The importance of Legal Gender Recognition in the HIV and AIDS Service Delivery – Philippines

The importance of Legal Gender Recognition in the HIV and AIDS Service Delivery – Philippines

The right to recognition before the law is enshrined in the Yogyakarta Principles as the most basic aspect of self-determination, dignity and freedom. Legal gender recognition for transgender women allows them to navigate freely in daily life while being allowed to identify with the gender that they identify with. This, unfortunately, is complicated in the vast majority of Asian countries with diverse legal systems and other pervasive religions and cultures. In the Philippines, there are no official options – a legal gender recognition law, policy or regulation – for transgender people in the Philippines to change name details on official documents.

One of the most notable legal challenges for transgender women in gaining legal recognition in the Philippines, is a landmark case in 2007 when the Supreme Court ruled against a transgender woman who had undergone gender-affirming surgery and wished to change her first name and gender marker on her birth certificate.
The identification documents of a person is required in daily activities and trans people face marginalization when they use identity verification documents that does not match their gender identity and expression. This extends to other challenges in accessing health and HIV services. Legal gender recognition should be a public health priority.
It is clearly visible in the February 2018 HIV/AIDS and ART Registry in the Philippines (HARP) that transgender women are lumped with the “men who have sex with men” (MSM) population in reporting the modes of transmission of key affected populations (KAPs). The cumulative data showing 25,704 cases of “male-male sex mode of transmission” since January 1984 include transgender women.

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While the HARP shows the MSM data to include transgender women, the Department of Health Epidemiology Bureau – Integrated HIV Behavioral and Serologic Surveillance (IHBSS) has separated transgender women from MSM and considered them part of the “most-at-risk populations”. They have been doing this since 2013 because HIV has shown to highly burden transgender women globally. The IHBSS shows data of both gender identity and gender expression, individually.

With both the HARP and the IHBSS showing HIV prevalence among transgender women, service delivery and inclusive policies become necessary. High levels of social exclusion, gender-based violence, discrimination, and marginalization challenges transgender women from accessing services, damaging their health and wellbeing, and putting them at higher risk of HIV. For more specific cases transgender women facing criminal prosecution, incarceration with male inmates can also put them at risk of sexual assault. Transgender women are 49 times more likely to acquire HIV than cisgender adults of reproductive age. In countries where transgender women who are excluded from national HIV surveillance systems, the risk of HIV infection increases because of exclusion from health services.

Legal gender recognition in the Philippines, and other countries in Asia, will eliminate the exclusion of transgender women in the HIV delivery network and registry, and lessen the disproportionate burden of structural barriers on transgender women in accessing services. The legalization of changes in the gender marker and legal name for transgender women would facilitate a wider reach of service provision and would promote inclusive health facilities.
As a key determinant, any law, policy, and practice, or lack thereof, which obstruct the self-determination of gender identity will threaten the goal of ending AIDS by 2030. As we move forward in our battle to end AIDS in the Philippines and in Asia, legal gender recognition will create inclusive communities that uphold each individual’s right to self-determination as we leave no one behind.

Justin Francis Bionat
Project Officer
Youth Voices Count


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