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Because Undetectable = Untransmittable

That an HIV-infected person with potent antiretroviral treatment (ART) is not sexually infectious (that is, he/she does not transmit the virus via sexual contacts) is already scientifically proven. But in the Philippines, no HIV-servicing body has yet to openly and officially back U=U. For Bruce Richman, in a resource-lacking setting like the Philippines, “this is a platform for expanded access to HIV treatment (since) reducing HIV stigma will encourage both testing and treatment.”

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In 2012, when 38-year-old Dave* was just diagnosed to be HIV-positive and his CD4 count was less than 10, he was a “regular” of a treatment hub in Metro Manila, be it because “I’d have fever for days, or I’d have rashes all over my body, or whatever,” he recalled. It was during one of his visits to the hospital when the supervising nurse supposedly told him that “ngayong may HIV ka na, huwag na mag-sex ha. Dadami lang kayo (now that you are HIV-positive, stop having sex. If you do so you’ll just help increase the number of HIV cases like yours).”

This of course highlights the discrimination experienced by PLHIVs from medical practitioners themselves. But this particular emphasis on sex/not having sex to stop the spread of HIV also puts a spotlight on the lack of knowledge even among those who are supposed to know better to be able to properly deliver much-needed services (e.g. in this case, there are safer sexual practices available, after all).

And perhaps when particularly considered in a newer context (say, 2017), the ignorance becomes even more apparent since it is now scientifically proven that people living with HIV who are undetectable cannot transmit the virus to their negative partners.

INTRODUCING U=U

In 2008, Pietro Vernazza, M.D. released a statement (“Advice Manual: Doing without condoms during potent ART”, which was approved by the Executive Board of Swiss Aids Federation) in the Bulletin of Swiss Medicine that claimed that “an HIV-infected person with potent antiretroviral treatment (ART) is not sexually infectious (that is, he/she does not transmit the virus via sexual contacts).”

There were parameters set for the claim, i.e.:

  1. As long as the therapy is practiced consistently and monitored regularly by the treating physician;
  2. The viral load on ART has been below the limit of detection for at least six months; and
  3. No infections with other STI are present.

Viral load, which is the level of HIV in a PLHIV’S blood, shows how active HIV is in one’s system. Usually (though not always), if the viral load is high, the CD4 (or T cells, which help activate immune response) count is low, so that the body’s response to the virus is compromised. A low or undetectable viral load indicates that the immune system is actively working to help keep HIV in check.

ART is medication that helps to keep under control the viral load in the body. The viral load is considered undetectable if test shows lower than 40 to 75 HIV virus particles in a milliliter of the blood. If the viral load is considered undetectable, it means the ART medication is working.

Vernazza’s claim – eventually dubbed as the Swiss Statement – that “under (the above) circumstances, potent ART therefore definitely prevents HIV transmission as safely as condoms” did not sit well with many, including public health and professional organizations (e.g. the US Centers for Disease Control and Prevention or CDC), which questioned Vernazza re his data, and even more pointedly, what he was thinking when he made the supposedly premature claim that was “getting ahead of science”.

Vernazza was, nonetheless, resolute about the message, largely derived from his work with HIV-positive straight people on treatment who wanted to have children with their HIV-negative partners. Condomless sex obviously happened between the serodifferent couples, but of 8,000 patients, not a single report of HIV transmission happened to a partner. This therefore became an ethical dilemma for a clinician like Vernazza since they are supposed to present all equally valid options available and let the patients decide for themselves.

Particularly eight years years later, in 2016, Vernazza was vindicated when studies validated the undetectable=untransmittable (U=U) message – i.e. HPTN 052 and the PARTNER study. But more than the vindication, this also helped evolve the messaging re HIV.

Bruce Richman of the Prevention Access Campaign was able to gather signatures of health experts from all over the world for a consensus statement about U=U; but he reported having a challenging time coaxing US HIV organizations to adopt language that removes the stigma of infectiousness from people who are undetectable.

STAY UNDETECTABLE=STAY UNINFECTIOUS

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The concept is not completely new, since treatment as prevention (TasP) has long been advocated to curb the spread of HIV. But there is now newer and strengthened push for this with the U=U message.

There’s the PARTNER study, which involved 1,166 serodifferent couples at 75 clinical sites in 14 European countries. To be included in the study, one partner had to be HIV-positive and have an undetectable viral load on ART, and the couple did not always use condoms when they had sex. Between September 2010 and May 2014, 1,000 positive/negative couples had 58,000 acts of penetrative sex without condoms. The study reported that not a single infection happened between the couples.

It is worth noting that 11 people involved in the study became HIV positive. However – and this is noteworthy – none of these infections were phylogenetically linked transmissions; meaning, they got infected not from their HIV-positive partners but from others.

The PARTNER study is particularly important because it included both gay and straight couples.

The PARTNER study is being continued, with PARTNER 2 expected to continue until 2019.

The same results from the PARTNER Study were reported in the HIV Prevention Trials Network (HPTN) 052 study, a Phase III, two-arm, randomized, controlled, multi-center trial to determine whether ART can prevent the sexual transmission of HIV-1 in HIV-1 serodiscordant couples. One thousand seven hundred and sixty-three (1,763) HIV serodiscordant couples at 13 sites in nine countries were enrolled in HPTN 052; one person is HIV-infected and the other is not.

In 2011, the study initially showed a 96% reduction of HIV transmission within the couples involved. The final results (reported in 2015) showed a sustained 93% reduction of HIV transmission within couples when the HIV-infected partner was taking ART as prescribed and viral load was suppressed.

The HPTN 052 study was, in fact, relevant in the recommendation of the World Health Organization (in 2013) that ART be offered to all PLHIVs who have uninfected partners to reduce HIV transmission.

U=U is now endorsed by numerous international organizations, including AIDES –France, AIDS Foundation of Chicago, Australian Federation of AIDS Organizations, British Columbia Centre for Excellence in HIV/AIDS – Canada, Human Rights Campaign, National Alliance of State and Territorial AIDS Directors (NASTAD), National Black Justice Coalition, New York City Department of Health and Mental Hygiene, San Francisco AIDS Foundation,, and the Terrence Higgins Trust – United Kingdom.

Various experts responding to HIV also already came out to back U=U.

For instance, Dr. Carl Dieffenbach, director of the Division of AIDS of National Institutes of Health (NIH), stated in an earlier interview: “If you are durably virologically suppressed you will not transmit to your partner… I’ll say this again, for somebody who is in a discordant couple, if the person (with HIV) is virologically suppressed, ‘durably’ – there is no virus in their system, hasn’t been for several months – your chance of acquiring HIV from that person is zero. Let’s be clear about that: zero. If that person the next day stops therapy for two weeks and rebounds, your chance goes up. That’s why we talk about ‘durable’ viral suppression… You’re as durably virologically suppressed as good as your adherence.”

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Dr. Michael Brady, medical director of the Terrence Higgins Trust in London, England was quoted as saying that “we can now say with confidence that if you are taking HIV medication as prescribed, and have had an undetectable viral load for over six months, you cannot pass on HIV with or without a condom.”

Meanwhile, Dr. Myron Cohen, chief of the Division of Infectious Diseases of the UNC School of Medicine; and principal investigator of HPTN 052 stated: “If people are taking their pills reliably and they’re taking them for some period of time, the probability of transmission in this study is actually zero… When you treat a person who is HIV infected you render them no longer contagious. Over a period of years that benefit is further realized… Sexual relationships can be much safer because [treatment] suppresses transmission. There is a societal benefit, a public health benefit, an altruistic benefit. ”

“We’ve also come across the shortsighted view that this information only improves the lives of people living HIV, when in fact this is a game changer for the epidemic because of its impact on HIV stigma, testing, treatment uptake and adherence, which will ultimately lead to more people knowing their status and getting to undetectable,” Bruce Richman said.

RESISTANCE TO THE MESSAGE

The benefits of U=U go beyond the medical – e.g. in helping serodifferent couples conceive. For instance, worth noting is how U=U can help deal with HIV criminalization, particularly since there are countries that still prosecute PLHIVs who do not disclose their HIV status to their sexual partners. The US, for instance, is infamous for sending to jail PLHIVs who spit, scratch or bite others sans disclosure of HIV status, and even if there were no known risks of transmission.

The Philippines’ own Republic Act No. 8504, or the Philippine AIDS Prevention and Control Act of 1998, also makes it necessary to disclose one’s status – albeit (unlike in other countries) it is mum on the possible criminal liability of those who fail to disclose. Section 34 (under Article VI, which deals with confidentiality) mandates disclosure to sexual partners – i.e. “Any person with HIV is obliged to disclose his/her HIV status and health condition to his/her spouse or sexual partner at the earliest opportune time.”

But despite the pluses of U=U, not everyone is on board (perhaps as of yet) with its promotion.

Interestingly – and this is a major point worth stressing, too – many of those who express reluctance (if not blatant opposition) to U=U are HIV community advocates and organizations. In the US, for instance, Bruce Richman of the Prevention Access Campaign was able to gather signatures of health experts from all over the world for a consensus statement about U=U; but he reported having a challenging time coaxing US HIV organizations to adopt language that removes the stigma of infectiousness from people who are undetectable.

The Prevention Access Campaign stated that “the majority of PLHIV, medical providers and those potentially at risk of acquiring HIV are not aware of the extent to which successful treatment prevents HIV transmission… Much of the messaging about HIV transmission risk is based on outdated research and is influenced by agency or funding restraints and politics which perpetuate sex-negativity, HIV-related stigma and discrimination.”

“We had a difficult time in the beginning because NGOs are not always early adopters, and some have been driven by 35 years of fear of HIV and PLHIV. They may not be confident in the science and are understandably concerned about saying anything that will lead to more transmissions,” Richman said to Outrage Magazine.

There’s also the “longstanding history in the field of overprotecting people who do not have HIV at the expense of people with HIV’s basic human rights to accurate information about our social, sexual and reproductive health. We’ve also come across the shortsighted view that this information only improves the lives of people living HIV, when in fact this is a game changer for the epidemic because of its impact on HIV stigma, testing, treatment uptake and adherence, which will ultimately lead to more people knowing their status and getting to undetectable,” Richman added.

READ:  Study stresses negligible risk of transmitting HIV during sex when viral load is suppressed

There have been pluses, and “we’re happy to see momentum now. NGOs are beginning to catch on because leaders in the US, like NYC Department of Health and Mental Hygience, National Association of State and Territorial AIDS Directors (NASTAD), Housing Works, and San Francisco AIDS Foundation have made statements and updated their public information and social marketing campaigns. Just (a few weeks ago), Canada’s official source for HIV information, CATIE, endorsed U=U.”

In the Philippines, however, no HIV-servicing body has yet to openly and officially back U=U.

CHALLENGES IN PHL CONTEXT

Dr. Jose Narciso Melchor Sescon, who helms the AIDS Society of the Philippines (ASP), said that U=U may still be considered a “medyo (somewhat) sensitive issue in the Philippines.”

For one, this is the number of PLHIVs availing of ART continues to be low. In November 2016, for instance, the total number of Filipinos living with HIV was pegged at 38,872. But only 17,388 are on ART.

Secondly, “ARV adherence is (still) a major concern.” Among people working in the HIV advocacy, it is not uncommon hearing about PLHIVs who are “lost to follow-up”.

Thirdly, “we should also consider co-morbidities,” Sescon said. One may have undetectable viral load yet still engage in other unsafe sexual practices, such as having numerous sexual partners. “So I’d still offer using (other forms of) protection.”

And fourthly, Sescon expressed apprehension based on “real life” situations particularly “in a context like the Philippines.” While clinical trials may have yielded desirable results, “how much of these can be translated and put into reality or the true context of the Philippines?”

Sescon said that “even with scientific evidence showing non-transmission, it will still take time for this to sink in the minds among serodiscordant couples.”

The benefits of U=U go beyond the medical – e.g. in helping serodifferent couples conceive. For instance, worth noting is how U=U can help deal with HIV criminalization, particularly since there are countries that still prosecute PLHIVs who do not disclose their HIV status to their sexual partners.
IMAGE FROM PIXABAY.COM

The consensus statement from the Prevention Access Campaign admitted certain limitations – e.g. that many PLHIVs may not be in a position to reach an undetectable status because of factors limiting treatment access (including inadequate health systems, poverty, racism, denial, stigma, discrimination and criminalization); pre-existing ART treatment resulting in resistance or ART toxicities; and refusal to start treatment. All the same, it stressed that “understanding that successful ART prevents transmission can help reduce HIV-related stigma and encourage PLHIVs to initiate and adhere to a successful treatment regimen.”

But Richman believes that in a resource-lacking setting like the Philippines (where less than half of PLHIVs access ART), “this is a platform for expanded access to HIV treatment. The more PLHIV on treatment in the Philippines, the closer the country will get to ending the epidemic. Test and treat is the most effective method. Reducing HIV stigma will encourage both testing and treatment.”

BOLSTERING THE U=U CONVERSATION

And while the conversation on U=U continues, perhaps worth underscoring is the relevance of this on how PLHIVs view themselves.

Back in the treatment hub in Metro Manila where Filipino PLHIV Dave goes to (and where he is now “with CD4 count over 500 – way better than the nine when I started; and with undetectable viral load to boot,” he said), U=U has helped him see himself as “a human again.”

“I must admit that there were times in the past when I felt like the virus itself, as if just waiting to make others ‘sick’; and even internalized this oft-repeated notion that people like me are ‘dirty’,” Dave said. “Now I know that if we truly want to deal with stigma and discrimination – not just the health benefits – linked with HIV, we should start talking about U=U.”

*IN THE PHILIPPINES, WHEN A PERSON LIVING WITH HIV IS ENROLLED/REGISTERED INTO A TREATMENT HUB, HE/SHE IS ASKED TO PROVIDE: 1) YEAR OF ENROLLMENT; 2) INITIALS OF FIRST NAME, MIDDLE NAME AND SURNAME; AND 3) NICKNAME. THIS IS THE CODE NAME USED BY THE INTERVIEWEE.

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).

FEATURES

March 9 of every year declared as LGBT Day in Municipality of Itogon

An executive order was passed in Itogon, a first class municipality in the province of Benguet in northern Luzon in the Philippines, declaring the ninth of March of every year as LGBT Day.

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Touched by the rainbow.

An executive order was passed in Itogon, a first class municipality in the province of Benguet in northern Luzon in the Philippines, declaring the ninth of March of every year as LGBT Day.

Executive Order No. 03, signed by Atty. Victorio T. Palangdan in April, noted that “section 3 of Republic Act 9710 state that ‘All individuals are equal as human beings by virtue of the inherent dignity of each person. No one should therefore suffer discrimination on the basis of ethnicity, gender, age, language, sexual orientation, race, color, religion, political or other opinion, national or social or geographical origin, disability, birth or other status as established by human rights standards.”

Under the EO, activities are being eyed to be held for the local LGBT community, including – and going beyond the one-day Pride parade – “knowledge sharing or technology transfer on good grooming, personal hygiene, beauty care, interior design, floral arrangements, et cetera, such that the knowledge and skills derived therefrom could be transformed into livelihood or income generating activities by the participants.”

The aforementioned professions/fields are – nonetheless – still stereotypically linked with the LGBTQIA community, at times limiting professional opportunities.

The EO also enjoins barangay officials to actively support the programs and activities of the LGBT community particularly in celebration of the LGBT Day.

The Municipal Social Welfare and Development Office is tasked to monitor and evaluate the success/failure of the EO.

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Founded in 1951, and is the largest municipality in Benguet by land area, Itogon is a mining town with a population of approximately 59,820 people occupying a total land area of 449.73 square kilometers (173.64 square miles).

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FEATURES

What it’s like to be a queer woman in Brunei…

Generally speaking, “living in Brunei as a woman – no matter what background, what orientation – everyone knows that being a woman is hard… and its definitely not any easier being a queer woman.”

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As a queer woman in Brunei, Naz always expressed herself in a stereotypically masculine manner. That is, she has short hair and doesn’t always present herself in what’s deemed “feminine”.

Perhaps because of this “classic assumption that a girl is queer or a tomboy by the shortness of her hair”, Naz was sexually harassed at work. And when she told the story of her harassment to her sister, the latter just (dismissively) told her: “He probably knows you’re gay so its ok for him to touch you.”

This dismissiveness, this disregard is (apparently) but an example of how – in Brunei – women (and particularly queer women) “tolerate sexism and homophobia everyday,” said A.B., who produced and directed “The Visible”, a documentary that looks at how women are treated in Brunei. Included in the interviewees is a queer woman and a transgender woman.

Brunei made the news recently, of course, with the implementation of a dated, and even barbaric law that will see the stoning to death of members of the LGBTQIA community, along with adulterers. The laws, parts/elements of which were first announced in 2013 and adopted in 2014 (and have been rolled out in phases since then), will be fully implemented this month. Ruled for 51 years by Sultan Hassanal Bolkiah, the Southeast Asian nation plans to implement a severe interpretation of Islamic sharia law. Under the strict laws, adultery, sodomy, robbery, rape and insulting Islam’s Prophet Muhammad would all be punishable by death. Those who are caught having gay sex or committing adultery would be executed by stoning.

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Upon hearing the implementation of this law, “I was honestly very surprised; at first I thought it was just old news being brought up again for whatever reason,” A.B. said. “But as it turned out, the law was put on hold from 2013 due to international criticism and is just now being implemented.”

For A.B., “it’s messed up because it seemed like no one in Brunei knew.” Her family, for one, “found out through international news. If you look at news articles about Brunei it’s all about the Sharia law; but if you look at news from Bruneian newspapers, there’s nothing about it. I’m living abroad and found out from friends sending me articles, it was only after a few days when there had finally been an official statement from the prime minister’s office.”

Brunei made the news recently, of course, with the implementation of a dated, and even barbaric law that will see the stoning to death of members of the LGBTQIA community, along with adulterers.

A.B. was born in Brunei, but she was raised abroad. And “it was only recently that I got to experience what life was really like for a queer woman like me in Brunei. For years I would view it from a distance, visiting for a few weeks once a year and always thinking ‘I can put up with it, I’ll be back home (in France) in two weeks.’ But moving back changed everything for me.”

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It changed because – in her experience in Brunei – women and queer women of tolerate sexism and homophobia everyday.

Naz’s case, for instance, rattled A.B., who said that “it’s unacceptable how issues like this are still predominant in Asia.”

“It’s a bit hazy with the law when it comes to that,” A.B. said, “because, in fact it is being caught in the act of (gay) sex that is banned, not just being LGBTQIA.”

If being LGBTQIA means living under scrutiny in Brunei, how do LGBTQIA people express themselves (if at all)? “It’s a bit hazy with the law when it comes to that,” A.B. said, “because, in fact it is being caught in the act of (gay) sex that is banned, not just being LGBTQIA. I always found everyone was capable of expressing themselves, to an extent; meaning, private accounts on social media (are available) but not necessarily changing the way you dress or express yourself. It’s more a ‘show don’t tell sort of situation’.”

Generally speaking, though, “living in Brunei as a woman – no matter what background, what orientation – everyone knows that being a woman is hard… and its definitely not any easier being a queer woman.”

Producing the documentary, by itself, was challenging.

“When we were in pre-production, I was unable to attend a meeting due to my family because ‘a woman is not allowed to be picked up by a man in Brunei’. During a production meeting I was stopped halfway by a family member because ‘a woman is not allowed to hang around with just men in Brunei’,” A.B. said. “So everything had to proceed with caution.”

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But even if things are challenging, “we pushed on. I was not going to let the opinions of others stop me from voicing a story that needed to be told. You find loopholes, you get back up again and keep going…”

A.B.: “I always found everyone was capable of expressing themselves, to an extent; meaning, private accounts on social media (are available) but not necessarily changing the way you dress or express yourself. It’s more a ‘show don’t tell sort of situation’.”

A.B. also noted the “bravery” of women in Brunei – in particular, her cast, who “really set an example for the women and the LGBTQIA community in Brunei, (explaining) to me that they never felt a sense of ‘danger’, just a sense of being cautious.”

Naz, for one, said that “despite the law, religion and her sexual orientation, she is still a muslim and won’t be doing anything to break the law.”

A.B. added that “it’s also important to note that no one has been executed in Brunei for anything since 1957.”

All the same, A.B. is pushing for the opening of minds.

“Being LGBTQIA is just who you are, it’s what you feel, it’s what you know, it’s something you should never be ashamed of,” she said. “The only ‘Western imposition’ is the fact that being LGBTQIA is a crime, which was brought by the British when they decided to colonize half of Asia. It’s like how our generation are standing up for gender quality; yes, in Brunei, that’s considered an influence from the West because you’re supposedly ‘going against the tradition’ of being a slaved housewife, when in reality it’s not just women of the West that have been fighting for rights, women all over the world have.”

And in the end, “it’s not really for me to say what’s right and what’s wrong (for Brunei). Brunei really is a lovely and beautiful country, but it also has a way to go… like all of Asia.”

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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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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.”

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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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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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