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The intersect of LGBTQ+ and women’s healthcare is marked by shared challenges and needs, such as reproductive health services, mental health support, and specialized care. Both groups often encounter discrimination and stigma in healthcare settings, impacting the quality and timeliness of the care received. Additionally, LGBTQ+ individuals grapple with issues related to stigma, discrimination, and body autonomy, whether it’s related to everyday experiences in households, school, workplaces, and communities, or gender-affirming treatments and surgeries. Despite the commonalities, Filipino LGBTQ+ health needs are not given equal attention, reflecting the heteronormativity of the health system.
Furthermore, it is crucial to recognize and address the unique challenges faced by each group to ensure comprehensive and inclusive healthcare. Pride Month has ended but the conversations on the issues of the LGBTQ+ community continue. In the Philippines, one of the shared experiences this community has faced is the inaccessibility of health services.
LGBTQ+ health services in the Philippines are mostly focused on HIV/AIDS. Gay, bisexual, and other men who have sex with men, as well as transgender women, have been identified as key populations for HIV, translating into targeted preventive screening and treatment. While these are successes for the community, pigeonholing the needs of LGBTQ+ individuals into minimal categories reflects the heteronormativity of current healthcare practices. General health services and programs, including reproductive health, mental health, and substance abuse, remain to utilize a one-size-fits-all approach, which fails to consider the unique factors experienced by LGBTQ+ individuals. Moreover, specialized services, including but not limited to gender-affirming therapies and surgeries for transgender and non-binary individuals, and hormone replacement therapies for intersex patients, remain inaccessible. While a few non-profit organizations and private health providers have established gender clinics, they are mostly based in metropolitan cities.
This narrow understanding of the community’s health needs fails to address their unique health disparities. With the prevailing stigma and lack of awareness on sexual orientation, gender identity, expression, and sex characteristics (SOGIESC) of health providers, LGBTQ+ Filipinos continue to experience discrimination in healthcare settings. This includes denial of health services, harassment, misgendering of transgender and non-binary individuals, and poor medical advice. As a result, LGBTQ+ Filipinos postpone or delay seeking healthcare due to these negative experiences. Moreover, transgenders, for example, resort to self-medication due to the inaccessibility of healthcare professional guidance.
In terms of health outcomes, men who have sex with men, and transgender women represent around 70% of HIV cases in the country. In addition, LGTBQ+ Filipinos have higher rates of suicide ideation, suicide attempts, depression, and stress than their non-LGBTQ+ heterosexual peers. Little is known about the burden of communicable and noncommunicable diseases among LGBTQ+ Filipinos with the absence of routinely collected epidemiologic data on gender identity and sexual orientation. This not only hinders the development of tailored healthcare interventions but also reinforces the systemic neglect of the community’s health needs.
The Philippine Universal Health Care Act of 2019 aspires for equitable healthcare for all Filipinos. However, its long-term goals cannot be achieved if the health system continues to overlook the needs of the LGBTQ+ community. The foundation of equitable healthcare for the LGBTQ+ community lies in the education of those who shape and deliver health services. These are not just health workers who interact with patients but also program implementers and policymakers that define the healthcare landscape. Health workers should have training that equips them with the knowledge and sensitivity to treat LGBTQ+ patients with the respect and understanding they deserve. For health program managers, this should focus on creating LGBTQ+-inclusive programs that actively work to eliminate barriers.
Policymakers hold immense power in shaping healthcare for the LGBTQ+ community, making their role crucial. It is vital for them to receive comprehensive training that encompasses the broader societal implications of the health disparities faced by this community, including the economic, social, and mental health costs of neglecting their needs. Equipped with this knowledge, policymakers can enact legislation and issue policies, including the SOGIE Equality Bill, that prioritize the health and well-being of the LGBTQ+ community and ensure they are not left behind in the pursuit of healthcare equity.
The healthcare disparities faced by the LGBTQ+ community, both in the Philippines and globally, are a pressing issue that requires immediate and comprehensive action. From healthcare providers to program managers and policymakers, a multi-layered approach is essential to address the unique challenges and needs of this vulnerable community. The conversations on the issues of the LGBTQ+ community must continue beyond Pride Month, and it is our collective responsibility to ensure that the healthcare system evolves to meet the needs of this vulnerable community. – Rappler.com
Gillian Garcia is a public health researcher in the Philippines. She is a member of Women in Global Health Philippines and engaged in several public health projects at the Alliance for Improving Health Outcomes.
Martha de la Paz is a public health practitioner and LGBTQ+ health advocate. As a Samya Stumo Fellow of ThinkWell, she led the development of a policy framework for the institutionalization of LGBTQ+ Health in Universal Health Care. Currently, she is taking a Master of Public Health at Johns Hopkins University, specializing in LGBTQ+ Health.
Kim Sales is a health policy and systems researcher in the Philippines. She is Co-Convener of Women in Global Health Philippines and Partner at the Alliance for Improving Health Outcomes.
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