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PhilHealth clarifies OHAT coverage

Different treatment hubs give PLHIVs different services, even if they pay the same amount to PhilHealth. But while the earlier PhilHealth circular that mentioned the services to be provided to PLHIVs in the Philippines did not specify all the services that PLHIVs may need, PhilHealth’s Dr. Mary Antoinette Remonte said that for “any laboratory tests related to ART treatment, they can use the OHAT Package for it.”

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As the Red Ribbon Project eyes to help the country get to zero (i.e. zero new HIV infection, zero AIDS-related death, and zero HIV-related discrimination), its beauty queens - Binibining ARV-Universe, Bb. ARV-World and Bb. ARV-International; joined by Miss ARG 2012 - gives the "beauty with a purpose" tagline flesh, this time by reaching out to Filipino PLHIVs in RITM. "That there's still something to live for," is the goal of the outreach, said Pozzie Pinoy, who helms Red Ribbon Project - seconded by Bb. ARV-Universe, who said in the vernacular that "if we can - even for a while - shed some hope, that's good and well."

As the Red Ribbon Project eyes to help the country get to zero (i.e. zero new HIV infection, zero AIDS-related death, and zero HIV-related discrimination), its beauty queens – Binibining ARV-Universe, Bb. ARV-World and Bb. ARV-International; joined by Miss ARG 2012 – gives the “beauty with a purpose” tagline flesh, this time by reaching out to Filipino PLHIVs in RITM.
“That there’s still something to live for,” is the goal of the outreach, said Pozzie Pinoy, who helms Red Ribbon Project – seconded by Bb. ARV-Universe, who said in the vernacular that “if we can – even for a while – shed some hope, that’s good and well.”

This is a continuing story on the disparities in the services received by PLHIVs in different hubs in the Philippines, even if they are required to pay the same amount by PhilHealth.

In the Philippines, the treatment, care and support received by most people living with HIV (PLHIVs) are covered by the Philippine Health Insurance Corporation’s (PhilHealth) Outpatient HIV/AIDS Treatment (OHAT) Package. Specifically, to those who are enrolled in PhilHealth, P30,000 is allocated per PLHIV per year, or P7,500 every quarter.

But – as stated in a previous report by Outrage Magazine – PLHIVs from different treatment hubs in the country experience different and at times confusing disparities in the services that they receive, even if they pay the same PhilHealth premium/amount of approximately P2,400 per year.

READING THROUGH

After the release of PhilHealth’s OHAT Package circular in 2010, DOH published Administrative Order No. 2010-0036 – The Aquino Health Agenda: Achieving Universal Health Care for All Filipinos – in December 2010, signed by then Health Secretary Enrique Ona.

It stated that “the Aquino Health Agenda (AHA) is a focused approach to health reform implementation in the context of HSRA (Health Sector Reform Agenda) and F1 (FOURmula One), that all Filipinos especially the poor receive the benefits of health reform.”

ARV is part of the "free" TCS services received by PLHIVs in the Philippines

ARV is part of the “free” TCS services received by PLHIVs in the Philippines

Under that guideline is the attainment of health-related Millennium Development Goals (MDG), which include the reduction of HIV/AIDS prevalence.

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The administrative order also mentioned that the “DOH shall develop guidelines and protocols to organize the community health team and service delivery network, implement a functional referral system, deliver health service packages, contract with private providers, implement clinical practice guidelines, generate, retain, and use hospital revenues, and establish hospital pricing system to maximize benefits from PhilHealth.”

In the 2010 OHAT Package circular, it stated that the “package shall be based on Department of Health (DOH) guidelines on anti-retroviral therapy among adults and adolescents with human immunodeficiency virus infection. All treatment hubs in accredited facilities are required to follow the guidelines set by the DOH.”

Meanwhile, the Guidelines on Antiretroviral Therapy (ART) among Adults and Adolescents with Human Immunodeficiency Virus (HIV) Infection – DOH Administrative Order No. 2009-0006 – released in January 2009 stated that as part of monitoring the response to ART treatment, “for patients with good compliance to ART, clinical response is recommended to be used together with CD4 count and viral load determination (whenever feasible) to detect treatment failure.”

And that “treatment hubs through its HIV AIDS Core Team (HACT) shall provide treatment and clinical monitoring of patients under ART.”

ACTUAL COVERAGE

In an interview with Outrage Magazine, PhilHealth’s Medical Specialist III and Millennium Development Goals Benefit Products Team Head Dr. Mary Antoinette Remonte said that “it has come to our attention that some treatment hubs charge for some laboratory tests, even after the release of the OHAT Package circular.”

The 2010 circular only specifically stated that “covered items under this benefit are drugs and medicines, laboratory examinations including Cluster Difference 4 (CD4) level determination test and test for monitoring of anti-retroviral drugs (ARV) toxicity and professional fees of providers.” As such, Remonte said that “some treatment hubs take what was written in the circular literally.”

Remonte, however, said that if a PLHIV needs “viral load, if it’s really needed, they can still charge it on the OHAT package. Any laboratory tests related to ART treatment, they can use the OHAT Package for it.” For Remonte, “even if viral load testing was not written in the first circular, it was already included in the coverage.”

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The revised OHAT Package released last June already clearly states that “covered items under this benefit are drugs and medications, laboratory examinations based on the specific treatment guideline including Cluster of Differentiation 4 (CD4) level determination test, viral load (if warranted), and test for monitoring anti-retroviral (ARV) drugs toxicity and professional fees of providers.”

PhilHealth also monitors the disparities among the services offered by treatment hubs, particularly on whether they are putting into effect what were stated in the circulars that were released.

“We are currently reviewing the OHAT Package, the implementation of it in treatment hubs, and the current rates; and if they have questions, we can discuss it with them,” Remonte said.

PLHIVs, meanwhile, are encouraged to contact PhilHealth if they have concerns regarding their PhilHealth membership and coverage.

PROPER MANAGEMENT

According to Dr. Rosanna Ditangco, research chief atThe Research Institute for Tropical-AIDS Research Group (RITM-ARG), a treatment hub located in Alabang, management issues also come to play in the delivery of TCS services to PLHIVs.

For instance, while “the OHAT Package does not cover baseline tests yet”, at RITM-ARG, PLHIVs are able to receive free baseline laboratory tests, such as CBC, chest x-ray, PPD and blood chemistry (i.e. lipid profile, BUN, Creatinine, FBS), and CD4 count.

“Due to good financial management, we can provide these free baseline services to new patients; and once they start treatment, they would be eligible for the OHAT Package and RITM would be able to regain the initial investment,” said Ditangco.

Older PLHIVs, meanwhile, can already use their PhilHealth membership when availing different services and laboratory tests that are needed and related to their antiretroviral therapy (ART) treatment.

There are minimun number of tests that DOH mandates for treatment hubs to give to PLHIVs, so that hubs now offer different services aside from those mandated - and even if the amount they pay to PhilHealth remain the same

There are minimum number of tests that DOH mandates for treatment hubs to give to PLHIVs, so that hubs now offer different services aside from those mandated – and even if the amount they pay to PhilHealth remain the same

“Every six months, we provide free CD4 and CBC tests. And yearly, during their anniversary, we provide free CD4, CBC, blood chemistry – depending on what ARV they are taking, and viral load tests. If the doctor suspects treatment failure, a free viral load test will be done anytime, plus HIV drug resistance testing,” Ditangco said.

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Ditangco added that “all of these are covered by OHAT. And this has been our system ever since PhilHealth released their first circular.”

RITM-ARG also receives “additional support” from the DOH, which the facility also uses when providing TCS services to PLHIVs.

“Our funding is mostly from our OHAT reimbursement, but every now and then, we receive funding from DOH and we use this to provide free viral load, CD4 or HIV drug resistance testing for other treatment hubs,” Ditangco said.

WAY FORWARD

Interviewed by Outrage Magazine in Davao City during the 1st HIV Summit in southern Philippines, DOH Usec. Vicente Y. Belizario Jr. said that the DOH mandates the “minimum package (to be provided by hubs to PLHIV).” However, “(health care) is decentralized to local government units, (and) there are LGUs that are more innovative.”

“The challenge is to ensure harmonization,” Belizario said, adding that this is what the DOH “will continue to push.”

For Dr. Jose Narciso Sescon of the AIDS Society of the Philippines, “one bright move towards ensuring standardization is that these are being discussed and taken on. This is a healthy step towards a more robust HIV package of services offered to clienteles… if and only if we are all open (government and private service providers) to take on to discuss and accept the real challenges faced by our program.”

“I believe all major government treatment hubs must agree on a standardized treatment package offered to their patients that can be availed under the PhilHealth OHAT Package. Having a national standard on HIV treatment services offered to Filipino PLHIVs will help avoid confusion and unnecessary inconvenience for patients,” said Kevin Kane Li of The AIDS Treatment Action Group (TATAG) Philippines.

Meanwhile, for Pozzie Pinoy of The Project Red Ribbon, “if your hubs are charging you for your laboratory tests in succeeding tests, you should start asking.”

Pozzie Pinoy likens the PhilHealth to having an insurance package, wherein “if you have an HMO, you have packages, and you must know what’s being spent on you.”  In the case of PhilHealth, “ask your hub what in your P30,000 is being spent. You paid for it, so it should be used for you. Learn to ask. Don’t turn a blind eye just to save face. This can be solved by asking.” – WITH INTERVIEWS BY MDCTAN

PhilHealth may be reached at (+63 2) 441 7444 or (+63 2) 441 7442, or email actioncenter@philhealth.gov.ph.

Outrage Magazine is one with the PLHIV community in demanding for a uniform implementation of TCS services, particularly as mandated by PhilHealth. 

Living life a day at a time – and writing about it, is what Patrick King believes in. A media man, he does not only write (for print) and produce (for a credible show of a local giant network), but – on occasion – goes behind the camera for pride-worthy shots (hey, he helped make Bahaghari Center’s "I dare to care about equality" campaign happen!). He is the senior associate editor of OutrageMag, with his column, "Suspension of Disbelief", covering anything and everything. Whoever said business and pleasure couldn’t mix (that is, partying and working) has yet to meet Patrick King, that’s for sure! Patrick.King.Pascual@outragemag.com

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Haircut battleground

FACT: A number of trans students fail to complete schooling because of strict implementation of uniform policies that affect their gender identity and expression. School officials claim they’re simply implementing (discriminatory) policies; while activists claim human rights violation. And while the discussions happen, the students are caught in the middle, who – in the end – really just want to finish schooling while being true to oneself.

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Photo by Mohamed Nohassi from Unsplash.com

In July 2018, Jenny* (not her real name), a transgender Senior High School (SHS) student from the Polytechnic University of the Philippines (PUP) was allegedly told to report to the principal’s office for the first time.

Pinatawag ako nung principal, tapos she told me that ano… kapag hindi ako nagpagupit until tomorrow morning, ganon, papalabasin niya ako ng PUP (I was told to report to the principal’s office, and there, she told me to get a haircut the next day, or risk getting asked to leave PUP),” she recalled to Outrage Magazine.

Jenny got a haircut this January. This had to be done as a prerequisite when she applied for graduation. But she said that she was promised that “after that, (I) won’t have to cut my hair again when I process my papers in the future.”

Jenny said that the experience affected her psychologically; because of this, she wasn’t able to go to school for two days. And with the eventual haircut, Jenny’s gender expression was also dictated by another, affecting her sense of self.

But in an interview with Dr. Minna L. Comuyog, PUP-SHS principal, she denied that she threatened any student, and that neither her office nor PUP-SHS’s registrar’s office denied any student of transaction or that their documents will be held if they won’t cut their hair.

Comuyog said that, in fact, PUP-SHS has a “No Discrimination Policy”, which is implemented in the entire PUP system (which includes SHS).

Hindi namin ina-identify ‘yung mga estudyante namin na bading ‘to, tomboy ‘to. Basta when they come here, estudyante namin sila (We don’t separately identify students as ‘He’s gay, she’s a lesbian’. For us, when they come here, they’re all students),” she said.

Comuyog added: “As a teacher, ang aking training ay students sila (They are students). They have their unique personalit(ies) and we adjust our lessons to their needs. So kahit anong mga bata ang dumating sa amin (So no matter what kind of student they are), we accept them for who they are.”

But notwithstanding the “No Discrimination Policy”, Comuyog believes that the haircut policy should be implemented and be observed by all students (in this case, particularly those under her care; i.e. PUP-SHS).

Comuyog claimed that she is unaware of the existence of transgender students in PUP-SHS; thus of transgender students being forced to cut their hair due to the school’s haircut policy. “It’s something na (that is) not known to me,” she said.

But Comuyog added that she looks at the students using the gender binary dictated by the assigned sex at birth – i.e. “I look at them as male, female, ganon ang classification nila (that’s how I classify them).” And so she believes that even if a student is a transgender woman, this student will still be mandated to get a haircut befitting those assigned male at birth (that is, she still won’t be allowed to have long hair, which is deemed socially acceptable only for those assigned female at birth).

On the handling of students who are transgender women (or those assigned male at birth) and with long hair, Comuyog said that she “normally asks” these students “what they needed to change or do.” As part of her training as a teacher, she lets the students think. And in this case, it is the students who often end up saying that it is their hair that they should change.

NON-DISCRIMINATION AS A POLICY

The Department of Education (DepEd) actually has pro-LGBTQIA policies, which – in December 2018 – it reiterated via a statement reminding “all public and private Kindergarten, elementary, and secondary schools of the necessity and importance of adopting and enforcing anti-bullying policies in their respective institutions.”

Various (specific) policies particularly touch on non-discrimination (including of LGBTQIA students).

DepEd Order No. 40, series 2012, or the “DepEd Child Protection Policy,” institutionalized zero tolerance against any form of violence against the child and provided for the establishment of a Child Protection Committee (CPC) in all public and private schools.

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DepEd Order No. 55, series 2013 (DO 55 s. 2013), or the “Implementing Rules and Regulations (IRR) of Republic Act No. 10627 (R.A. 10627) Otherwise Known as the Anti-Bullying Act of 2013,” requires all public and private schools to submit a copy of their child protection or anti-bullying policy to the Division Office.

Meanwhile, Rule IV of DO 55 s. 2013 underscores that “the bullying prevention program in schools shall be comprehensive and multifaceted, and shall involve all education stakeholders and personnel. Schools shall develop intervention strategies like counseling, life skills training, education and other activities that will enhance the psychological, emotional and psychosocial well-being of victims, bullies, and other parties who may be affected by the bullying incident.”

Particularly pertaining the uniform policy (which touches on the haircut policy), DepEd released in 2008 DepEd Order No. 46, s. 2008, guidelines on “proper school attire”. It stated that “while the general policy is that the wearing of a school uniform shall not be required in public schools (as embodied in DepEd Order No. 45 s. 2008), it is necessary to provide guidance on what constitutes proper school attire.”

The following principles are offered as a guide:

  1. A student’s basic right to go to school, study and learn is of paramount importance and should be respected and promoted at all times.
  2. A student’s attire should reflect respect for the school as an institution for learning.
  3. A student’s attire should not become a cause for discrimination particularly for students belonging to a lower socio-economic status.
  4. Promoting physical hygiene and proper school decorum is part of the teaching- learning process in schools, thus a student’s attire and physical appearance should manifest learnings from this process.

Nowhere in the DepEd Order No. 46, s. 2008 was “proper” haircut discussed.

According to PUP Kasarianlan’s Watson Vergara, the haircut policy implemented in schools is a form of oppression. “Not only the right of the student to express oneself was trampled, but the student’s right to education was put on line.”
Photo by Cassidy Kelley from Unsplash.com

Having policies and actually implementing them are – however, and also – two different things.

In 2015, for instance, a United Nations Education, Scientific and Cultural Organization (UNESCO) report observed that only 38% of schools submitted child protection or anti-bullying policies in 2013, and the “low rate of submission has been attributed to a low level of awareness of requirements of the Act and weak monitoring of compliance.”

Releasing a report in 2017, the Human Rights Watch (HRW) also touched on the uniform policies (including forcing particularly transgender women to get haircuts) and stated that “students who are transgender or do not identify as their sex assigned at birth face especially pervasive discrimination as a result of uniform and hair-length policies and other gendered restrictions.” This is made more apparent because “right to free expression of students is violated when schools limit displays of same-sex affection or gender expression solely for LGBTQIA youth” – meaning, the policies are used differently for them to make them tow some lines.

Also, according to Watson Vergara, who heads PUP Kasarianlan, the official student organization for people with diverse SOGIE in PUP, even anti-discriminatory policies (such as DepEd’s) fail to take into consideration the power dynamics within educational institutions.

Vergara said that they know of students who asked for help from PUP Kasarianlan, claiming that they feel threatened that if they won’t cut their hair, then their names will be taken out of the list of graduating students. Non-compliance may also be seen as insubordination, which means that these students won’t be given a good moral certificate (which is needed when enrolling in college/university), or will even be kicked out of PUP.

PUP Kasarianlan also documented other cases like Jenny’s – e.g. in one case, a student claimed that she was kept in an office, prohibited to go out unless she signs a statement stipulating her to cut her hair.

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Syempre (Of course), the kid, crying, shaking and afraid, signed the paper. Kasi wala siyang (Because she did not have a) choice, she wants to go out,” Vergara said.

Vergara is aware that there are people who may see this as a non-issue – i.e. it’s “just hair.”

But PUP Kasarianlan also received stories of transgender students who refused to have their graduation photos taken, and of one transgender student who “can’t do homework or even eat properly because of this (traumatizing experience).”

For Vergara, this is a form of oppression. “Not only the right of the student to express oneself was trampled, but the student’s right to education was put on line.”

For Kate Montecarlo Cordova, if uniform is really needed, then schools should implement gender neutral school uniforms (e.g. gender neutral or unisex design and cut of school uniforms, and no prescribed length of hair for those assigned male at birth). Or, simply, “let the students wear uniforms based on their sense of being,”
Photo by Chen Feng from Unsplash.com

DETRACTING FROM SENSE OF SELF

According to Kate Montecarlo Cordova, founder of the Association of Transgender People in the Philippines (ATP), “One of the identified positive benefits of school uniform is to promote a “sense of community” (which actually refers to classification or clustering). But this can be detrimental to transgender students if not properly managed/implemented for this can deprive their self-expression, their sense of identity, their authenticity.”

Cordova added that “the imposition of school uniform with strict observance to the heteronormative gender binary can be an utter threat to transgender students while serving a meaningless purpose to learning.”

There are somewhat practical efforts that can be done.

For one, Cordova suggested that if uniform is really needed, then schools should implement gender neutral school uniforms (e.g. gender neutral or unisex design and cut of school uniforms, and no prescribed length of hair for those assigned male at birth). Or, simply, “let the students wear uniforms based on their sense of being,” Cordova said.

Secondly, Cordova said that it is important for any educational institution to “undergo extensive trainings, workshops and lectures not just about gender sensitivity but also, specifically, about transgender issues to understand the complexities of transgender human rights and health needs.”

And thirdly, Cordova suggests for transgender students to “rightfully assert and claim their rights to exist and learn by standing up to what is just and righteous to their authentic self by: 1. Being knowledgeable of their rights, 2. Being vocal about their identity, and 3. Being brave to socially present their sense of self.”

STARTING THE DISCUSSIONS

Back in PUP-SHS, the school principal Comuyog thinks that high school students are “confused” because they can see some transgender college students grow their hair, and they may also want to do the same. While she acknowledges how some of the SHS students want to “emulate” the college students, she also said that this isn’t necessarily possible because of “certain policies”.

Particularly, Comuyog noted PUP-SHS’s Code of Conduct that highlights (in Section 3) that “every student shall dress up according to the conventions of decency and proper grooming… dyan nakapaloob ang haircut for male and hairstyle for female.”

Section 3 of the Code of Conduct specifically states: “Every PUP student shall dress up according to the conventions of decency and proper grooming.

Also, to wit:

3.1 – Every PUP Senior High student is expected to demonstrate personal grooming standards of cleanliness and to wear the prescribed uniform while inside the school premises, during educational exposures or work immersion, and during official off-campus events.

3.2 – Students must observe the following provisions when wearing the prescribed school uniform:

3.2.1 – Uniforms should be kept buttoned and properly worn;
3.2.2 – School ID must be worn at all times within the school premises;
3.2.3 – The hairstyle for female should be simple and well kept, while the acceptable haircut for male must be off the eyebrows and above the collar line (EMPHASIS OURS);
3.2.4 – Moustache and side beards are not allowed;
3.2.5 – Hair color may be allowed provided that it is not vulgar.

The Code of Conduct does not discuss SOGIE (and implications to the uniform policy), but enforce these requirements based on assigned sex at birth.

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Comuyog quipped that it is only now that the said (haircut) policy is becoming an issue. And here, she also holds accountable some educators.

Yun namang teacher nila, napapabayaan sila kaya if there is a person na mas liable, itong mga teacher kasi ina-allow nila. Kasi may teacher din tayong mahaba ang buhok, may teacher tayong nakatali ang buhok. ‘Yun ang nakikita nitong mga bata (There are teachers who just let their students be, so if there’s someone liable, it’s the teacher who allows this. This may also be because some teachers assigned male at birth grow their hair long. And this is what these students see),” Comuyog said.

But – again – since there aren’t any students who talked to her and said that she is a transgender person, Comuyog said that she remains “unaware of this.” And that “just in case that she will be aware” of this, then she will have to consider the individual student’s situation.

For Professor Earl Guzman, SHS and college professor, and an open member of the LGBTQIA community, forcing the students to cut their hair, especially if they identify as gay or transgender, is abuse. “Kasi itong mga taong ‘to, itong mga kabataang ito, yung buhok nila (These kids’ hair) and how they present themselves are part of their gender identity,” he said.

Guzman added that teaching the students how to be gender sensitive yet confining them in the same heteronormative stereotypes, same heteronormative ways of expressing themselves, “kind of defeats its purpose.”

Tayo as PUPians (Products of PUP), we’re so proud of being at the frontier of fighting for sexual equality. Eh eto nga, ginigipit natin ngayon (And now we’re pressuring these students to conform). It all makes us look like hypocrites,” Guzman said.

For Guzman, the principal should listen to the students as well because what is happening most of the time is that teachers become just enforcers of rules or policies, and teachers owe it to the students to listen to them.

Anong klaseng lesson kasi ‘yung tinuturo natin sa students kapag ganon (What kind of lesson are we teaching the students), when we refuse to hear them out? Are we telling them that we know better than them? May mga pagkakataon na (There are times when) we know better than them pero kasi (but also) we’re not the ones living their lives right now, it’s them,” he said. “Maybe we should take their experiences into account; maybe we should listen to what they have to say. Kasi hindi puwedeng ano (Because the case shouldn’t be)… in our desire to enforce obedience, ang nangyayari ay (what happens is we create) blind obedience.”

For his part, PUP Kasarianlan head Vergara said that this kind of discrimination against members of the LGBTQIA community also happens in other schools – i.e. this goes beyond PUP-SHS.

In “Being LGBT in Asia: The Philippines Country Report” – written by Michael David C. Tan for USAID and UNDP – it was reported that forcing transgender women to get haircuts before allowing them to access education is one of the common anti-LGBTQIA policies still common in the Philippines, along with: the conduct of “masculinity tests” (where effeminate students had to “prove” they were “man enough” to be allowed to enroll, or stay in school) conducted by some schools, and instances when LGBTQIA students were made to sign “contracts” to ensure they did not express their sexual orientation or gender identity while going to school.

But Watson also acknowledges that – sadly – they can only do what little help they can.

In 2017, the Human Rights Watch (HRW) reported that “students who are transgender or do not identify as their sex assigned at birth face experience especially pervasive discrimination as a result of uniform and hair-length policies and other gendered restrictions.”
Photo by Ryan Tauss from Unsplash.com

In the end, Guzman hopes that this will be settled, with all parties involved discussing this. “Let’s be civilized. Let’s add something positive to the discourse. ‘Wag nating gawing (Let’s not turn the issue into an) excuse para siraan ‘yung mga bagay, tao, o policy na hindi naman natin dapat siraan (to destroy people or policies that need not be destroyed). And then, let’s come to an agreement. I think we should all try to understand where everyone is coming from,” Guzman said.

And while the discussions happen, the likes of Jenny are caught in the middle, who – in the end – really just want to finish schooling while being true to oneself.

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FEATURES

UP Mindanao marks rainbow Pride

The University of the Philippines-Mindanao in Davao City held its 2nd Pride march, with UP faculty members and students, as well as ally organizations and individuals joining to “appeal to end gender-based violence and recognize once and for all that LGBTQIA rights are human rights.”

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All photos courtesy of Prof. Jay Jomar Quintos, coordinator of the Office of Gender and Anti-Sexual Harassment (OGASH) of UP-Mindanao

Rainbow pride rises in Davao City.

The University of the Philippines-Mindanao in Davao City held its 2nd Pride march, with UP faculty members and students, as well as ally organizations and individuals joining to “appeal to end gender-based violence and recognize once and for all that LGBTQIA rights are human rights.”

In a statement to Outrage Magazine, Prof. Jay Jomar Quintos, coordinator of the Office of Gender and Anti-Sexual Harassment (OGASH) of UP-Mindanao, said that “at present, there (is) a large number of cases documented that involved violence against the LGBTQIA community.” And so “let us never forget the faces of these victims, like Jennifer Laude who was killed by Joseph Scott Pemberton.”

Quintos also stressed the need to broaden the struggle for social justice, and that “we (should) never forget the different forms and shapes of discrimination against class, gender, race and ethnicity. (So) we must unite and fight for our rights, freedom and equality… especially in these ‘days of disquiet and nights of rage’ when the State has become its own terrorist.”

For his part, Jayvie Cabajes, vice president for Mindanao of KABATAAN Partylist, said that “in this time of continued oppression, violence and discrimination, we must not remain silent but instead, unite and rally in the streets to register our calls to end gender-based violence and to recognize the LGBTQIA rights. After all, Pride is protest. It is a protest where rights are yelled and marched down to show our united stand on issues… We must not cower in fear because our combined strength can overthrow even a dictator, such as what happened in EDSA Revolt. Let us unite and continue the struggle towards a free and equal nation.”

READ:  3 Ways to use what you've learned from your own experiences to help others

The first Pride march in UP-Mindanao happened in 2017.

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#KaraniwangLGBT

Lesbian Lumad

What is it like to be a lesbian and also a part of an indigenous group? For Teng Calimpang, the Tagbawa ethnic group of people at the foot of Mt. Apo accepted her, so she hopes other lesbian Lumads live good lives both as LGBTQIA community members and as Lumads.

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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.”

Dili lisod mag-lesbian ka diri kay tanan diri murag paryente lang nako, mga pinsan lang (It isn’t hard to be a lesbian here because everyone here is just like a relative, just like my cousins),” Teng Calimpang, who is from Meohao at the foot of Mt. Apo, said. “Tanan pud mga tawo nakabalo kung kinsa ko ug unsa ko (People here also know who I am and what I am).”

Teng’s family is from the Tagbawa Manobo ethic group of people. Originally from Bansalan, her mother met her father in Meohao, where they decided to eventually settle. Also because of being based here, Teng is fluent in Bagobo Diangan, spoken by another ethnic group of people particularly at the foot of Mt. Apo.

At least in her experience, being a lesbian is a non-issue for her people (Tagbawa Manobo), as well as for her “adopted” Bagobo Diangan family.

Teng was 10 when she recognized her “otherness”; she did not like wearing girls’ clothes, and she preferred doing things that boys do. At 15, “diha na nako napansin nga… na-feel na nako nga dili gyud nako ma-love ang boy (I noticed that I was not attracted to members of the opposite sex).” Teng said that “babae ang mugawas sa akoang heart ba (I was attracted also to women).”

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Teng told her family about “ang tinuod (the truth).” And “okay lang sa ilaha. Tanggap gyud ko nila (it’s fine with them. They accepted me as a lesbian).”

Now 48, Teng works for Dole Phils. (Stanfilco Division). After work, she is also a local healer, giving “hilot (traditional massage)” to those who seek her out for the same.

Teng credits her “lolo (grandfather)” for her gift to heal.

She was 15 when she was “taught” how to “help people”; she dreamt her then-deceased grandfather show her how to do so, serving as a passing-of-the-torch to heal others.

Teng said that there are two kinds of people who help – one who expects to be grandly paid for the effort, and one who doesn’t. “Donation, okay lang sa ako-a (I’m okay with just receiving donations),” she said, adding that it already makes her happy that “nakatabang ko sa ilahang kinahanglan sa lawas (at least I’ve helped people with their needs).”

Teng had a heterosexual-identifying GF in the past; but that relationship didn’t last. She noted that there are some women who just want to be financially supported; they leave their partners when they have gotten what they wanted, or if their partner can’t offer them what they really want (i.e. wealth). “Pait kaayo ba (This makes being lesbian hard).”

Now single, Teng has other lesbian friends, and not all of them from Lumad communities. But her friends are now based overseas, where they work. She admitted that it can be lonely at times, but that technology (e.g. social networking sites) help alleviate the loneliness since she can at least chat with them even if they’re apart.

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Teng also has an adopted child, given to her when the child was only a month old. She is now 18.

Lisud gyud (sa sinugdanan) kay syempre ang acting nimo is as a boy, so nalisdan ko pagpa-dako niya (It was hard for me to raise her at first because I am masculine/not stereotypically motherly),” Teng said. “But I gradually learned how to properly raise her.”

To other lesbians who may also belong to Lumad communities, Teng said: “Kung unsa gyud sila sa ilang panginabuhi, ipadayun na nila (Continue living your true selves in living a good life).”

And in the end, “learn from me as I say that you can be good people as lesbians.”

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#KaraniwangLGBT

Trans and Muslim

An interview with a human rights defender from General Santos City, Ali Macalintal, who is also trans and Muslim. As she calls for LGBT acceptance, she believes that the struggle for social justice needs to be holistic and shouldn’t neglect other minorities in society.

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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.”

Growing up, trans woman Ali Macalintal never wanted to do what boys her age did. “Nasa puso ko na talaga na ako ay isang nagbababae (In my heart, I always identified with being a girl),” she said. And then she started having boy crushes, and it made her further realize that, yes, she is part of the LGBTQIA community.

The big “challenge” for Ali even then was her belonging to the Maguindanao ethnic group of people in southern Philippines, which is part of the wider Moro ethnic group. And being LGBTQIA is – generally speaking – still condemned in Islam (a “great sin”).

The now 32-year-old Ali remembered one time, during Ramadan (a holy month of fasting, introspection and prayer for Muslims), when she was asked by her father what she wanted to be. “I sort of knew what he was asking; but I wasn’t ready to give him an answer,” she recalled.

Knowing she couldn’t lie, she said: “I want to be a lawyer.”

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But her father was adamant, asking her directly if “gusto mo magka-GF o BF (if I wanted to have a girlfriend or a boyfriend)?”

With tears in her eyes, Ali told her father that she wanted to have a BF.

Her father embraced her, to her surprise, and he told her: “Alam mo na kung and ang gusto mo at sino ka. Dahil kung hindi mo matanggap kung sino ka, mahihirapan ka (Now you know who and what you are. Because if you can’t accept yourself, you will have a hard time).”

But not everyone is as lucky as Ali, and she recognizes this.

In fact, she knows the “double discrimination” encountered by Muslims who are also LGBTQIA – i.e. you get discriminated for being a Muslim, and then you get discriminated as LGBTQIA. This does not include (even) further discrimination from within the minority communities one belongs to – e.g. Muslims can discriminate LGBTQIA people; just as LGBTQIA people can also discriminate Muslims.

This recognition of the harshness of life for people like her pushed Ali to become a human rights defender, working for a non-government organization in General Santos City, south of the Philippines.

Ali believes in a holistic approach to the struggle for human rights.

Mahirap sa LGBTQIA community na kumilos na sila lang (It’s hard for the LGBTQIA community to fight on its own),” she said. “Naniniwala aka sa sama-sama nating pagkilos (I believe in unified struggle).”

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This is because, she said, the struggle for social justice of the LGBTQIA community is no different from the struggle of other minority sectors – e.g. Indigenous Peoples, women, youth, persons with disability, seniors, Muslims, et cetera.

“We will succeed only if the effort is multi-sectoral,” she said.

Particularly addressing other transgender Muslims (and Lumads/Indigenous People), Ali said that – to begin – one needs to find oneself and then find pride in that. “Remember that whatever we are, whatever our gender identity may be, we need to be open to accept ourselves,” she said.

With self-acceptance, she said, it is easier to push others to accept “our identity also as children of God, of Allah.”

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Extreme exposure: Journal of a traveling exhibitionist

An interview with a gay Filipino exhibitionist who is unable to stop with what he is doing despite knowing that indecent exposure is: 1) considered a mental health issue, and 2) considered gross indecency, which is a serious criminal offense. As he eyes to enjoy this phase in his life, “go lang nang go (just do it),” he says.

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“I think I’m doing it because I want attention.”

Twenty-three year old Twinky (not his real name) is somewhat forthright about his exhibitionism, recognizing that he does what he does because he wants people to pay attention to him.

In truth, over four years ago, Twinky met a guy who liked having sex in public. That was – in a way – his initiation into exhibitionism, since he admitted “getting excited” having sex with that guy in the open.

Prior to that, Twinky said that his view of any person into exhibitionism was somewhat clouded; but that this guy broke this expectation because he looked “respectable” and was even “very smart” so that “I learned a lot from him”. This guy’s “exhibitionist side” couldn’t be deduced by just looking at him.

But just as Twinky was falling for this guy, he left to live overseas. This devastated Twinky, so that he started doing all by himself what they did together in the past. He recorded this, and then posted it online.

“I never thought that people would also be excited about this,” he said. “I posted the videos to get his attention; instead, maraming (iba) and nakapansin (others started paying attention to them).”

These people – many of them strangers following his Twitter account – messaged him to tell him “ang galing (that’s awesome)” and “malakas ang loob (you’re gutsy).” These served as validation for Twinky, so that – he said – the guy he liked may have continued to ignore him, but at least others already started giving him the attention he desired.

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As of writing, Twinky’s Twitter account already has over 19,500 followers. To put that in perspective, Sen. Leila de Lima’s Twitter account only has 13,420 followers; while Cong. Geraldine B. Roman’s has 4,295 followers.

And so “na-engganyo ako lalo (this enticed me to do more)” until this became a regular thing to do for him (related to his alter account).

BARING THE BARING

In a gist, as written by George R. Brown, MD, “Exhibitionistic Disorder” in MSD Manual, “exhibitionism is characterized by achievement of sexual excitement through genital exposure, usually to an unsuspecting stranger. It may also refer to a strong desire to be observed by other people during sexual activity.”

But Brown also noted that “most exhibitionists do not meet the clinical criteria for a exhibitionistic disorder.” Also, it is diagnosed as exhibitionistic disorder “only if the condition has been present for ≥ 6 months and if patients have acted on their sexual urges with a nonconsenting person or their behavior causes them significant distress or impairs functioning.”

But just to be clear, exhibitionistic practices are sanctionable by existing laws.

The Revised Penal Code of the Philippines, for instance, has specific provisions that offend “decency and good customs”, to wit:

Art. 336. Acts of lasciviousness. — Any person who shall commit any act of lasciviousness upon other persons of either sex, under any of the circumstances mentioned in the preceding article, shall be punished by prision correccional.

Art. 200. Grave scandal. — The penalties of arresto mayor and public censure shall be imposed upon any person who shall offend against decency or good customs by any highly scandalous conduct not expressly falling within any other article of this Code.

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GOING AT IT

That he may be castigated (and even penalized) does occur to Twinky; but – surprisingly – this does not prevent him from exhibitionism.

Twinky’s “magic hours” are from 12.00 midnight to past 3.00AM.

He goes to locations far from where he lives; and before doing anything there, he scouts the place first to make sure that there are no CCTV cameras there (and that the place is, by and large, not going to put him in danger).

This is also his “protection” re illegality of his act.

If the place is conducive for exhibitionism, he then preps his phone to get a video (or ask someone to video him) as he goes about his business.

And “you’d be surprised,” he said, that “90% of those who see me, sumasali sila o nanonood (join or watch me). And that excites me.”

For Twinky, this is worth stressing: No, he does NOT want women to see him; instead, he prefers masculine and muscled men (preferably twinks or twink-ish).

By the time he reaches 30, Twinky hopes not to do this anymore, as he eyes to be “stable” in life – e.g. have a good job, and maybe find a partner in life. “There’d be no place for me to do these things.”

FUTURE FORWARD

Twinky is actually conscious about the videos he posts in his alter account – e.g. he won’t post those that clearly identify him; or he would alter sections that would lead these back to him.

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He knows that this is/may be categorized as a mental illness, but that “it’s what excites me.” He never considered seeking professional help since he doesn’t believe he is addicted to it. “I would know,” he said, adding that maybe if he feels he is becoming addicted, he would seek professional help because “I realize the importance of mental health.”

By the time he reaches 30, Twinky also hopes not to do this anymore, as he eyes to be “stable” in life – e.g. have a good job, and maybe find a partner in life. “There’d be no place for me to do these things.”

No, he isn’t worried his family may know of what he’s doing. He said that the people who may tell his relatives are – themselves – keeping secrets, so he doubts they would out him. For instance, he encountered his brother’s closeted gay friend in Grindr, and this initially scared him since this guy may out Twinky to his family (i.e. they do not even know he’s gay). But since this guy is also not out as a gay guy to his friends, he didn’t inform on Twinky.

In the end, “if someone asks ‘Hindi ka ba nandidiri sa ginagawa mo (Are you not disgusted with what you’re doing)?’ I just smile. I can’t please everyone. I I can’t make them understand where I’m coming from. And if that’s the point, I don’t think there’s a point for me to explain my side.” – With Russelle Dagdayan

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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.

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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).

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In June, student councils from seven of the biggest Catholic schools in Metro Manila released a unified statement expressing support for the ADB.

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.

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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.

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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.

For instance, while the DOH is complaining about budget cut, it was able to spend money ON A BEAUTY PAGEANT in September, showing erroneous prioritization.

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.

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