challenge traditional ideas about the meaning of intimacy.
The 21st century ushered in a “quiet revolution” in the diversity of intimate relationships. With the scale and pace of this social transformation, what is needed is a “reboot” of relationship studies.
This is according to Phillip Hammack, professor of psychology at the University of California, Santa Cruz; and lead author of “Queer Intimacies: A New Paradigm for the Study of Relationship Diversity,” an article that appeared in the online edition of The Journal of Sex Research. Hammack’s co-authors include David Frost, associate professor of social psychology at University College London, and Sam Hughes, a graduate student at UC Santa Cruz.
For the authors, social media and the internet empowered individuals with diverse identities and relationship practices to find each other, raising awareness of connections that challenge traditional ideas about the meaning of intimacy.
“I’ve been calling it a quiet revolution, because it’s very different than the sexual revolutions of the 1960s and ’70s, which were so visible,” said Hammack.
Particularly in countries like the US, Hammack said that marriage equality (same-sex marriage was legalized in the US in 2015) is the backdrop for the explosion of relationship diversity that has occurred since the early 2000s.
“Marriage equality opens up the lens to think about diversity beyond just the gender of the people in a relationship,” said Hammack, noting that asexuality, polyamory, and kink/fetish all challenge dominant notions of intimacy.
These people are thriving in intimate relationships far from the cultural norms of monogamy and heterosexuality, including asexual, polyamorous, transgender and gender nonbinary, pansexual, and kink/fetish relationships.
He also said that “it’s a myth that asexual people aren’t in relationships just because they experience little or no sexual desire,” said Hammack. “The assumption is that they are suffering, lonely, and without partners, but that’s not true. They do have intimate relationships, but we don’t know much about them.”
People who identify as asexual “violate the fundamental assumption that intimate relationships are inherently characterized by sex,” said Hammack. They started to organize in the early 2000s, thanks to the internet.
Asexuality was removed from the latest edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association in 2013.
In a similar challenge to cultural norms, those who choose polyamorous relationships violate conventions of monogamy by allowing partners to love more than one person. Although gay men have a long tradition of open relationships, and ‘swinging’ was favored by some straight couples in the 1970s, polyamory now appears in the Oxford English Dictionary, following what Hammack referred to as a “simmering movement that challenged heteronormative conventions about what an ideal relationship is supposed to look like.”
Mainstream representations are also affecting concepts and/or relationship practices. For instance, the success of the 2011 novel Fifty Shades of Grey is said to have helped propel mainstream discussion of kink/fetish relationships, which highlight consensual asymmetrical power dynamics in intimate relationships.
Hammack, nonetheless, admitted that even if it made people curious, “the novel was problematic because it didn’t accurately represent the consensual way relationships are configured in the kink community… Kink relationships have been stigmatized because the expectation is that relationships are supposed to be ‘equal’.”
Unfortunately, Hammack said that researchers still know little about what happens within kink/fetish relationships. “To what extent is the power asymmetry just during sex? We don’t know,” said Hammack. “Most of this science doesn’t talk about the relationships. It just talks about specific kinky practices… There’s almost no recognition of relationships – it’s all about sexual gratification, which is only part of the picture.”
Yet other concepts that have emerged are: “queer heterosexuality”, as well as changes in ideas about “chosen families.”
“Heterosexuality is opening up like never before,” said Hammack. “More people who identify as straight will have some same-sex experience – they even refer to ‘heteroflexibility.’ They are not opposed to same-sex encounters.”
This trend is long-established among women, but it’s new among men – and it’s distinct from bisexuality because these men don’t feel equally attracted to men and women. “It’s fascinating to see masculinity opening up this way,” he said.
Hammack noted that still “very, very little” is known about the phenomenon of chosen families as distinct from biological families. This is a phenomenon that has been historically associated with gays and lesbians who “create their own families” after being rejected by biological relatives; however, its prevalence remains a mystery.
This is why Hammack said that more research initiatives should be done to focus on diversity in intimate relationships to “document the diversity of what’s happening out there,” Hammack ended.
1 percent of children aged 9-10 self-identify as gay, bi or trans
While 1% of youth aged 9 and 10 self-identified as LGBT, their parents reported they believed their children were gay, bisexual or transgender at a higher rate.
About 1% of 9 and 10-year old children surveyed self-identified as gay, bisexual or transgender.
This finding was detailed in “Child Sexual Orientation and Gender Identity in the Adolescent Brain Cognitive Development Cohort Study,” co-authored by Jerel P. Calzo and Aaron J. Blashill, and which appeared in JAMA Pediatrics.
Majority of studies indicate that lesbian, gay, bisexual and transgender (LGBT) self-identification generally occurs during the mid-adolescent years. So “this is such an important stage, biologically and socially,”said lead author Calzo, an associate professor in the SDSU School of Public Health.
At 9 and 10, youth – whether through their peers, media or parents – are beginning to be exposed to more information about relationships and interacting in the world. Also, they may not see any of this as sexual, but they are beginning to experience strong feelings, said Calzo.
Calzo and Blashill utilized the Adolescent Brain Cognitive Development (ABCD) Study dataset, a multisite, longitudinal study exploring brain development and health among children aged 9 and 10 over a 10-year period, leading to the 1 percent finding for self-identification.
“One percent is sizable, given that they are so young,” Blashill said. “For so long, social scientists have assumed that there is no point in asking kids at this age about their sexual orientation, believing they do not have the cognitive ability to understand.” But “it is important to have a baseline to understand how sexuality develops and how it may change over time.”
Blashill and Calzo also sought to understand how parents perceived their children’s sexual and gender identities. Surprisingly, nearly 7% of parents, when asked about the sexual identity of their children, reported their child might be gay; and 1.2% reported that their child might be transgender.
Another finding was that children overwhelmingly reported no problems at home or school related to their minority sexual orientation or gender identity while 7% of parents reported gender identity-based problems.
As sexual and gender minorities experience higher rates of physical and mental health issues than do their heterosexual counterparts, the research “may provide crucial insights into resiliency development within the LGBT community”, said the authors, adding that “it could also help lead to improved programs and policies to better serve the community.”
Yet another key finding is the need for researchers to identify better ways to explore identity issues among younger populations, with about 24% of those surveyed indicating that they did not understand questions about sexual orientation.
“If we can understand identity development earlier and can track development using large datasets, we can begin improving research and prevention around risk and protective factors,” Calzo said,.
Bullying ‘follows’ LGB people from school to work
35.2% of gay/bisexual men who had experienced frequent school-age bullying experience frequent workplace bullying. Among lesbian women, the figure was 29%.
Around one in three lesbian, gay and bi individuals who are bullied at school will have similar experiences in the workplace later in life.
This is according to “School-Age Bullying, Workplace Bullying and Job Satisfaction: Experiences of LGB People in Britain”, a research done by Nick Drydakis from The Manchester School.
For this research, Drydakis approached 400 LGB individuals to ask them about their experiences at school, and also asked them about bullying at their current workplace. He found that 35.2% of gay/bisexual men who had experienced frequent school-age bullying experience frequent workplace bullying. Among lesbian women, the figure was 29%.
When describing their experiences at school, 73% of gay men said they were either constantly, frequently or sometimes bullied. Just 9.9% said they were never bullied. Among lesbian women, 59% experienced constant, frequent, or occasional bullying. The mean age of participants was 37, meaning their school years would have been approximately between 1985 and 1997.
The research also examined job satisfaction. Most gay men said they were “dissatisfied” with their job (56%), while this was also the most common answer for lesbian women (47%).
“This study suggests that bullying may be a chronic problem for LGB individuals, which continues from school to the workplace,” Drydakis said.
This could be for a number of reasons – school-age bullying could be more likely to lead to low self-esteem, a difficulty in forming trusting relationships, or a greater risk of poor mental health. Factors like these may make it more likely they will experience bullying in the workplace later in life.
“Post school-age bullying victims might exhibit characteristics of vulnerability, such as sub-assertive behaviors, which make them attractive targets for unfavorable treatments and evaluations from colleagues and employers in the workplace. “In turn, individuals, firms and society as a whole face long-lasting negative effects which appear to begin in the playground,” Drydakis said.
There is also a negative association between bullying of LGB individuals, and job satisfaction.
Interestingly, the research found that the existence of a workplace group for LGB individuals appeared to result in better job satisfaction, perhaps a lesson for employers wanting a more satisfied and motivated workforce.
“The outcomes of this study suggest… that bullying, when it is experienced by sexual orientation minorities tends to persist over time,” the research concludes. And so “anti‐bullying strategies and affirmative actions in school and the workplace might be of consideration.”