By Pola Esguerra del Monte for BusinessWorld Weekender

CHARLOTTE Quijon, 24, allots Php1,700 every month to be more like a woman. She spends Php800 to enlarge her breasts and widen her hips through estrogen pills, and Php900 to prevent masculinization of her biologically male body through anti-androgen pills. The cost of her hormone replacement therapy, shipping not included, pales in comparison to the millions required for sex reassignment surgery, breast augmentation, laryngeal shave, and facial feminization surgeries — more advanced procedures she is considering for the future. In the process of constructing her new body one anatomical part at a time, Ms. Quijon sees only one thing: “I’m slowly becoming my true self.”

When a human being is brought forth in the planet of Adam and Eve, one of two boxes decides the newborn’s fate: [ ] Male or [ ] Female. With a person’s sex follows a slew of other two-choice categories: name (Jr. or Maria), pronoun (he or she), color (blue or pink), wardrobe (pants or skirt), toys (guns or dolls), restroom to use (male or female), sex to marry (the opposite), adjective to be defined with (handsome or beautiful), even insult to be scathed with (a — hole or slut). The world is divided according to genitalia.

But Ms. Quijon is one of the many people around the globe whose deeply held sense of gender does not fit into the sex they were assigned at birth. For the Gay and Lesbian Alliance Against Defamation or GLAAD, the communications epicenter of the LGBT (lesbian, gay, bisexual, transgender) movement, “transgender” is an adjective that describes people whose gender identity and/or expression differ from what is typically associated with the sex they were born with. In other words, a “trans man” is someone who was conceived with a female anatomy but lives as a male. On the other hand, the “trans woman” came out into this world as a boy, but sees beyond the protrusion between her legs, and knows she is at heart a woman. Gender identity and sexual orientation are not the same, and a transgender person may just as well be straight, lesbian, gay, or bisexual.

"I am slowly becoming my true self."
Charlotte Quijon, trans woman

NEEDS AND WANTS
There are economics involved in being a trans man or a trans woman. While a transgender identity does not depend on medical procedure, many transgender people take hormones and some undergo surgery to align their gender expression with their gender identity, and achieve a long-term personal comfort with their gendered selves.

The World Professional Association for Transgender Health (WPATH), an international association that upholds transgender health, declares that hormones and surgeries are medical needs, not cosmetic wants. Access to these pathways to transition is essential for transgender people to maximize their overall health, psychological well-being, and self-fulfillment. WPATH promotes health to eliminate prejudice, discrimination, and stigma because gender identity is an integral part of a person’s identity, and the refusal to accept a person’s identity can harm their self-esteem.

Hormones and surgeries are medical needs, not cosmetic wants.
World Professional Association for Transgender Health

Altering one’s birth sex is not a one-time thing. Transitioning is a long, tedious, and complex process that occurs over an extensive period of time and includes telling one’s family, friends, and co-workers; using a different name and new pronouns; dressing differently; changing one’s name and/or sex on legal documents (in the Philippines, this is not yet legal); hormone therapy; and, possibly, undergoing one or more types of surgery.

All these medical interventions come with a price. Not all transgender people are born with a silver spoon. Some look to the black market and transition without a doctor’s supervision, which poses serious health risks. Others are left feeling depressed and anxious. As economic reasons hinder some trans people to receive the health care they need, the effects on their overall mental health threaten the way they function every day.

TRANS WORK FORCE
In countries like the United States of America where transgender health studies are more advanced, small and large businesses have acknowledged the need to provide medical care specifically for transgender people.

The Human Rights Campaign (HRC) Foundation’s Corporate Equality Index (CEI) enumerates employers that provide at least one transgender-inclusive health care coverage plan, which shoulders expenses needed by a transgender person for mental health counseling, hormone therapy, medical visits, surgical procedures, and other treatments related to gender transition or sex reassignment. The justification there is, if a transgender employee feels good about himself or herself in coming to work, then he or she may be more productive.

HRC notes that businesses are increasingly addressing the discrimination in health insurance as the percentage of employers with transgender-inclusive health insurance benefits increase. Where only 1% of the 2004 Fortune 100 companies provided such benefits that year, 2012 recorded 56%. By 2014, 418 businesses rated in the CEI had provided insurance with at least a minimum coverage for sex affirmation or reassignment treatments and services. The long list of American workplaces that provide this plan includes Apple Inc., Google Inc., Moody’s Corp., Nike Inc., and Starbucks Corp.

Kate Montecarlo Cordova, founder and chair of the Association of Transgender People in the Philippines (ATP), laments that the same benefits are not yet provided in the Philippines. She adds that the discrimination is not only health insurance-bound — but affects employment starting from hiring.

Discrimination is manifested in various ways. A trans man nurse who has female checked on his birth certificate will be required to report to work wearing a skirt. When a trans woman wears the most logical outfit she wishes to wear — female clothing — she runs the risk of being labeled as a crossdresser, and certain offices have a dress code against that.

Past the uniform, the working environment itself can be a potential scene of embarrassment. Ms. Cordova, who graduated with a degree in mass communication, once dreamed of being a newscaster. But with the defamatory stigma surrounding transgenders (deceptive, fooling, pretending, masquerading), she said: “Do you think I can stand in front of the camera and people will believe me the same way they believe Jessica Soho? Maybe yes, but I’ll be asked to cut my hair.”

What can awareness do? It can help lawyers understand how to handle legal cases on changing names and sexes. It can persuade nightclub owners to rethink their cross-dressing regulation. It can help customer service people treat transgenders more fairly. At the most basic, it can help ordinary citizens be more compassionate toward people who may look odd in their eyes, but not any less human.

In the same way, hundreds, if not perhaps thousands of transgender Filipinos are kept from practicing what they have studied in the university, succumbing to jobs that are a mismatch to their expertise: parloristas, Japayukis, or sex workers. (There is no record of the exact number of mismatched skills among transgenders, because the research is still lacking, and “transgender” is not a widely used category as much as “bakla,” referring to any effeminate male.)

Ms. Cordova is one such proof of the mismatch. After graduation, she worked for eight years in Japan as guest relations officer. With the advent of business process outsourcing (BPO) in the Philippines — an industry that follows international standards, she has since found a place in an off-shore arm of an American bank, duly recognized in this work environment as Ms. Cordova, and has excelled there as a manager.

She observed that the BPO industry has many good transgender leaders holding middle-management and executive positions. “This is an international company and the standards are so high. Performance is very important,” she said. “And these people, transgender men and women, are excelling. So, had these companies not invested in the Philippines, where would these people be? Kahit nga sa fastfood chain, hindi makakapag-crew ang mga ito.” It must be a contradiction to the LGBT sector that foreign enterprises are the ones that provide work opportunities to transgenders.

LOCAL CONTRIBUTION
Otherwise often excluded from the workplace, transgender people fight to give back to the local community. Nil Nodalo, a trans man, leads the Association of Transgender Men of the Philippines or TransMan Pilipinas which organizes charity work, among other activities.

Last week, they distributed school supplies to grade one pupils at Industrial Valley Elementary School in Marikina, under a tarpaulin proudly announcing the organization’s name, TransMan Pilipinas. “We want to show that identity should not stop one from serving your fellows,” he said. “The LGBT has its plight, but we are here not only to ask for better things, but also to contribute.”

"Nobody wants to be discriminated. If you can study how to train your dog, why can't you study how to treat other people right?"
Kate Montecarlo Cordova, trans rights activist

Trans women also help out, with the encouragement of some local government units, which have been tapping trans women as tanods to help in monitoring theft and traffic. From wandering aimlessly in the streets, these trans women are given a responsibility and take their new roles to heart.

Before Mr. Nodalo knew he was “transgender,” he was not comfortable oscillating between being a “tomboy” and being “less than a man,” he said. He felt empty, alone, and he reported to work as a mediocre employee — clocking in on time and waiting for payday.

“When I was introduced to the word ‘transgender,’ I found a direction,” he said. This brought about a chain reaction of positive events. He married a cisgender woman, met more people like himself, and discovered a new vocation as an entrepreneur selling “LGBT stuff” — testosterone boosters, dildos, chest supporters, sold online through a page after his name.

“Now, I wake up in the morning with 50 messages and notifications from people asking me to help them in their transitioning,” he smiled. “It’s nice to know that people need you. The feeling of being needed is very empowering.”

Ms. Cordova and Mr. Nodalo realize that the transgender movement has a long way to go, comparing it to the feminist movement which has taken decades to grow and continues to be relevant. They believe that awareness is the key for transgender people to coexist with the people who were lucky enough to be born with their gender aligned with their sex.

ATP conducts awareness training — Trans 101 — to explain the philosophies behind gender and transgender, more so for the majority to realize that there are people different from them who deserve their respect. What can awareness do? It can help lawyers understand how to handle legal cases on changing names and sexes. It can persuade nightclub owners to rethink their cross-dressing regulation. It can help customer service people treat transgenders more fairly. At the most basic, it can help ordinary citizens be more compassionate toward people who may look odd in their eyes, but not any less human. Ms. Cordova said, “Nobody wants to be discriminated. If you can study how to train your dog, why can’t you study how to treat other people right?”

The path for transgenders is a long and winding road. Ms. Quijon, who is only five months into transitioning, already recognizes its challenges. “Transitioning is not easy. I consider it one of the biggest decisions I have made in my life so far, and I know that not all people will understand and agree with this, but I have to do what I need to do. I have never been happier in my life.”