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Molecular epidemiology of HIV in Phl changing, more aggressive subtype now predominant

A study finds that the molecular epidemiology of HIV in the Philippines has changed from subtype B, with the more aggressive CRF01_AE now being the predominant subtype. “It shows that the strain of HIV in the Philippines has changed to a potentially more aggressive (faster time to AIDS) and more transmissible variant,” said Edsel Maurice Salvaña, MD, FIDSA, one of the people behind the study. The finding of the study may also explain – at least partially – the unprecedented increase in the number of HIV cases in the Philippines.

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The molecular epidemiology of HIV in the Philippines has changed from subtype B, with the more aggressive CRF01_AE now being the predominant subtype. This is according to a study that was “done to better characterize the Philippines’ HIV epidemic,” shared to Outrage Magazine by Edsel Maurice Salvaña, MD, FIDSA, one of the people behind the study. “Since 2006, the number of new HIV cases has been growing exponentially, and so we wanted to know if there was any change in the character of the virus that could help explain the surge.”

Doing the study with Salvaña were Brian Schwem, PhD; Jill Itable, MD; Patrick Ching, MD; Sharie Ganchua; Marissa Alejandria, MD; Jodor Lim, MD; and Raul Destura, MD.

For Salvaña, their findings should be a cause of concern.

“It shows that the strain of HIV in the Philippines has changed to a potentially more aggressive (faster time to AIDS) and more transmissible variant,” Salvaña said. “It also means that it is more likely a local epidemic due to the predominance of one genotype because multiple genotypes would be more likely if most of the HIV cases were imported from different parts of the world.”

INCREASING RATES

For Salvaña, the “finding of the study at least partially explain the unprecedented increase in the number of cases.”

In April of this year alone, over 500 (to be exact: 560) new HIV cases were reported in the country, according to the Department of Health (DOH). The 560 new cases are 42% higher than the 393 cases reported in April 2014. Earlier – in March – the figure was higher, with 667 new HIV cases reported; this was the highest figure ever recorded since the first case of HIV was reported in the country in 1984.

As such, the Philippines is not only one of only nine countries globally with rapidly increasing rates of HIV infection; it is, in fact, the country with the highest infection rates. An average of 20 new HIV cases are being reported every day since the start of 2015, compared with an average of 17 HIV cases a day and an average of nine in 2012.

READ:  The great divide…

With the numbers from April, the number of people living with HIV in the Philippines for the first four months of the year alone reached 2,409. The figure includes 65 deaths. In total – since 1984 – the number of HIV cases in the country reached 24,936, with 2,213 of these progressing to AIDS, and 1,183 ending in death.

While sexual transmission still accounts for over 95% of HIV cases in the Philippines, a major shift from a heterosexual to men who have sex with men (MSM) transmission has been noted. In March, for instance, 547 of the new cases were transmitted through sex, particularly among men who have sex with men (MSM), who accounted for 477 (87%) of the cases. Particularly, 295 of the cases were through homosexual contact, while 182 were through bisexual contact.

WORRYING CHANGE

The shift (in the molecular composition of HIV in the Philippines) may have occurred beginning in 2006. However, as per Salvaña, “if we look at published data for HIV genotypes in the Philippines, there is a big gap between 2003 and 2013 in terms of molecular characterization of HIV genotypes.”

For this study, 81 newly-diagnosed, treatment-naive HIV-positive patients at the Philippine General Hospital (PGH) were interviewed and underwent genotyping of HIV RT and PR genes using World Health Organization (WHO) approved protocols for HIV genotyping. Generated sequences were analyzed using the Stanford Drug Resistance Database. Demographics, sexual habits and CD4 counts at presentation were collected.

The study’s participants only included MSM, which was “not intentional,” Salvaña said. But “during the period of enrolment, very few women tested positive and we were unable to capture them during the recruitment process. This is consistent with the current national statistics of the epidemic, where over 90% of newly diagnosed cases are men.”

However, “we can look at that kind of data in two ways: that there really are more cases of HIV in men, or that men are more likely to get tested due to their own perceived need for testing (e.g. risk, employment for abroad, et cetera). The DOH estimates that only 12% of the at-risk population has been tested, and so we certainly do not have the complete picture. But it is better to have some of the picture than not to have any of it, it is just harder to make more widely applicable conclusions.”

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The cohort had an average age of 29 years (range 19-51 years), CD4 count of 254 cells/mm3 (2-744 cells), and self-reported acquisition time of 2.42 years (0.17-8.17 years). All were male, and 79 were MSM. Genotype distribution was CRF01_AE (75%), B (22%), C (1%), and CRF01_AE/K (1%).

According to the study, pooled analysis of published data from samples collected from 1985-2000 showed that the majority of Philippine HIV infections were previously caused by subtype B (71%, N=100), followed by subtype CRF01_AE (20%). Comparison with this newer study’s cohort shows a highly significant shift in subtype (p<0.001 by Chi-square).

Comparison of CD4 counts at presentation between CRF01_AE and B showed a significantly lower count (233 cells/mm3 versus 350 cells/mm3, p=0.03 by T-test) despite no difference in age (p=0.15), and self-reported time to acquisition (p=0.66).

As per the study: “This is consistent with previous reports that CRF01_AE is more aggressive, with faster progression to AIDS. While no viral loads were available for this cohort, CRF01_AE has been reported to have a higher rate of transmission. “

For this study – and again – “these two factors may partly explain the explosive increase in the number of new infections.”

CHANGING FACE OF HIV?

HIV continues to be a source of worry; but this news is even more worrisome, particularly when taken following the news about the new, aggressive HIV strain that was discovered in Cuba. In a study conducted by researchers from the University of Leuven in Belgium, several HIV-infected people in Cuba developed AIDS in less than three years, which is faster than the usual 10 years it typically takes. All patients infected with CRF19, a recently-discovered strain of the HIV virus, had higher levels of it in their body.

A major difference – and this is worth highlighting – is that the Cuban strain is a new variant of HIV which may be more aggressive in time to AIDS. “It wasn’t the predominant strain there, only that it was discovered there in a small pool of samples,” Salvaña said.

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The Philippine study actually had more samples (n=80) than the one in Cuba (n=73). But “we need to be very careful in interpreting these kinds of data because strong evidence is needed to support conclusions and most of what is available is typically done retrospectively (reviewing case files) and in uncontrolled situations. The data can be influenced by bias and other confounders. There seems to be at least some evidence to suggest that this strain is more virulent, but whether this is borne out in the future in bigger and more stringent prospective studies remains to be seen.”

Salvaña added: “HIV is a very complex virus in that it mutates very fast and gives rise to multiple variations which also recombine. The original virus likely originated from at least five different transmission events from apes, and more will likely be found. The nature of this virus is to constantly change, and that is why it took so long to find appropriate treatment using a three-drug combination that suppressed the mutations, and it is taking even longer to find a durable cure. We need to stay on top of this virus by starting everyone on treatment (which prevents it from mutating further and decreases the risk of transmitting it to others), educating the public on protecting themselves from infection, and supporting research that is looking for an effective vaccine and a cure.

STRENGTHENING RESPONSES

Salvaña sees the need to work together to fight HIV.

Academic institutions, for instance, can take part by helping in characterizing the epidemic and watching out for more aggressive variants. As such, however, “funding more studies like ours helps keep an eye on the emergence of these new strains.”

The media, meanwhile, “has a key role to play in spreading the word, educating the public, and helping people understand how they can make a difference in the fight against HIV and AIDS.”

And with HIV continuing to be a major concern, “the government and others working on HIV eradication should redouble their efforts in controlling the spread of HIV in the country,” Salvaña ended.

The founder of Outrage Magazine, Michael David dela Cruz Tan is a graduate of Bachelor of Arts (Communication Studies) of the University of Newcastle in New South Wales, Australia. Though he grew up in Mindanao (particularly Kidapawan and Cotabato City in Maguindanao), even attending Roman Catholic schools there, he "really, really came out in Sydney," he says, so that "I sort of know what it's like to be gay in a developing and a developed world". Mick can: photograph, do artworks with mixed media, write (DUH!), shoot flicks, community organize, facilitate, lecture, research (with pioneering studies under his belt)... this one's a multi-tasker, who is even conversant in Filipino Sign Language (FSL). Among others, Mick received the Catholic Mass Media Awards (CMMA) in 2006 for Best Investigative Journalism. Cross his path is the dare (read: It won't be boring).

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3rd Iloilo LGBTQI gathering stresses that #PRIDEisProtest

Iloilo hosted its 3rd LGBTQI Pride parade, with the core message highlighting that Pride remains an act of protest.

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PHOTOS PROVIDED BY ‘HUMANS OF ILOILO’; CHANNEL BIBANCO; ALJHUR ALQUIZAR III

The city of Iloilo hosted the third iteration of its Pride parade, with the core message highlighting that Pride remains an act of protest. In a way, this is contrary to the current direction many Pride-related parades are taking – including in Metro Manila – where advocacy is getting trumped by commercialization/partying.

Metro Manila’s LGBT gathering breaks attendance records, highlights ubiquity of LGBT people if not causes

In a statement provided to Outrage Magazine, Carlo Gabriel Evidente of the Iloilo Pride Team said that the move to focus on #PRIDEisProtest is “in recognition of the legacy of the Stonewall Riots, and the continuing gender-based violence and discrimination experienced by persons of various SOGIEs all over the world.”

Irish Granada Inoceto, vice chairperson of Iloilo Pride Team, added: “Through this (gathering we hoped to) make all colors of gender visible and celebrated. This is our way of saying we are here and we are not going anywhere.”

Over 2,000 people joined this year’s gathering, the biggest for the three-year-old annual gathering.

Iloilo has actually been making rainbow waves lately.

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.

Iloilo City passes anti-discrimination ordinance on final reading

Following this, in August, Iloilo Mayor Jose S. Espinosa III declared the city as “LGBT-friendly”, with plan to establish an office that will develop programs and activities for the LGBT community.

Iloilo declared as ‘LGBT-friendly’ city; mayor eyes to establish office to handle LGBTQI-related efforts

For Inoceto, “as long as Pride remains inclusive of the issues of the most marginalized, when it continues to be a platform for the courage of those who stand for LGBT rights and human rights, Pride will never grow passé.”

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PHOTOS PROVIDED BY ‘HUMANS OF ILOILO’; CHANNEL BIBANCO; ALJHUR ALQUIZAR III

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Malabon passes anti-discrimination ordinance on the basis of SOGIE

Malabon City now has 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.

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Still slow national move; better local endeavors.

In the absence of a national law that will protect the human rights of LGBTQI Filipinos, a growing number of local government units are taking the lead in ensuring that LGBTQI-related discrimination is checked. And now the city of Malabon has joined the list of LGUs with an anti-discrimination ordinance (ADO).

City Ordinance 16-2018, signed on September 10 by Mayor Antolin Oreta III, declares “as a policy of Malabon City to actively work for the elimination of all forms of discrimination that offend the equal protection clause of the Bill of Rights.”

Among the prohibited acts in the ADO are: 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.

As with other ADOs, the Malabon ordinance similarly mandates the creation of the Malabon City Pride Council, tasked to monitor complaints, assist victims of stigma and discrimination, as well as recommend to the city council additional anti-discrimination policies and review all existing resolutions, ordinances and codes if these have discriminatory policies.

The same Pride council will oversee the implementation of an anti-discrimination campaign and the organization of LGBTQI groups in the barangays of the city.

The Malabon ADO also aims to include anti-discrimination programs (including psychological counseling, legal assistance, and forming of barangay-level LGBTQI organizations), with the budged to be sourced from the gender and development (GAD) plans, projects and programs (uo to 5%).

READ:  Stop biding your time

The ADO also tasks the Malabon police station to investigate cases involving violence based on SOGIE.

Also with the ADO, Malabon will now commemorate LGBTQI-related events, including the International Day Against Homophobia and Transphobia on May 17; Pride parade in December; World AIDS Day on December 1; and Human Rights Day on December 10.

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What it’s like to be trans in Taiwan

Tamsin Wu visits gay-friendly Taiwan, where she meets Abbygail Wu, founder of Intersex, Transgender and Transsexual People Care Association (ISTSCare), who said that the country is still failing its LGBTQ citizens, and particularly lags in promoting trans rights.

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Photo detail by Thomas Tucker from Unsplash.com

Taiwan may be the most gay-friendly country in Asia, but according to Abbygail Wu, founder of Intersex, Transgender and Transsexual People Care Association (ISTSCare), the country still receives a “failing mark” when it comes to LGBTQ equality. Transgender people, in particular, usually bear the brunt of sex-based discrimination.

ISTSCare has a one-woman 24/7 hotline service. Abby has dealt with calls concerning struggles related to suicide attempts, job insecurity or homelessness, and even domestic violence. To provide support and assistance to hotline callers, ISTSCare also partners with NGOs and other LGBTQ-related organizations.

Aside from the hotline service, the organization does its advocacy work through protests, by maintaining an online presence, as well as directly communicating with political figures and trans-friendly journalists to rouse awareness and discussion on transgender and intersex issues.

ISTSCare in Taiwan

In 2014, four years after the first official notice regarding gender reassignment procedures in Taiwan was issued, the Ministry of Interior (MOI), with the support of the Ministry of Health and Welfare (MOHW), announced the easement of legal requirements on changing gender identity. MOI promised that it would immediately work on letting transgender citizens change their gender marker without having to go through rigorous psychiatric assessments, sex reassignment surgery (SRS) and parental approval. However, MOI backtracked since then.

“MOI, which is handling the national ID cards, they said there are still a lot of research to do about the gender issue and they try to get some professional opinions, but MOHW already said this is not a medical issue, it’s an internal affair issue. So MOI, they’re just under the pressure and paused a lot of meetings… and now the issue is still under research for four years,” Abby lamented. “We’re the first Asian country to pass the bill but it’s not implemented.”

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Despite MOHW already stating that medical professionals should not have a say when it comes to determining one’s gender identification, transgender citizens are still presently forced to consider SRS. Besides that, they are also required to seek the expensive involvement of psychiatrists and, outrageously, the consent of their parents. Otherwise, their gender identity cannot be legally recognized.

Abby clarified that not all transgender people want the help of doctors to validate their gender identity. Hence, SRS is especially discriminatory towards transgender citizens who do not wish to undergo surgery. “What is gender? Is it just based on our anatomy? Or is it in our behavior? In our mind? Or in the way we dress?… There are a lot of factors that influence what gender one identify as, but society focus on the least publicly visible aspect – our sex organ.”

Abby continued, “There are risks to surgery and that is one of the reasons why not all transgenders want to go through it. And also, they may question themselves, ‘Do I really want to have surgery or is it just for the sake of getting this ID?’”

Abby standing beside the transgender pride flag.
Photo credit: Ketty W. Chen

“One day before the presidential election, I went to the DPP (Democratic Progressive Party) headquarters to talk with the Department of Woman. I told them, ‘tomorrow is already the day for voting, are you going on stage and advocate for transgender rights? This has been neglected for the past 3-4 years. Then they just told me, ‘this requires social consensus’… I went out of that meeting deeply upset,” Abby shared.

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With lack of funding, community support and societal understanding of trans issues, how could transgender rights obtain social consensus when this feat requires acceptance and approval from the status quo in order for the relevant social change to take effect? Why should the rights and well-being of a minority group fall in the hands of the majority? Currently, both the public and the government possess inadequate knowledge in dealing with transgender issues, which exacerbates the struggles transgender citizens face.

Prejudice against transgender folks can also be felt within LGBTQ communities. On one hand, some non-transgender members of the LGBTQ community question the gender identity of trans people. On the other hand, there is also internalized transphobia.

“A lot of transgender are more binary [in the way they see gender]. They think a man should act and look a certain way and that a woman should act and look a certain way… ISTSCare does not condone this kind of thinking,” Abby said.

Trans activist Abbygail Wu and her partner in a protest for their marriage right.
Photo credit: Ketty W. Chen

When asked why ISTSCare is run by only three people (including Abby and her partner), she shared that many transgender citizens in Taiwan find it difficult to prioritize doing advocacy work because their life situation is oftentimes mentally and emotionally taxing. On top of having to deal with an unsupportive family, they often face discrimination in the job market. Hence, there’s a high level of difficulty for them to get a good job, gain professional working experience and make a decent living, let alone have the financial resources to go through SRS. As of now, they’re in this loop of societal discrimination and economic vulnerability with no recourse.

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Another reason for the lack of transgender-focused activists in Taiwan is attributed to the problem of privilege. Abby adds that well-off transgender citizens tend to be exclusive in their social group. Post-surgery and after assimilating in heteronormative society, they also tend to ignore the struggles faced by less fortunate transgender citizens. They would rather not get associated for fear of being found out and face discrimination. Albeit joining Pride Parades, they are at other times nowhere to be found when it comes to advocating for transgender rights.

Abby clarified that not all transgender people want the help of doctors to validate their gender identity.
Photo credit: Abbygail Wu

Abby said that ISTSCare’s main goal right now is to push for a non-discriminatory, comprehensive gender identity law in Taiwan.

“We hope to be like Argentina. Just file [required] papers to the courthouse and they will assign the legal gender change. No need to go through any kind of medical process.”

Having a well thought out gender identity law may not help solve all transgender issues and alleviate them from all of their struggles. However, getting the said law done and implemented right would be one significant progress for the recognition of the human rights and dignity of, not only transgender citizens, but also intersex and non-binary people.

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Chance of HIV-positive person with undetectable viral load transmitting the virus to a sex partner is scientifically zero

The PARTNER 2 study found no transmissions between gay couples where the HIV-positive partner had a viral load under 200 copies/ml – even though there were nearly 77,000 acts of condomless sex between them.

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Confirmed and needs to be stressed: The chance of any HIV-positive person with an undetectable viral load transmitting the virus to a sexual partner is scientifically equivalent to zero.

This is according to researchers who released at #AIDS2018 the final results from the PARTNER study. Results originally announced in 2014 from the first phase, PARTNER 1, already indicated that “Undetectable equals Untransmittable” (U=U). But while the first study was lauded in tackling vaginal sex, the statistical certainty of the result did not convince everyone, particularly in the case of gay men, or those who engage in anal sex.

But now, PARTNER 2, the second phase, only recruited gay couples. The PARTNER study recruited HIV serodifferent couples (one partner positive, one negative) at 75 clinical sites in 14 European countries. They tested the HIV-negative partners every six to 12 months for HIV, and tested viral load in the HIV-positive partners. Both partners also completed behavioral surveys. In cases of HIV infection in the negative partners, their HIV was genetically analyzed to see if it came from their regular partner.

And the results indicate “a precise rate of within-couple transmission of zero” for gay men as well as for heterosexuals.

The study found no transmissions between gay couples where the HIV-positive partner had a viral load under 200 copies/ml – even though there were nearly 77,000 acts of condomless sex between them.

PARTNER is not the only study about viral load and infectiousness. Last year, the Opposites Attract study also found no transmissions in nearly 17,000 acts of condomless anal sex between serodifferent gay male partners. This means that no transmission has been seen in about 126,000 occasions of sex, if this study is combined with PARTNER 1 and 2.

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While this is good news overall in the fight against HIV, related issues continue to plague HIV-related efforts, particularly in countries like the Philippines.

Why aren’t we talking about ‘undetectable = untransmittable’ in the Philippines?

For instance, aside from the overall silence on U=U (undetectable = untransmittable), use of anti-retroviral therapy (ART) continue to be low. As of May 2016, when the country already had 34,158 total reported cases of HIV infection, Filipinos living with HIV who are on anti-retroviral therapy (i.e. those who are taking meds) only numbered 14,356.

The antiretroviral medicines in use in the Philippines also continue to be limited, with some already phased out in developed countries.

All the same, this is considered a significant stride, with science unequivocally backing the scientific view helmed in 2008 by Dr. Pietro Vernazza who spearheaded the scientific view that viral suppression means HIV cannot be passed via a statement in the Bulletin of Swiss Medicine.

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‘God loves LGBTQIA people; so do we.’

A Christian church wants members of the LGBTQIA community to know that “they are loved by God.” Val Paminiano, pastor of the Freedom in Christ Ministries, says that “we would like to apologize on behalf of the mainstream churches that condemn the LGBTQIA community. Sorry for hurting you; (and) even for using the Bible to hurt you.”

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God’s love is for all.

“(We want the members of the LGBTQIA community to know that) they are loved by God,” said Val Paminiano, pastor of the Freedom in Christ Ministries, which has been making its presence known particularly in LGBTQIA Pride events to highlight its Christian anti-anti-LGBTQIA position.

Approximately 80% of Filipinos are Roman Catholic, and the church’s teachings continue to dominate public life in the Philippines. As it stands, church’s teachings re LGBTQIA people still often revolve around the “hate the sin, love the sinner” statement, so that LGBTQIA people are tolerated so long as they do not express their being LGBTQIA.

This “hate the sin, love the sinner” stance seems to be reflected in dominant perspectives re LGBTQIA people in the Philippines.

In 2013, for instance, in a survey titled “The Global Divide on Homosexuality” conducted by the US-based Pew Research Center, 73% of adult Filipinos agreed with the statement that “homosexuality should be accepted by society”. The percentage of Filipinos who said society should not accept gays fell from 33% in 2002 to 26% that year.

But more recently, in June 2018, a Social Weather Stations (SWS) survey showed that a big percentage of Filipinos still oppose civil unions. When 1,200 respondents across the country were asked whether or not they agree with the statement “there should be a law that will allow the civil union of two men or two women”, at least 61% of the respondents said they would oppose a bill that would legalize this in the country. Among them, 44% said they strongly disagree, while 17% said they somewhat disagree. Meanwhile, 22% said they would support it, while 16% said they were still “undecided”.

READ:  The great divide…

For Paminiano, “we would like to apologize on behalf of the mainstream churches that condemn the LGBTQIA community. Sorry for hurting you; (and) even for using the Bible to hurt you.”

Churches continue to be lambasted for not changing with time – perhaps most obvious in the treatment of LGBT people of those with faith. But the number of denominations openly discussing – and even coming up with statements of support of – LGBTQIA issues is increasing.

Finding room for #queerinfaith

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All hail the beauty queen

A glimpse into the life of a trans woman beauty pageant enthusiast, Ms Mandy Madrigal of Transpinay of Antipolo Organization.

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This is part of #KaraniwangLGBT, which Outrage Magazine officially launched on July 26, 2015 to offer vignettes of LGBT people/living, particularly in the Philippines, to give so-called “everyday people” – in this case, the common LGBT people – that chance to share their stories.
As Outrage Magazine editor Michael David C. Tan says: “All our stories are valid – not just the stories of the ‘big shots’. And it’s high time we start telling all our stories.”

“I feel accepted.”

That, said Mandy Madrigal, is the main appeal of joining beauty pageants.

“I feel so loved when I join pageants. Especially when people clap for us, cheer for us. And when you win… it (just) feels different.”

FINDING ACCEPTANCE

Assigned male at birth, Mandy was in primary school when her father asked her if “I was a boy or a girl”. That question scared her, she admitted, because – as the only boy among six kids – she thought she did not really have “any choice”. “So I answered my father, ‘I am a boy’.”

But Mandy’s father asked her the same question again; and this time, “I said, yes, I am gay.”

No, Mandy is NOT gay; she is a transpinay, and a straight one at that. But the misconceptions about the binary remains – i.e. in this case, she is associated with being gay mainly because she did not identify with the sex assigned her at birth.

In a way, Mandy said she’s lucky because “I believe he (my father) accepted (me) with his whole heart.”

The rest of her family did, too.

Though – speaking realistically – Mandy said this may be abetted by her “contributions” to the family. “Hindi naman aka basta naging bakla lang (I’m not a ’typical’ gay person),” she said, “na naglalandi lang o sumasali lang ng pageant (who just flirts, or just joins beauty pageants). Instead, Mandy provides financial support to her family by – among others – selling RTW clothes and beauty products. In fact, some of her winnings also go to the family’s coffers. By helping provide them with what they need, “it’s easy for them to accept me as a transgender woman.”

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Growing up, Mandy realized that while “makakapagsinungaling ka sa ibang tao, pero sarili mo, hindi mo maloloko. Kaya mas magandang tanggapin mo ang sarili mo para matanggap ka ng ibang tao (you may be able to lie to others about who you really are, but you can’t lie to yourself. So it’s better to accept your true self so that others will be able to accept you too).”

Mandy was “introduced” to beauty pageants when she was 13 or 14. At that time, a friend asked her to join a pageant; and “I won first runner up.” She never looked backed since, even – at one time – earning as much as P20,000 after winning a title. Like many regular beauconeras (beauty pageant participants), she also heads to distant provinces to compete, largely because – according to her – prizes in provincial competitions tend to be higher. The prize money earned helps one buy more paraphernalia for the next pageants, and – in Mandy’s case – also helps support her family.

Generally speaking, Mandy Madrigal said that “ang tunay na queen ay may malaking puso (a real queen has a big heart).”

FORMING A FAMILY

Beauty pageants are competitions, yes; but for Mandy, pageants also allow the candidates to form bonds as they get close to each other. Pageants, she said, can be a way “na maging close kami, magkaroon ng magagandang bonding… at magkakilala kami (for us to be close, to bond and get to know the others better).”

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Pageants can be costly, Mandy admitted – for instance, “you have to invest,” she said, adding that a candidate needs to be able to provide for herself (instead of just always renting) costumes, swimsuits, casual wear, gowns, and so on.

In a way, therefore, having people who believe in you helps. In Mandy’s case, for instance, a lot of people helped (by providing necessities she needs) because “naniniwala sila na I am a queen inside and out,” she smiled.

But this support can also rack the nerves, particularly when people expect one to win (particularly because of the support given).

One will not always win, of course; and this doesn’t always give one good feelings. In 2017, for instance, Mandy joined Queen of Antipolo, and – after failing to win a crown – she said many people told her she should have won the title, or at least placed among the runners-up. “naguluhan ang utak ko (That confused me),” she said. “‘Bakit ako ang gusto ninyong manalo?’ But that’s when I realized na marami ako na-i-inspire na tao dahil marami nagtitiwala sa akin (I ask, ‘Why do you want me to win?’ But that’s when I realized that I inspire a lot of people, which is why they count on me).”

This gives her confidence; enough to deal with the nervousness that will also allow her to just enjoy any pageant she joins.

A TIME TO SHINE

Mandy believes pageants can help LGBTQI people by providing them a platform to showcase to non-LGBTQI people why “hindi tayo dapat husgahan (we should not be judged).”

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Generally speaking, Mandy said that “ang tunay na queen ay may malaking puso (a real queen has a big heart).”

And she knows that not every pageant is good for every contestant. There will be pageants where you will be crowned the queen, she said, just as there will be pageants where you will lose. But over and above the winning and losing, note “what’s most important: that there’s a lot of people who supported you in a (certain) pageant.”

At the end of the day, “sa lahat ng patimpalak, pagkatandaan natin na merong nananalo at may natatalo. Depende na lang yan sa araw mo. Kung ikaw ay nakatadhanang manalo ay mananalo ka; kung nakatadhanang matalo ay matatalo ka talaga. Yun lang yun. Isipin mo na lang na meron pang araw na darating na mas maganda para sa iyo (in all competitions, remember that there will always be a winner and a loser. It all depends on your luck for the day. If you are fated to win, you will win; if you are fated to lose, you will lose. That’s that. But still remember – even when you lose – that there will always come a day that will be great for you).”

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