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Transgender youth faced with tough decision to freeze sperm or eggs

Fertility preservation only recently became an elective option for transgender youth. It can be difficult and ethically complex to approach the topic with adolescents.

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Photo by Sharon McCutcheon from Pexels.com

The last thing on most teens’ minds is whether or not they want to have kids someday. But transitioning transgender adolescents are forced to consider whether to preserve their sperm or eggs at a young age.

Whether or not they pursue fertility preservation is influenced by certain key factors, such as their family values, gender dysphoria, the cost of the procedure or not feeling ready to make such an important, lifelong decision at their age, reports a new study from Northwestern Medicine and the Ann & Robert H. Lurie Children’s Hospital of Chicago.

The findings shed light on how difficult this choice can be for such young adults (aged 15 to 24), and highlight the need to establish standardized protocols for primary care doctors when counseling transgender patients as they consider sex reassignment.

“As a child psychologist, I’m usually talking to adolescent patients about contraception to prevent unwanted pregnancies, not, ‘Down the line, do you want to be a parent? And if so, how important to you is a genetic connection to your child?’,” said first author Diane Chen, assistant professor of psychiatry and behavioral sciences and pediatrics at Northwestern University Feinberg School of Medicine and a pediatric psychologist at Lurie Children’s. “It can be difficult for kids who are transitioning in adolescence to have to be thinking about these things. It’s not developmentally typical.”

The study was published in the journal LGBT Health. It is the first study to use in-depth interviews rather than retrospective chart reviews to explore factors that impact fertility preservation decisions in transgender adolescents and young adults.

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Fertility preservation only recently became an elective option for transgender youth. It can be difficult and ethically complex to approach the topic with adolescents, which is why Chen was drawn to the research.

“Potentially compromised fertility should not be a reason to prevent transgender adolescents from transitioning with hormones, but we should be taking steps to train doctors on how to talk to transgender youth about options for fertility presentation and support them in making these decisions,” Chen said.

This can be particularly complicated because it is not until a person is in their mid-20s that their frontal lobe is fully developed, which has led some to question whether adolescents and young adults can fully understand the potential implications of their decisions.

Additionally, doctors should consider referring some patients to see a specialized fertility counselor for support, Chen said. But even specialists might need to revamp their protocols to include more information, which, as one study participant said, can be lacking.

“I do kind of regret not doing the fertility [preservation] thing,” said one 18-year-old study participant who had received fertility preservation counseling but did not pursue fertility preservation. “I felt like if I didn’t do my own research, and I didn’t know, hey, I can be on testosterone then get off, and then I can just like start taking ovulation medication … like imagine if I didn’t do my own research! I just wish they had told me, ‘hey, there is a way, even after you start testosterone to do [fertility preservation].'”

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The study identified the following four key factors that influence transitioning transgender youth when deciding whether to pursue fertility preservation:

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  1. Either knowing they wanted biological children or weren’t sure
  2. Family values such as a parent encouraging or pressuring them to consider fertility preservation
  3. The cost of the procedure and storage of their eggs or sperm
  4. Concern for worsening gender dysphoria by completing invasive fertility preservation or delaying testosterone or estrogen initiation

“In this population in particular, there are unique barriers to fertility preservation related to gender dysphoria,” Chen said. “If someone feels their reproductive organs don’t align with their gender identity, it could be distressing to pursue fertility preservation.”

A trans male who was assigned female at birth and wants to preserve his eggs, for instance, will need to go through a cycle of hormonal stimulation and egg retrieval similar to a woman pursuing in vitro fertilization due to infertility, which Chen said can be quite invasive.

Determining fertility options at a young age is not a new concept. For years, female pediatric cancer patients at Northwestern’s Oncofertility Consortium have received consultation about whether and how to preserve their eggs before undergoing their cancer treatment.

The transitioning transgender study involved 18 patients between the ages of 15 and 24 years old. See the attached table for a breakdown of their responses.

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Sotto says SOGIE Equality Bill has ‘no chance’ of passing Senate

In a message, Sen. Sotto stated: “Anti-discrimination on persons, pwede, pero [it’s possible, but] focused on gays, which the SOGIE bill is, and religious and academic freedom impeded plus smuggling of same sex marriage? No chance!”

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Senate President Vicente “Tito” Sotto III declared that the bill that seeks to ban discrimination on the basis of sex, sexual orientation, gender identity and gender expression (SOGIE) has “no chance” of passing in the Senate – at least under his leadership.

In a message, Sotto stated: “Anti-discrimination on persons, pwede, pero [it’s possible, but] focused on gays, which the SOGIE bill is, and religious and academic freedom impeded plus smuggling of same sex marriage? No chance!”

Sotto has repeatedly shown his opposition of the anti-discrimination bill, known in its current iteration as the SOGIE Equality Bill. For instance, during the 17th Congress, he was among the senators who – in essence – blocked the passage of the measure because of his insistence to want to interpellate the bill’s sponsor, Sen. Risa Hontiveros. The same interpellation didn’t happen until Congress adjourned, thereby killing the measure.

Surprisingly, in 2018, he actually stated that the ADB’s passage is “possible”. But his response even then was tempered by his position to continue allowing education/religious institutions to discriminate, and was similarly still stuck in toilet use (i.e. disallowing people to use restrooms according to their gender identity).

More recently, still confused about the meaning of LGBTQIA – coming after years of hosting Eat Bulaga, which has a trans pageant Super SiReyna, segment Suffer SiReyna, and co-hosts who are part of the LGBTQIA community, including Liza Seguerra and Allan K – Sotto suggested removing the acronym and instead just refer to members of the community as “homo sapiens”.

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The onus is not on Sotto alone, however, but those who placed him in his position of power to maneuver what will be discussed in the Senate’s session hall. Last June 4, 13 senators signed a resolution backing Sotto’s so-called leadership in the then incoming 18th Congress. These included: Sens. Juan Miguel Zubiri, Panfilo Lacson, Manny Pacquiao, Ralph Recto, Nancy Binay, Loren Legarda, Grace Poe, Sonny Angara, Francis Escudero, Sherwin Gatchalian, Gregorio Honasan, Aquilino Pimentel III, and Joel Villanueva.

Escudero, Honasan and Legarda ended their terms on June 30.

In contrast to the Senate under the so-called Sotto leadership, the Lower House/House of Representatives passed the bill in 2017.

The first anti-discrimination bill was filed 19 years ago. It was first filed in the 11th Congress by Akbayan Party-List Representative Etta Rosales. That version of the bill was approved on third and final reading in the 12th Congress, but failed to gain traction in the Senate. In 2006, during the 13th Congress, the ADB reached second reading.

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‘Patuloy na itaguyod ang SOGIE Equality Bill’ – LGBTQIA activists

Though there are still politicians who refuse to see the merits to pass #SOGIEEqualityNow, #LGBT Filipinos are taking this as a challenge to keep pushing for a national policy that will protect the rights of all no matter their SOGIESC.

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As far as the equal protection of LGBTQIA Filipinos are concerned, “may mga gaps talaga (there are really gaps in the laws of the land),” said Anastacio Marasigan, executive director of TLF SHARE Collective Inc. “Kailangan ng SOGIE lens sa mga batas natin; yun ang nawawala sa current laws natin (Our laws need to use SOGIE lens/awareness; this is what’s not present in our current laws).”

Marasigan stressed that this SOGIE focus that is needed may best come in the form of the SOGIE Equality Bill, the current iteration of the anti-discrimination bill that has been pending in Congress for 19 years now.

Marasigan’s call was also made following the continuing confusion – and retaliation, for that matter – with passing the SOGIE Equality Bill.

At the Senate hearing on the SOGIE Equality Bill on August 20, Sen. Ronald “Bato” dela Rosa said that “you can’t just consider one portion of the society.”

Dela Rosa’s biggest concern, for instance, revolves around providing trans people access to toilets befitting their gender identity (not their assigned sex at birth).

“What if isang lalaking manyak magsuot ng pambabae at papasok sa CR ng babae (What if a heterosexual male who is a sex predator/maniac dresses up as a woman and enters the female toilet)?” Dela Rosa asked.

Dela Rosa’s comments were also triggered by the incident involving Gretchen Diez, who recently made the news because of her ordeal while trying to access the female toilet in Farmers Plaza, a mall in Cubao, Quezon City.

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Incidentally, Diez, who has been in the limelight following her experience and not because of her involvement in LGBTQIA advocacy, now fashions herself as the sole representative of the local LGBTQIA community, claiming to be the “face of the LGBT movement.”

The new senator stressed that “this is not an attack on your group (the LGBTQIA community).” But that this is a concern of “totoong babae (real women)” (sic), he added, referring to those who were assigned female at birth.

For TLF SHARE Collective’s Marasigan, “we are not expecting that the SOGIE Equality Bill will be passed smoothly,” he said. “There will be questions, there will be challenges; those will be part of the process.” The bigger challenge is “for us advocates to see to it that the version (of the bill) that we like will be the one that will become a law.”

From her end, Naomi Fontanos, executive director of GANDA Filipinas Inc., noted that there are those who say that there are already existing laws that could serve the intent of the SOGIE Equality Bill.

But Fontanos said that “wala pang batas na nagpoprotekta sa mga LGBTQIA Filipinos sa diskriminasyon at karahasan base sa kanilang SOGIESC. Kailangang malinaw na sinasabi ito ng isang batas na hindi tama mag-diskrimina at mag-abuso ng mga Pilipinong LGBTQIA dahil sa kanilang SOGIESC (there is currently no law protecting LGBTQIA Filipinos from discrimination and violence committed against them based on their SOGIESC. This has to be specifically stipulated in a law, that it is not right to discriminate and abuse LGBTQIA Filipinos solely because of their SOGIESC).”

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Sen. Rosa Hontiveros, sponsor of one of the ADBs filed in the Senate now, said that “halos 20 taon na na ang SOGIE Equality Bill ay sinusulong sa Congress (the SOGIE Equality Bill has been getting pushed in Congress for almost 20 years now).”

And yet, she added that even if discriminatory acts reach the hears of politicians, the bill continues not to be a priority.

Hindi puwedeng hanggang pasensiya na lang (It’s not enough for us to say ‘bear with us’ before acting on the SOGIE Equality Bill),” Hontiveros said.

And so “kailangan ipagpatuloy natin ang pagtataguyod para maging isang batas ang SOGIE Equality Bill (we need to continue pushing until the SOGIE Equality Bill finally becomes a law),” Fontanos ended.

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Sen. Pimentel questions need for anti-discrimination bill, pans emphasis on Diez as face of ADB

Senator Aquilino Pimentel III questioned the need to pass the SOGIE Equality Bill, the latest iteration of the anti-discrimination bill in the Senate, particularly if acts of discrimination committed against members of the LGBTQIA community are actually “already covered” under present laws.

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Senator Aquilino “Koko” Pimentel III questioned the need to pass the SOGIE (sexual orientation and gender identity and expression) Equality Bill, the latest iteration of the anti-discrimination bill in the Senate, saying that some acts of discrimination committed against members of the LGBTQIA community are actually “already covered” under present laws.

During the August 20 hearing of the Senate committee on women, children, family relations and gender equality, Pimentel expressed the need to specify what the SOGIE Equality Bill will really address.

Ang dapat nating sagutin talaga is, ano ang maitutulong ng SOGIE (Equality) Bill para mawala o ma-address ‘yung mga na-share na karanasan ng discrimination? Kasi marami nang nagsasabi na ang pakiramdam, punishable na rin naman sila ngayon by set of laws (What we need to answer is, how can the SOGIE Equality Bill help to remove or address the experiences of discrimination that were shared? Because some said that it feels like these are punishable by existing set of laws),” Pimentel said.

For instance, some of the discriminatory acts faced by members of the LGBTQIA community may already be covered by Republic Act No. 11313 or the Safe Spaces Act, which prevents various forms of sexual harassment and use of words or gestures that ridicule on the basis of sex, gender, or sexual orientation, among others acts.

Pimentel stressed the need for the identification of discriminatory acts done against LGBTQIA people in the SOGIE Equality Bill, instead of waiting for the implementing rules and regulations t identify the same, as this will avoid confusion.

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Klaruhin natin ‘yan. Otherwise there will be no need for SOGIE bill dahil ang lalabas, may confusion pa (Let’s clarify that. Otherwise there will be no need for a SOGIE Equality Bill as it will just confuse/obfuscate),” Pimentel said.

During the same hearing, Pimentel also panned the use of the case of Gretchen Diez to push for the passage of the ADB.

On August 13, Diez – a trans woman – attempted to use the female toilet of Farmer’s Plaza in Cuba, Quezon City. After an altercation with the janittress manning the facility, she was handcuffed and then detained.

After only being in the limelight following her experience and not because of her involvement in LGBTQIA advocacy, Diez now fashions herself as the “face of the LGBT movement.”

“I don’t think that the case of Gretchen (Diez) is a good example of (a discrimination case against LGBTQIA people) to promote this bill,” Pimentel said, adding that “if you conduct a survey, people will be divided.”

For Pimentel, “there would be discrimination if Gretchen (was not) allowed to use any CR.” But this was not the case, since Diez was allowed to use other toilet facilities – e.g. male toilet, and all-gender PWD toilet. It was Diez who refused to do so.

There is a need for “balancing of interests,” Pimentel stressed, particularly if may “umaangal naman na female (there are women who are complaining)”, referring to those who were assigned female at birth and who may express discomfort sharing toilet facilities with transgender women.

For Sen. Koko Pimentel, “there would be discrimination if Gretchen (was not) allowed to use any CR.” But this was not the case, since Diez was allowed to use other toilet facilities – e.g. male toilet, and all-gender PWD toilet. It was Diez who refused to do so.

Various LGBTQIA activists have repeatedly stressed that the discrimination experienced by members of the LGBTQIA community in the Philippines go beyond the issue raised in the Gretchen Diez debacle.

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Still during the Senate committee hearing, mentioned was a survey conducted by Rainbow Rights Project Inc. (R-Rights) with Metro Manila Pride Inc. from 2017 to 2019, with the results showing that 51% of 400 LGBTQIA community members surveyed claiming that they experienced discrimination in public schools, 31% in the streets, and 28% in private schools.

In the 17th Congress, the House of Representatives passed the SOGIE bill on third and final reading but its counterpart measure languished in the Senate and did not even make it past second reading. Now, in the 18th Congress, three senators filed their own versions of the SOGIE Equality Bill in the Upper House: Sen. Risa Hontiveros, Sen. Imee Marcos and Sen. Francis Pangilinan.

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‘Bato’ dela Rosa backs same-sex marriage; still can’t detach trans people from sexual misconduct in toilets

Neophyte Sen. Ronald “Bato” dela Rosa expressed his support for same-sex marriage, even as his supposedly pro-LGBTQIA support is softened by his continuing stance on not allowing people to use toilets based on their gender identity.

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Neophyte Sen. Ronald “Bato” dela Rosa expressed his support for same-sex marriage, making his position on the issue known during a Senate hearing on the proposed anti-discrimination bill (ADB).

“I’d like to manifest na ako po (that me), I’m on your side,” dela Rosa said, addressing members of the LGBTQIA community. “Ako nga (Me), I’m advocating, kung pwede magpakasal kayo parehong lalaki, parehong babae, okay lang sa akin, walang problema. Magsama kayo, magpakasal, walang problema sa akin (If two men, two women want to get married, that’s fine by me, that’s not a problem for me. If you want to live together, if you want to marry each other, that’s a non-issue for me).”

Only last May, Dela Rosa said he is still torn on proposals for recognizing same-sex marriage in the country.

But Dela Rosa’s supposedly new pro-LGBTQIA support is softened by his continuing stance on not allowing people to use toilets based on their gender identity. It may be true/documented that there are no recorded cases of any transgender woman harassing another woman inside a toilet, the former head of the Philippine National Police (PNP) raised the possibility of it happening in the future.

“You can’t detach me from my wild imagination being a retired police officer,” Dela Rosa said. “Pag in-allow kasi natin yan… hindi naman kailangang you just consider one portion of the society, kung hindi lahat i-consider mo yung mga maapektuhan na grupo din like yung totoong babae din (If we allow that…. we’d end up just giving in to the needs of one sector of the society, and yet we should also consider the other affected sectors, such as ‘real women’). Are our sisters and daughter safe in those bathroom?”

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By way of explanation, Dela Rosa said he asked his own daughter, and she expressed apprehension sharing toilets with a transgender woman.

To offer clarification, Naomi Fontanos, who helms Gender and Development Advocates (GANDA) Filipinas, said she understands the concern of the senator about sexual violence. But Fontanos stressed that sexual violence can happen anywhere, and “they don’t necessarily have to be in the toilets alone.”

GANDA Filipinas is a human rights organization that promotes the dignity and equality of transgender people in the Philippines and beyond

Fontanos added that there are already existing laws against sexual violence in the Philippines.

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Duterte pledges to work with Congress to pass SOGIE Equality Bill; still not considered urgent

Though Pres. Rodrigo Duterte vowed to work with Congress to push for the passage of the SOGIE Equality Bill, the bill was still not certified as urgent. And aside from planning to finally formalize the formation of an LGBTQIA commission he earlier pledged, the president is said to be eyeing a national conference – something the LGBTQIA community has already been doing sans government support.

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Courtesy of the Office of Sen. Bong Go

President Rodrigo Duterte vowed to work with Congress to push for the passage of the Sexual Orientation and Gender Identity and Expression (SOGIE) Equality Bill that would protect the rights of members of the LGBTQIA community against discrimination.

This came after a meeting with select members of the LGBTQIA community, including Gretchen Diez, a transgender woman who was recently in the news after being barred from entering a female restroom.

As relayed by Sen. Christopher “Bong” Go, who organized the meeting, also discussed during the meeting was the possibility of creating a commission for LGBTQIA Filipinos pending the enactment of a SOGIE law.

This is – however – not a new pledge, but a delayed one, with Duterte promising the formation of the same in December 2017.

During the gathering that was also joined by 1st District of Bataan Rep. Geraldine Roman, Go also said that the government plans to coordinate with LGBTQIA groups to create a national LGBTQIA convention in September, when advocates from different regions will be represented to raise their concerns and come up with policy proposals to promote and protect their welfare.

It is worth noting that this, too, is not a new solution; in the past, the country’s LGBTQIA community already held such a gathering, with the latest, 4th LGBTQIA National Conference, co-hosted by Bahaghari Center for SOGIE Research, Education and Advocacy Inc., Outrage Magazine and Cebu City-based Bisdak Pride Inc. with funding support not from the national government, but from UNDP and the offices of Rep. Roman and Sen. Chiz Escudero, among others.

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In fact, the national gathering’s 2013 iteration, the 3rd LGBT National Conference, produced “Being LGBT in Asia: The Philippines Country Report” in 2014; it was funded by UNDP and USAID. The report – written by Michael David C. Tan – reviewed the legal and social environment faced by LGBTQIA people in the Philippines. By doing so, it already cited many of the issues besetting members of the LGBTQIA community; and the solutions that may be considered for the same.

“The (LGBTQIA) advocates… are looking forward to the passage of a law that will protect them from discrimination before the President’s term ends,” Go said in a statement.

But following the meeting, it was not immediately made clear if Duterte is certifying the SOGIE Equality Bill as urgent.

The SOGIE Equality Bill, re-filed by Senator Risa Hontiveros in the 18th Congress, seeks to penalize discrimination against the LGBT community by a fine of P100,000 to P500,000 or imprisonment of six to 12 years subject to the discretion of the court.

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Mental health talk series on women, LGBTQ+ slated starting Aug. 23

SPARK! Philippines is organizing a three-part mental health talk series called SPARK! Conversations, to be held on August 23, September 6 and 27 at Commune Cafe + Bar, Makati City.

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Photo by Camila Quintero Franco from Unsplash.com

SPARK! Philippines is organizing a three-part mental health talk series called SPARK! Conversations, to be held on August 23, September 6 and 27 at Commune Cafe + Bar, Makati City.

The mental health talk series is specifically targeted towards women and members of the LGBTQ+ community who have suffered from mental health issues due to social factors such as gender based violence, socioeconomic disadvantage and income inequality. With the passage of the Philippine Mental Health Law, this mental health talk series aims to promote efforts to improve the awareness and encourage discussions on mental health in the Philippines, especially on women and the LGBTQ+ community.

The three-part series of SPARK! Conversations Mental Health Talk Series will focus on the topics of:

  • Single working mothers and the structural disadvantages they tend to experience, such as financial insecurity and lack of social support
  • Supporting the supporter, the struggles that the support system of people who have mental health disorders go through especially in balancing what they can offer to others while also looking after their own needs
  • Members of the LGBTQ+ community and the mental health challenges that they face due to discrimination, societal pressures and stigma that they come across every day

The series is held in partnership with Vanguard Assessments and the Austrian Embassy Manila with the support of J. Amado Araneta Foundation and Philippine Business Coalition for Women Empowerment.

For more information, contact Kassandra Barnes at ktbarnes@sparkphilippines or 09177287961.

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