Not just seen, but heard: The fight for LGBTQIA+ health visibility in the Philippines
By Mark Laurenz B. Handayan
Before the end of this year’s Pride celebration, Quezon City Mayor Joy Belmonte launched the ‘Right to Care’ card which allows resident queer couples to make crucial medical decisions for their partners. The legal safeguard garnered tremendous support from the community, being the first of its kind in the country. This card, operationalized through a Special Power of Attorney (SPA), allows queer couples to consent to types of medical care should their partners be in critical care. Upon its implementation, selected hospitals will provide cardholders the privilege to allow or deny medical treatments concerned with their partner’s medical condition.
However, despite its potential to trailblaze more queer-inclusive policies in the country, this milestone also resurfaces the inadequacy of our current infrastructure and systems to support the medical needs of the Lesbian, Gay, Bisexual, Transgender, Queer, Intersex, Asexual (LGBTQIA+) community.
The trivialized state of LGBTQIA+ health is a manifestation of a decades-long suppression of their rights and identities.
Remnants of colonization have permeated hatred in a Filipino society that once embraced a culture of diversity. Regressive social norms coupled with lacking legal safeguards, outdated medical curricula, and SOGIE-insensitive standards of care put LGBTQIA+ individuals at higher health risk.
Beyond the colorful parades lies a neglected state of queer health that not even the greatest attempt at rainbow-washing strategies could reverse. The invisibility of LGBTQIA+ health in Philippine society is a looming public health concern that, if left unaddressed, could lead to thousands of preventable morbidity and mortality.
Invisible colors: State’s failure to LGBTQIA+ health
Status quo promotes the non-recognition of LGBTQIA+ among various institutions. Despite numerous attempts to move forward, the community remains victimized by prejudice and discrimination founded on rhetoric of moral condemnation and ignorance. Hence, it is arguable that stagnant LGBTQIA+ health is caused by the systemic inaction of dominant structures in Philippine society.
This apathy for queer rights, therefore, trickles down to health and further impairs the already ostracized community. It is no surprise that queer visibility in the country is often reduced to comedic relief or discriminated against cisgender-heterosexual individuals due to ‘biological reasons.’
By way of illustration, members of the LGBTQIA+ community, particularly transgender people, are more vulnerable to health issues due to a lack of gender-affirming and protective policies for transgender health. The inaccessibility of medical care focused on facilitating a healthy transition puts transgender Filipinos at higher risk to engage in dangerous behaviors, such as self-medicating practices and purchasing hormones from unauthorized markets.
Another case in point is the surging epidemic of HIV/AIDS among men having sex with men (MSM) in the Philippines. The lack of structural and social support disproportionately affects Filipino gay men. And as a result, the country has been known to have the fastest-growing HIV epidemic in the Western Pacific region.
Despite the willingness of the community to seek appropriate health services, access to quality care is barricaded by pervasive stigma, sociopolitical conditions, and inadequacy of sensitive health personnel.
Clearly, the lack or absence of health service delivery catered to LGBTQIA+ individuals does not eliminate the growing health demands of a community. Instead, it pushes queer individuals to seek precarious health alternatives.
The convoluted demands of LGBTQIA+ health require urgent actions from different sectors with the utmost inclusion of the members of the community.
Contrary to stereotypes, it is abhorrent to trivialize queer needs as only cosmetic procedures. If we truly want to lobby for inclusive healthcare, then our society’s perception of queer health needs to be cognizant of the domineering structures that have led to its failure.
Needs and skills mismatch
Another obstacle to LGBTQIA+ health in the Philippines is the lack of appropriate human resources for health (HRH) trained to be knowledgeable, sensitive, inclusive, and culturally aware of the nuances of queer health.
While some healthcare providers have specialized in gender-affirming hormone therapy (GAHT) for transgender persons, others have been enablers and perpetrators of stigma and microaggressions (i.e. deadnaming trans clients, refusing to provide services). Clinicians ought to be competent in the unique set of mental and physical needs of the community, particularly for transgender individuals who face challenges in conditions where sex is a major indicator for further prognosis.
One could also argue that this aversion stems from the gaps in medical education, which rarely discusses the health needs of the LGBTQIA+ community. Unfortunately, the current Philippine medical curriculum lacks health education requirements that discuss LGBTQIA+ health. Only a few institutions have integrated sexual health divisions into their programs; however, the vast field of queer health remains untackled in most Philippine medical schools.
As a result, fewer health workers are equipped to care for the rapidly growing population. This has resulted in the invisibility of LGBTQIA+ health in medical education and society which creates challenges among healthcare workers in providing quality care for patients within the community.
Vibrant future: A world beyond mere toleration
Lobbying for change in the state of LGBTQIA+ health requires collaborative efforts among legislators, healthcare workers, and stakeholders. Health policies, like any other legislative action, boil down to the political will of people in power; thus, it is a prerogative to criticize public officials regarding their stances and platforms to improve the overlooked state of queer health in the country.
Unfortunately, the Philippines remains archaic despite the calls of different organizations and groups to pass queer-inclusive legislation. It is evident in contemporary Philippine society how easily swayed legislation is by dominating institutions, such as the Catholic Church.
The pushbacks from conservative groups, alongside legislators who are adamant to legislate gender-inclusive laws, have stalled the passing of LGBTQIA+-affirming policies (i.e. the Sexual Orientation, Gender Identity and Expression, and Sex Characteristics Bill), arguing that it is integral for Filipinos to preserve heteronormative values such as family formation and marriage.
However, public clamor proves that the evolving Philippine society demands better visibility of LGBTQIA+ rights. The implementation of the ‘Right to Care’ card is just one of the countless initiatives that could serve as stepping stones for more inclusive rights that respond to the needs of the community.
The state’s political will set the tone for societal attitudes and actions toward LGBTQIA+ health. And it is the state’s duty to provide avenues that mitigate the effects of retroactive policies on the already ostracized minority.
Still, it takes more than just political will to overturn a healthcare system that has long been accustomed to a rigid male-female dichotomy. Our advocacy to lobby for better LGBTQIA+ health visibility could start by making the current medical curriculum comprehensive and perceptive to the nuances of queer needs. It is also integral to include SOGIE-SC courses in basic education to hone gender-sensitive future generations.
A responsive LGBTQIA+ health should center on the community’s voices. An action that views queer struggles beyond the heteronormative lens deeply ingrained in the social fabric of Philippine society. An amplified #HealthForAll that is inclusive, sensitive, and culturally aware.
While much progress is yet to be done, a genuine understanding of the community’s plight could translate to a more inclusive healthcare system. A solution where queer Filipinos are not merely seen but also heard.
