Below the Rainbow Flag: A report from #MentalHealthPH’s #UsapTayo


June 30, 2021


Writers: K Ballesteros, Shane Wendy Sarabia, Ian Stephen Velez, Krystle Mae Labio, and Tobey Fhar Isaac Calayo
Researchers: Alvin Joseph Mapoy, Angelica Jane Evangelista, and Gie Lenna dela Peña
Graphics: Krystle Mae Labio, Jacklyn Moral, and Klein Xavier Boiser
Tweet Chat Moderators: Marga Miñon, Christine Joy Salva Cruz, Ian Stephen Velez, and Tobey Fhar Isaac Calayo
Documentation: Angelica Jane Evangelista and Ian Stephen Velez
Spaces Moderators: Richardson Mojica, K Ballesteros, Krystle Mae Labio, and Ian Stephen Velez


“Takot at pangamba ang laging bumabalot sa bawat kaisipan ng illan sa tuwing iisipin nila kung kailan ba talaga pwedeng magpakatotoo at maging masaya,” wrote Rain, describing the attitudes and behaviors he regularly encounters in Manila as a member of the LGBTQIA+ community. Each of the three anecdotal accounts collected for this report describe living with restrictive religious dogma reinforced in daily life by close family. This is an unfortunate hallmark of LGBTQIA+ individuals’ lived experience in the Philippines, across social classes. It cannot be overstated how mental health is the cumulative effect of systemic, socio-cultural, and economic factors. Despite popular narratives that relegate mental health and self-are as individual concerns, in low-and-middle-income countries (LMIC), LGBTQIA+ individuals’ mental health rely on their overall environment, and the various levels of support to which they have access.  

An active and critical reframing of approaches to mental health interventions are driven by a crucial first step: to acknowledge that mental health professions were historically rooted in anti-LGBT stigma (Manalastas, 2016). In the Asia Pacific Forum of National Human Rights Institutions and the United Nations Development Programme’s published paper Promoting and Protecting Human Rights in relation to sexual orientation, gender identity, and sex characteristics (2016), the organizations acknowledge  the “discrimiantory treatment in health care [which] includes not only the refusal of needed health services but [treatment] that can amount to abusive treatment” (p. 49). Another study by Ray Cabrera (2017) on the “Gender Role Strain and the Psychological Health of Filipino Gay Men” notes that “therapists, even with their good intentions, may sometimes feel challenged when dealing with client groups whose cultural backgrounds or sexual orientation are different from their own because unexpected biases may emerge in the course of their therapeutic work” (Cabrera, 2017, p. 46). While the notion that mental health issues disproportionately affect LGBTQIA+ individuals has begun to become more mainstream in response to strong, empirical evidence that linked these issues with sexual minority status, current research trends are now more concerned with deepening academic and institutional knowledge about the risks attached to being part of sexual minorities. 

Minority stress is experienced by members of minority groups within a majority heterosexual culture (O’Donnell, Meyer, & Schwartz, 2011; Reyes, Lanic, Lavadia, Tactay, Tiongson, Tuazon, & McCutcheon, 2015; Manalastas, 2016); LGBTQIA+ individuals must cope with general stressors, as well as the “double burden of being a minority in a heterosexist culture that places little value on their romantic relationships and identities” (Manalastas, 2013, p. 10 as cited in Reyes et al., 2015, p. 248). Minority stress can come from overt acts of aggression, violence and rejection. But what typifies minority stress is its consistency across several subsectors. 

Rejection, microaggressions, & outright violence  

Pink–a bisexual, feminine, cisgender woman–recounts how she kept her relationship hidden because her parents were conservative and traditional. According to Pink, her parents “wished she could change someday”, preferring to believe that her attraction to members of the same sex were part of a temporary experimental stage. Pink reports that her coming out of the closet was met with microaggressions and intrusive questioning by her friends and members of her immediate family. Samples of these heteronormative questions include: “who [is] the man [in your relationship]?”; “you are not obvious because you’re both feminine!”; “you can’t have babies.” Pink notes that these reactions came from self-identified LGBTQIA+ allies who nonetheless retained deeply held, pervasive beliefs about LGBTQIA+ relationships and the individuals who engage in them. 

Rain has also been on the receiving end of vicious comments and remarks meant to attack his self-worth and shame him for his sexuality. Rain recounts his first Pride March, which was attended by religious fundamentalist organizations holding placards which read “magsisi kayo, hindi pa huli ang lahat.” To him, their presence was an unwelcome reminder of the rejection he had experienced as a child. Rain repeatedly received abusive comments like, “salot ka”, “sayang ka”, “[bakit] malambot ka?”, and “paano ka magkaka-anak?” 

Inappropriate and deeply painful remarks like these contribute to the double burden, and the minority stress experienced by Filipino LGBTQIA+. Advocates and LGBTQIA+ activists from UP Babaylan report that “being hurt by the closest people [in an LGBTQIA+] individual’s life can bring the most serious fear and trauma. That makes LGBT people feel more scared to come out to the public and it is also the main cause of mental illness” (Tang & Poudel, 2018). This study is further supported by previous research about adolescents and young adults who “perceived parental disapproval are more likely to develop views of themselves as bad, shameful, or unlovable” (Reyes et al., 2015, p. 246). According to “Bata at Bahaghari: experiences of LGBT Children in the Philippines,” a study prepared by the ASEAN SOGIE Caucus (2017), Filipinos who face this form of rejection and stigma respond and cope by developing compensatory behavior whereby “people attempt to deflect attention from or make up for one’s perceived faults and shortcomings…by excelling in particular activities or over-achieving in one’s career” (p. 6). Compensatory behavior teaches LGBTQIA+ that their rights as human beings are conditional, and further reinforces the erroneous notion that there is something wrong with them, that “being LGBT is something you need to be redeemed from–and that they must work harder to be considered a human being” (ASEAN SOGIE Caucus, 2017, p. 6). 

Filipinos’ thorny relationship with Catholicism informs policies, legislation, and social response to LGBTQIA+ individuals, their needs, and the issues surrounding their sexual orientation, gender identity and expression (SOGIE). In a study about lesbian and bisexual Filipina women and instances of suicidal ideation and suicide attempts relative heterosexual populations, Eric Julian Manalastas (2016) found that “traditional religion is often used as a means to suppress equality for sexual minorities, as when clergy publicly oppose proposed anti-discrimination laws, claiming that they will pave the way for ‘immoral’ practices like same-sex marriage” (pp. 105-6). Rain’s personal experience lends further proof to the way Catholic and Christian religious narratives, in particular, are weaponized against LGBTQIA+ Filipinos everyday. Rain writes: “Minsan pa’y inihahalintulad nila ang pagiging bading sa demonyo, dahil daw wala namang nilikha ang Diyos na ganito at tanging babae at lalaki lamang.”

It is therefore unsurprising that Manalastas’s (2016) study concludes “gay and bisexual youth in the Philippines have disproportionately higher levels of non-fatal suicide behaviors compared to heterosexual peers” (p. 106). Another key finding of this study is the application of the gender paradox of suicide to Filipino LGBTQIA+ populations. According to Manalastas, “women have higher rates of suicide ideation and attempt, while men have higher rates of suicide deaths” (Hawton, 2000, as cited in Manalastas, 2016, p. 102). On the other hand, Filipino gay men must further contend with narrow masculinity norms, under which they are constrained. According to Cabrera, the “Filipino gay identity is characterized by the preference to be perceived as masculine by the public and to be disconnected from being identified as bakla” (2017, p. 45). Cabrera described how Filipino gay men “the more they confirm to masculinity norms, the more they feel good about themselves” (2017, p. 45). The corollary of this is also true: Filipino gay men who choose not to perform masculinity may develop mental health issues including depression, anxiety, social anxiety.

From the perspective of a male ally, Yellow’s experience was marked by casual ridicule, and the awareness that “living in the Philippines is personally dangerous and isolating”, specially for an ally who describes himself as having a “soft and cheerful personality”, traits that are traditionally perceived as counter-masculine. For Yellow, self-expression is a “call to carry through a promise, that your personality deserves to be lived out at its best, against society’s degrading comments and hypocritical traditions.”

This brief intersectional view of LGBTQIA+ mental health lends itself to a more pressing question: which Filipino LGBTQIA+ communities are under-served, least represented, and bear the brunt of minority stress? 

Pride along the margins  

The idea that mental health issues are primarily a young adult and middle class concern has empowered services, education, and the participation of LGBTQIA+ individuals who align with these demographic categories. However: those who find themselves participating in continuing class struggle, LGBTQIA+ older adults and younger children, and those who may be based outside urban centers or who are part of urban poor communities may struggle in the periphery. 

A glaring blindspot for LGBTQIA+ communities are representative narratives and stories coming out of Mindanao and the Visayas. According to Being LGBT in Asia: The Philippines Country Report, a review and analysis conducted jointly by the United Nations Development Programme (UNDP) and the US Agency for International Development (USAID), LGBTQIA+ communities in Mindanao must contend with a hostile environment due to the political unrest in parts of the island. Within certain communities in Mindanao, “LGBT people are treated with less dignity because they are perceived to promote ‘non-Islamic’ ways in society…There are also stories of religiously inspired hate crimes with a pattern of the targeted killings of Muslim gay men and [transwomen]” (UNDP & USAID, 2014, p. 28).

There are also few studies specializing in the experiences of Trans and intersex Filipinos (ASEAN SOGIE Caucus, 2017, p. 3), a trend that is not uncommon in Southeast Asia. According to the Asia Pacific Forum of National Human Rights Institutions (2016), “in [Southeast Asia] and globally, transgender organizations have attempted to monitor the most extreme forms of violence, when transgender people have been killed because of their gender identity. The vast majority of those murdered are transgender women” (p. 46). These killings and instances of grievous violence often go unreported and uninvestigated in the Philippines where members of the law enforcement and other powerful institutions themselves perpetrate violence. There is also a lack of systemic support for transwomen, men, and intersex LGBTQIA+ Filiplinos, of whom “[transmen] face high levels of violence and abuse within [their families]” (Asia Pacific Forum of National Human Rights Institutions, 2016, p. 48). Transwomen and transmen often face direct discrimination, in which mainstream media is complicit: “their portrayal in the media, derogatory terms used to describe transgender people, and inappropriate references made to intimate parts of their bodies…dehumanize transgender people and are an invasion of their privacy” (Asia pacific Forum of National Human Rights Insitutions, 2016, p. 48). 

While Filipino families are enshrined and celebrated in Filipino value systems, it is within these closed spaces where trauma and LGBTQIA+ Filipinos may most keenly experience instances of discrimination. According to the ASEAN SOGIE Caucus (2017), young LGBTQIA+ Filipinos face a greater risk of finding themselves in stressful circumstances including emotional abuse, verbal harassment, neglect, battery, and sexual assault perpetrated by parents, siblings, and their relatives. The spaces that young LGBTQIA+ Filipinos occupy–their homes and schools–may expose them to bullying, a form of violence with long-term impact (Asia Pacific Forum of National Human Rights Institutions, 2016, p. 47) on young individuals. A culture of silence characterizes schools and homes, spaces where LGBTQIA+ children should have access to care, but where “they are unsure whether their problems will be taken seriously or can be properly addressed…met with silence, they turn silent themselves” (ASEAN SOGIE Caucus, 2017, p. 4). 

Finally, the notion of Pride as a middle-class struggle and the reality of the Philippines as a lower-middle-income country (LMIC) contributes to a certain blindness to the manifold effects of poverty and issues of access to mental health services. In fact, “global estimates indicate that about 20% of adolescents and youth are affected each year by mental health issues…85% to 90% of these live in  LMIC, and their needs are generally neglected” (Newman, Prabhu, Akkakanjanasupar, & Tepjan, 2021). UP Babaylan members are working to address this misconception; this student-led organization believes that “LGBT people exist in every class and actually most of them come from the lower class, so their issue belongs to the lower class” (Tang & Poudel, 2018). To further ground the claim, a study on HIV and mental health issues provides empirical evidence to prove that “young people in LMIC have increased vulnerability to mental illness and associated mortality owing to higher rates of HIV and adverse social determinants of health, such as poverty, food insecurity, community violence, and low access to mental health care” (Newman et al., 2021). 

Answering systemic, multi-sectoral, and deeply entrenched attitudes will require coordinated, consistent effort across several sectors of government, down to the level of grassroots community-based organizations. 

Pride Today, Pride Tomorrow 

Pink reports that she was “exposed to ways to help other people become aware of SOGIE, recognize diversity, and promote inclusivity.” She continues to participate in Cebu’s LGBTQIA+ communities, in particular the Cebu Coalition for Equality, a non-governmental organization based in Cebu that promotes awareness of SOGIE, making LGBTQIA+ more visible, organizing Pride parades and online events. According to Pink, the Cebu Coalition for Equality is a partner in promoting the SOGIE Bill and the Anti-Discrimination Bill, encouraging LGUs to implement changes on the ground. Her advocacy brought Pink to a Pride March in Cebu where she heard homophobic remarks hurled at drag queens. Pink was not surprised. She notes that “these were part of the sad reality that LGBTQIA+ persons face everyday, but they continue to march”. 

An organized and highly visible Pride March is a celebration of diversity and inclusivity that is meant to amplify conversations about LGBTQIA+ issues, forward necessary legislation, and encourage Filipinos to challenge existing heteronormative and homophobic attitudes. Although the visible Pride movement succeeds in awareness building, part of the optics of Pride is its unification. In fact, there are “opposing views on priority issues” (UNDP & USAID, 2014, p. 44) across LGBTQIA+ organizations in the Philippines. According to the UNDP & USAID review (2014), various strands that find common ground in LGBTQIA+ spaces include the political will to push for passage of an anti-discrimination bill, the legalization of same-sex marriages, the AIDS and HIV epidemic, and LGBTQIA+-related hate crimes.  

In the face of a stalled national anti-discrimination bill, different local governments have instead taken initiative to pass more local legislature. In 2016, Mandaue City, Cebu, passed a “comprehensive lesbian, gay, bisexual, and transgender (LGBT) code” (Rappler, 2016), an ordinance based on SOGIE that “protects the LGBT community’s rights based on the Philippine Constitution’s Bill of Rights, existing laws, and international conventions” (Rappler, 2016). Mandaue City joined several cities–including Quezon City, Manila City, and Davao City–with specific, citywide legislation guaranteeing varying levels of protection for LGBTQIA+ individuals, and providing space to address community concerns. Davao City’s 2012 ordinance, on the other hand, protects minority groups and persons with disabilities, while Quezon City’s 2014 legislation “seeks to eliminate all forms of discrimation that offend the equal protection clause of the Bill of Rights enshrined in the Constitution, and other existing laws to value the dignity of every person” (Rappler, 2016). Where Rain is based in Manila City, the 2020 local government passed an “anti-discrimination ordinance…[requiring] businesses to have gender-neutral toilets by 2023” (Abad, 2019). 

In Quezon City, legislation is in place that prohibits acts of discrimination against LGBTQIA+ “in the workplace, educational institutions, and in delivery of goods, services, and accommodation” (Abad, 2019). It is no coincidence that it was also in 2014 when Jennifer Laude was brutally murdered by a US Marine (Abad, 2019).  

Despite top-down legislation, however, the ASEAN SOGIE Caucus (2017) claims that among the most vulnerable LGBTQIA+ Filipinos, young children, are unable to seek and access support “because they do not know where to go or because traveling to these places — centered mostly in Metro Manila — is costly” (p. 5). Another issue of access is in the form of frontliners whose lack of adequate training impedes implementation of citywide or national legislation. For example, UNDP & USAID’s (2014) review includes a report describing a Philippine National Police (PNP) Women’s and Children’s desk whose officer was unable to deal with the case of a gay man reporting rape. According to the report, “this was because the PNP’s Women’s and Children’s Desk only handles cases involving biological females” (UNDP & USAID, 2014, p. 39). 

Community-based programs remain crucial intervention points to address gaps in national and LGU-level services. Organizations like UP Babaylan are instrumental to celebrating diversity, pushing for inclusivity, and fighting for visibility. According to a study conducted by Xijia Tang and Ak Narayan Poudel (2018) in which representatives of UP Babaylan were interviewed in-depth, student and youth-led organizations prioritize their members’ mental health in recognition of the effects of minority stress. UP Babaylan shelters LGBTQIA+ students who need accommodations, and work to organize Pride Marches in solidarity with the larger communities. Tang and Poudel’s (2018) study recommends that these and other youth-led organizations receive access to medical services, and robust partnerships with mental health organizations to “resolve mental and other health issues suffered by LGBT students” (Tang & Poudel, 2018).

“Hanggang kailan kaya magiging ganito ang buhay namin?” Rain’s question underpins both Yellow and Pink’s attitudes regarding the future of LGBTQIA+ advocacy in the Philippines.  Pink’s response is hopeful: “Pride…is about respecting and honoring everyone’s existence and identity…with no fears, no judgement, no shame.” For Yellow, the promise of Pride is inevitable. It is only a matter of time: “the next time you [encounter] someone calling you ‘sayang’ or ‘salot’, just smile, defend the community…mauubos din sila!” 

Pre-Session Questions

  1. What is your LGBT Anthem?
  2. Which of the letters in LGBTQIA+ represents you? (insert infographics) 
  3. Name an LGBTQIA+ icon you admire! 


  1. What minority stressors do LGBTIAQ+ Filipinos experience? Are Filipinos more willing to support LGBTQIA+ communities? 
  2. What kind services should be available to LGBTQIA+ Filipinos in your city or region?
  3. Saang sangay ng LGBTQIA+ ang sa tingin mo ay kailangan pa ng pag-intindi, at pag-unawa?



Dohrenwend, B. P. (2000). The role of adversity  and stress in psychopathology: some evidence and its implications for theory and research. National Library of Medicine 41(1): 1-19.

ASEAN SOGIE Caucus (2017). Bata at Bahaghari: Experiences of LGBT Children. Asc Discussion Series No. 1. Available at: (Accessed: 25 June 2021). 

UNDP, USAID (2014). Being LGBT in Asia: The Philippines Country Report. Bangkok. Available at: https:/ (Accessed: 25 June 2021). 

Manalastas, E.J. (2016). “Suicide Ideation and Suicide Attempt Among Young Lesbian and Bisexual Filipina Women: Evidence for Disparities in the Philippines”, Asian Women. 32 (3):101-120. Available from: (Accessed: 25 June 2021). 

Abad, M. (2019). “Timeline: SOGIE equality in the Philippines”, Rappler. Available from: (Accessed: 25 June 2021). 

Asia Pacific Forum of National Human Rights Institutions and the United Nations Development Programme. (2016). Promoting and Protecting Human Rights in relation to Sexual Orientation, Gender Identity and Sex Characteristics. Available from: (Accessed: 25 June 2021). 

Peter A. Newman, Shirley Mark Prabhu, Pakorn Akkakanjanasupar & Suchon Tepjan (2021). HIV and mental health among young people in low-resource contexts in Southeast Asia: A qualitative investigation, Global Public Health, DOI: 10.1080/17441692.2021.1924822

Cabrera, R. (2017). “Gender Role Strain and the Psychological Health of Filipino Gay Men”, IAFOR Journal of Psychology and the Behavioral Sciences, Tees, Esk and Wear Valleys NHS Foundation Trust, UK. Available from: (Accessed on: 25 June 2021). 

Tang X, Poudel AN. Exploring challenges and problems faced by LGBT students in Philippines: A qualitative study. J Public Health Policy Plann. 2018;2(3): 9-17.

Rappler (2016). What does Mandaue’s LGBT ordinance mean for gender rights?. 13 February. Available from: (Accessed on: 25 June 2021). 

Reyes, Marc Eric & Lanic, Paul John & Lavadia, E.N.T. & Tactay, E.F.J.L. & Tiongson, E.R. & Tuazon, P.J.G. & McCutcheon, Lynn. (2015). Self-stigma, self-concept clarity, and mental health status of Filipino LGBT individuals. North American Journal of Psychology. 17. 343-350. 


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