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.
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.:
- As long as the therapy is practiced consistently and monitored regularly by the treating physician;
- The viral load on ART has been below the limit of detection for at least six months; and
- 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.
STAY UNDETECTABLE=STAY UNINFECTIOUS
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.”
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. ”
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.
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 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.
San Juan hosts 2nd Pride parade to stress city’s support for ‘equality in diversity’
The City of San Juan held its second LGBTQIA Pride parade. According to San Juan City Vice Mayor Janella Ejercito Estrada: “San Juan Pride is about people recognizing individuality, diversity and equality. We are all equal…”
Rainbow explosion in the City of San Juan.
Just as the year is about to close, the City of San Juan held its second LGBTQIA Pride parade. This is part of the mandate of City Ordinance No. 55, or the anti-discrimination ordinance (ADO) of the City of San Juan, which was passed in the third quarter of 2017 to protect the human rights of its LGBTQIA constituents.
Exclusively interviewed by Outrage Magazine, San Juan City Vice Mayor Janella Ejercito Estrada – who backed the ADO when it was still being proposed by Councilor Mary Joy Ibuna-Leoy – said that “San Juan Pride is about people recognizing individuality, diversity and equality. Lahat naman tayo ay pantay-pantay (we are all equal)… and (so) I’m an advocate for equality.”
Estrada added: “We acknowledge that LGBT rights are human rights; and we protect (those) rights here in San Juan.”
Pride – including Metro Manila’s – is admittedly fast be becoming a commercial endeavor. But Faustino “Bubsie” L. Sabarez III, national chairman of LGBT Pilipinas, said that “we still need Pride because it highlights individuality and the celebration of diversity.” He added that “safe spaces are still needed to celebrate being LGBTQIA, and (Pride) is one such space.”
Dindi Tan, Secretary-General of LGBT Pilipinas, added that Pride – such as San Juan’s – shows “where we are now.”
The city, for instance, has its ADO. This ADO, by the way, is not exclusive to LGBTQI people, but is also for those who may experience discrimination based on: race, disability, ethnicity and religious affiliation.
San Juan’s ADO prohibits, among others: employment-related discrimination; discrimination in education; discrimination in delivery of goods and services; discrimination in accommodation; verbal/non-verbal ridicule and vilification; harassment, unjust detention and involuntary confinement; disallowance from entry or refusal to serve; and the promotion of LGBT discrimination. Any person held liable under the ordinance may be penalized with imprisonment for 60 days to a year or fined up to P3,000, or both, depending on the discretion of a court.
Tan is also realistic in saying that the anti-discrimination bill (ADB) being pushed in the Senate by Sen. Rosa Hontiveros of Akbayan is basically dead. Its counterpart in the House of Representatives was passed with the big help of trans Rep. Geraldine Roman of the First District of Bataan; but the version in the Upper House failed to gain traction not only because of the opposition of select senators particularly Tito Sotto, Manny Pacquiao and Joel Villanueva, but also because of the exclusivist approach in the pushing for the ADB.
“Until an ADB is passed, we need ADOs,” Tan said. And local government units with ADOs “should be commended.”
Tan is also pushing for the election (in the 2019 May elections) of “politicians who will deliver,” she said, particularly “the promise for an ADB.”
Moving forward, Vice Mayor Estrada said that they are already eyeing other LGBTQIA-related efforts – e.g. broadening the city’s anti-HIV efforts to “ensure that testing, and then treatment, care and support are widely rendered in the city.”
People now embrace different forms of intimate relationships that flout cultural norms
Social media and the internet empowered individuals with diverse identities and relationship practices to find each other, raising awareness of connections that challenge traditional ideas about the meaning of intimacy.
The 21st century ushered in a “quiet revolution” in the diversity of intimate relationships. With the scale and pace of this social transformation, what is needed is a “reboot” of relationship studies.
This is according to Phillip Hammack, professor of psychology at the University of California, Santa Cruz; and lead author of “Queer Intimacies: A New Paradigm for the Study of Relationship Diversity,” an article that appeared in the online edition of The Journal of Sex Research. Hammack’s co-authors include David Frost, associate professor of social psychology at University College London, and Sam Hughes, a graduate student at UC Santa Cruz.
For the authors, social media and the internet empowered individuals with diverse identities and relationship practices to find each other, raising awareness of connections that challenge traditional ideas about the meaning of intimacy.
“I’ve been calling it a quiet revolution, because it’s very different than the sexual revolutions of the 1960s and ’70s, which were so visible,” said Hammack.
Particularly in countries like the US, Hammack said that marriage equality (same-sex marriage was legalized in the US in 2015) is the backdrop for the explosion of relationship diversity that has occurred since the early 2000s.
“Marriage equality opens up the lens to think about diversity beyond just the gender of the people in a relationship,” said Hammack, noting that asexuality, polyamory, and kink/fetish all challenge dominant notions of intimacy.
These people are thriving in intimate relationships far from the cultural norms of monogamy and heterosexuality, including asexual, polyamorous, transgender and gender nonbinary, pansexual, and kink/fetish relationships.
He also said that “it’s a myth that asexual people aren’t in relationships just because they experience little or no sexual desire,” said Hammack. “The assumption is that they are suffering, lonely, and without partners, but that’s not true. They do have intimate relationships, but we don’t know much about them.”
People who identify as asexual “violate the fundamental assumption that intimate relationships are inherently characterized by sex,” said Hammack. They started to organize in the early 2000s, thanks to the internet.
Asexuality was removed from the latest edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association in 2013.
In a similar challenge to cultural norms, those who choose polyamorous relationships violate conventions of monogamy by allowing partners to love more than one person. Although gay men have a long tradition of open relationships, and ‘swinging’ was favored by some straight couples in the 1970s, polyamory now appears in the Oxford English Dictionary, following what Hammack referred to as a “simmering movement that challenged heteronormative conventions about what an ideal relationship is supposed to look like.”
Mainstream representations are also affecting concepts and/or relationship practices. For instance, the success of the 2011 novel Fifty Shades of Grey is said to have helped propel mainstream discussion of kink/fetish relationships, which highlight consensual asymmetrical power dynamics in intimate relationships.
Hammack, nonetheless, admitted that even if it made people curious, “the novel was problematic because it didn’t accurately represent the consensual way relationships are configured in the kink community… Kink relationships have been stigmatized because the expectation is that relationships are supposed to be ‘equal’.”
Unfortunately, Hammack said that researchers still know little about what happens within kink/fetish relationships. “To what extent is the power asymmetry just during sex? We don’t know,” said Hammack. “Most of this science doesn’t talk about the relationships. It just talks about specific kinky practices… There’s almost no recognition of relationships – it’s all about sexual gratification, which is only part of the picture.”
Yet other concepts that have emerged are: “queer heterosexuality”, as well as changes in ideas about “chosen families.”
“Heterosexuality is opening up like never before,” said Hammack. “More people who identify as straight will have some same-sex experience – they even refer to ‘heteroflexibility.’ They are not opposed to same-sex encounters.”
This trend is long-established among women, but it’s new among men – and it’s distinct from bisexuality because these men don’t feel equally attracted to men and women. “It’s fascinating to see masculinity opening up this way,” he said.
Hammack noted that still “very, very little” is known about the phenomenon of chosen families as distinct from biological families. This is a phenomenon that has been historically associated with gays and lesbians who “create their own families” after being rejected by biological relatives; however, its prevalence remains a mystery.
This is why Hammack said that more research initiatives should be done to focus on diversity in intimate relationships to “document the diversity of what’s happening out there,” Hammack ended.
1 percent of children aged 9-10 self-identify as gay, bi or trans
While 1% of youth aged 9 and 10 self-identified as LGBT, their parents reported they believed their children were gay, bisexual or transgender at a higher rate.
About 1% of 9 and 10-year old children surveyed self-identified as gay, bisexual or transgender.
This finding was detailed in “Child Sexual Orientation and Gender Identity in the Adolescent Brain Cognitive Development Cohort Study,” co-authored by Jerel P. Calzo and Aaron J. Blashill, and which appeared in JAMA Pediatrics.
Majority of studies indicate that lesbian, gay, bisexual and transgender (LGBT) self-identification generally occurs during the mid-adolescent years. So “this is such an important stage, biologically and socially,”said lead author Calzo, an associate professor in the SDSU School of Public Health.
At 9 and 10, youth – whether through their peers, media or parents – are beginning to be exposed to more information about relationships and interacting in the world. Also, they may not see any of this as sexual, but they are beginning to experience strong feelings, said Calzo.
Calzo and Blashill utilized the Adolescent Brain Cognitive Development (ABCD) Study dataset, a multisite, longitudinal study exploring brain development and health among children aged 9 and 10 over a 10-year period, leading to the 1 percent finding for self-identification.
“One percent is sizable, given that they are so young,” Blashill said. “For so long, social scientists have assumed that there is no point in asking kids at this age about their sexual orientation, believing they do not have the cognitive ability to understand.” But “it is important to have a baseline to understand how sexuality develops and how it may change over time.”
Blashill and Calzo also sought to understand how parents perceived their children’s sexual and gender identities. Surprisingly, nearly 7% of parents, when asked about the sexual identity of their children, reported their child might be gay; and 1.2% reported that their child might be transgender.
Another finding was that children overwhelmingly reported no problems at home or school related to their minority sexual orientation or gender identity while 7% of parents reported gender identity-based problems.
As sexual and gender minorities experience higher rates of physical and mental health issues than do their heterosexual counterparts, the research “may provide crucial insights into resiliency development within the LGBT community”, said the authors, adding that “it could also help lead to improved programs and policies to better serve the community.”
Yet another key finding is the need for researchers to identify better ways to explore identity issues among younger populations, with about 24% of those surveyed indicating that they did not understand questions about sexual orientation.
“If we can understand identity development earlier and can track development using large datasets, we can begin improving research and prevention around risk and protective factors,” Calzo said,.
Bullying ‘follows’ LGB people from school to work
35.2% of gay/bisexual men who had experienced frequent school-age bullying experience frequent workplace bullying. Among lesbian women, the figure was 29%.
Around one in three lesbian, gay and bi individuals who are bullied at school will have similar experiences in the workplace later in life.
This is according to “School-Age Bullying, Workplace Bullying and Job Satisfaction: Experiences of LGB People in Britain”, a research done by Nick Drydakis from The Manchester School.
For this research, Drydakis approached 400 LGB individuals to ask them about their experiences at school, and also asked them about bullying at their current workplace. He found that 35.2% of gay/bisexual men who had experienced frequent school-age bullying experience frequent workplace bullying. Among lesbian women, the figure was 29%.
When describing their experiences at school, 73% of gay men said they were either constantly, frequently or sometimes bullied. Just 9.9% said they were never bullied. Among lesbian women, 59% experienced constant, frequent, or occasional bullying. The mean age of participants was 37, meaning their school years would have been approximately between 1985 and 1997.
The research also examined job satisfaction. Most gay men said they were “dissatisfied” with their job (56%), while this was also the most common answer for lesbian women (47%).
“This study suggests that bullying may be a chronic problem for LGB individuals, which continues from school to the workplace,” Drydakis said.
This could be for a number of reasons – school-age bullying could be more likely to lead to low self-esteem, a difficulty in forming trusting relationships, or a greater risk of poor mental health. Factors like these may make it more likely they will experience bullying in the workplace later in life.
“Post school-age bullying victims might exhibit characteristics of vulnerability, such as sub-assertive behaviors, which make them attractive targets for unfavorable treatments and evaluations from colleagues and employers in the workplace. “In turn, individuals, firms and society as a whole face long-lasting negative effects which appear to begin in the playground,” Drydakis said.
There is also a negative association between bullying of LGB individuals, and job satisfaction.
Interestingly, the research found that the existence of a workplace group for LGB individuals appeared to result in better job satisfaction, perhaps a lesson for employers wanting a more satisfied and motivated workforce.
“The outcomes of this study suggest… that bullying, when it is experienced by sexual orientation minorities tends to persist over time,” the research concludes. And so “anti‐bullying strategies and affirmative actions in school and the workplace might be of consideration.”
Conversion ‘therapy’ begins at home
Study shows pivotal role of parents in “conversion” efforts to change LGBT adolescents’ sexual orientation.
LGBT hate – like love – begins at home.
Parents – not just therapists and religious leaders – play a big role in attempts to change the sexual orientation (often called “conversion therapy”) of lesbian, gay, bisexual and transgender (LGBT) young people who experience sexual orientation change efforts during adolescence.
This is according to a study from the Family Acceptance Project (FAP), dubbed “Parent-Initiated Sexual Orientation Change Efforts with LGBT Adolescents: Implications for Young Adult Mental Health and Adjustment“, which examined the sexual orientation change experiences for LGBT youth across several domains and asked about conversion experiences with both parents/caregivers and with practitioners and religious leaders. This study builds on an earlier FAP project study on family rejection and health risks that identified and measured more than 50 specific family rejecting behaviors that include parental and caregiver efforts and external interventions to change their LGBT child’s sexual orientation.
In the study published online in the Journal of Homosexuality, more than half (53%) of LGBT non-Latino white and Latino young adults, ages 21-25, reported experiencing sexual orientation change efforts during adolescence. Of these, 21% reported specific experiences by parents and caregivers to change their sexual orientation at home; and 32% reported sexual orientation change efforts by both parents and by therapists and religious leaders.
Notably, according to the researchers, “any sexual orientation change efforts – whether by parents alone or by parents, therapists and religious leaders contribute to higher risk for LGBT young people. However, those who experience both parental and external conversion efforts by therapists or religious leaders had the highest levels of risk.”
The role of parental support is worth highlighting, because – whether change efforts are carried out at home by parents and caregivers or by practitioners and religious leaders – parents serve as gatekeepers to both engage in and take their LGBT children for external conversion interventions. Both home-based parent and external sexual orientation conversion interventions by therapists and religious leaders, coupled with parent conversion efforts, contribute to multiple health and adjustment problems in young adulthood. These include higher levels of depression and suicidal behavior, as well as lower levels of self-esteem, social support and life satisfaction, and lower levels of education and income in young adulthood, compared with LGBT young people who did not experience conversion efforts.
Other study findings include:
- Rates of attempted suicide by LGBT young people whose parents tried to change their sexual orientation were more than double (48%) the rate of LGBT young adults who reported no conversion experiences (22%). Suicide attempts nearly tripled for LGBT young people who reported both home-based efforts to change their sexual orientation by parents and intervention efforts by therapists and religious leaders (63%).
- High levels of depression more than doubled (33%) for LGBT young people whose parents tried to change their sexual orientation compared with those who reported no conversion experiences (16%) and more than tripled (52%) for LGBT young people who reported both home-based efforts to change their sexual orientation by parents and external sexual orientation change efforts by therapists and religious leaders.
- Sexual orientation change experiences during adolescence by both parents / caregivers and externally by therapists and religious leaders were associated with lower young adult socioeconomic status: less educational attainment and lower weekly income.
- LGBT adolescents from highly religious families and those from families with lower socioeconomic status were most likely to experience both home-based and external conversion efforts, while those who were gender nonconforming and who were from immigrant families were more likely to experience external conversion efforts initiated by parents and caregivers.
“Although parents and religious leaders who try to change a child’s LGBT identity may be motivated by attempts to ‘protect’ their children, these rejecting behaviors instead undermine an LGBT child’s sense of self-worth, contribute to self-destructive behaviors that significantly increase risk and inhibit self-care which includes constricting their ability to make a living,” said Dr. Caitlin Ryan, director of the Family Acceptance Project at San Francisco State University and lead author noted.
“We now have even more dramatic evidence of the lasting personal and social cost of subjecting young people to so-called ‘change’ or ‘conversion’ therapies. Prior studies with adults have shown how harmful these practices are. Our study shows the role central role that parents play. It is clear that there are public health costs of ‘change’ efforts for LGBT adolescents over the long-term. The kind of change we really need is family education and intervention” added study co-author, Stephen T. Russell, Ph.D., Regents Professor, University of Texas at Austin.
Although responses to prevent conversion efforts particularly overseas have focused on adopting laws to curtail licensed practitioners from engaging in sexual orientation change interventions (deemed unethical and harmful by mainstream professional associations), this study nonetheless underscores “the urgent need for culturally appropriate education and guidance for families and religious leaders to provide accurate information on sexual orientation, gender identity and expression, on the harmful effects of family rejecting behaviors which include sexual orientation conversion efforts, and on the need for supporting LGBT young people to reduce risk and increase well-being.”
3rd Iloilo LGBTQI gathering stresses that #PRIDEisProtest
Iloilo hosted its 3rd LGBTQI Pride parade, with the core message highlighting that Pride remains an act of protest.
The city of Iloilo hosted the third iteration of its Pride parade, with the core message highlighting that Pride remains an act of protest. In a way, this is contrary to the current direction many Pride-related parades are taking – including in Metro Manila – where advocacy is getting trumped by commercialization/partying.
In a statement provided to Outrage Magazine, Carlo Gabriel Evidente of the Iloilo Pride Team said that the move to focus on #PRIDEisProtest is “in recognition of the legacy of the Stonewall Riots, and the continuing gender-based violence and discrimination experienced by persons of various SOGIEs all over the world.”
Irish Granada Inoceto, vice chairperson of Iloilo Pride Team, added: “Through this (gathering we hoped to) make all colors of gender visible and celebrated. This is our way of saying we are here and we are not going anywhere.”
Over 2,000 people joined this year’s gathering, the biggest for the three-year-old annual gathering.
Iloilo has actually been making rainbow waves lately.
In June, the city of Iloilo joined the ranks of local government units (LGUs) with LGBTQI anti-discrimination ordinances (ADOs), with the Sangguniang Panlungsod (SP) unanimously approving its ADO mandating non-discrimination of members of minority sectors including the LGBTQI community.
Following this, in August, Iloilo Mayor Jose S. Espinosa III declared the city as “LGBT-friendly”, with plan to establish an office that will develop programs and activities for the LGBT community.
For Inoceto, “as long as Pride remains inclusive of the issues of the most marginalized, when it continues to be a platform for the courage of those who stand for LGBT rights and human rights, Pride will never grow passé.”
PHOTOS PROVIDED BY ‘HUMANS OF ILOILO’; CHANNEL BIBANCO; ALJHUR ALQUIZAR III