“I’ve had moments in the past [when] I wasn’t even allowed to be with someone I was seeing at the ER because I wasn’t legally considered family. That made them feel alone, and it made me feel like I didn’t matter.”
These harrowing words from Noah*, a second-year student, capture the painful reality that countless LGBTQIA+ couples encounter when navigating the Philippine healthcare system. Scenarios like this play out across the Philippines regularly, underlining the missing piece in healthcare access for same-sex couples—a piece that was addressed by a pioneering initiative from a local government unit in Metro Manila: Quezon City’s Right to Care (RTC) card.
This inventive initiative, launched in June 2023 through the Gender and Development Council Office of Quezon City (QC) government, represents an important milestone in addressing these challenges, but it also illuminates the broader obstacles that LGBTQIA+ individuals and couples continue to face in accessing equitable healthcare across the nation.
Access denied
Healthcare discrimination faced by LGBTQIA+ couples goes far beyond just recognition in the emergency room; it creates an even more complex line of prejudice and exclusion that affects every aspect of medical care for same-sex couples, from routine checkups to emergency medical interventions.
At the core of these challenges lies the issue of legal recognition. As Akbayan Partylist Representative Perci Cendaña explains in Filipino, the Philippines “doesn’t recognize the rights of LGBTQIA people to marry.” Without marriage rights or any legally binding documents to establish their relationship, same-sex couples are rendered invisible in medical settings, frequently excluded from accessing patient information and making medical decisions.
Beyond legal barriers, medical discrimination itself deters LGBTQIA+ individuals from seeking care. Dr. Rowalt Alibudbud, an assistant professorial lecturer under the Department of Sociology and Behavioral Sciences, cites studies reporting that patients from the community face “higher rates of being discriminated upon, being rejected from service, and not being affirmed with their lived names” in medical settings. Healthcare providers, while often well-intentioned, may be ill-equipped to provide proper medical care for LGBTQIA+ individuals, resulting in insensitive treatment or inadequate care that fails to address the basic healthcare needs of the community.
These problems are compounded by economic limitations. Existing legal mechanisms like the Special Power of Attorney (SPA), a legal document allowing couples to consent to or refuse medical decisions on each other’s behalf, remain an expensive luxury most can’t afford. As Cendaña notes in Filipino, “if you were an urban poor couple, or a couple in a rural community and you don’t make that much money, of course you wouldn’t spend your money on these things.”
Insurance restrictions deepen the exclusion. Most policies in the Philippine Health Insurance Corporation (PhilHealth) do not allow same-sex partners to be listed as dependents. “If you’re paying for PhilHealth or if you have a health card, hindi mo [rin] siya p’wedeng ilagay sa health card mo, yung partner mo (as a dependent),” Alibudbud explains.
(If you’re paying for PhilHealth or if you have a health card, you can’t enroll your partner as a dependent.)
The psychological impact of these issues cannot be understated. Research shows that marriage generally supports better mental health and well-being, including for LGBTQIA+ couples. However, the inability of same-sex couples to marry legally in the Philippines creates an additional source of mental health struggles. Navigating a discriminatory system and society while dealing with medical concerns increases stress, worsens health conditions, and perpetuates healthcare inequalities that affect both physical and mental well-being.
Designing plan B
As legalizing civil unions for same-sex couples would require an amendment to the Family Code of the Philippines, local ordinances granting similar rights are not legally binding. In response, the QC Pride Council developed a framework of programs, projects, and activities designed, in principle, to grant these couples the same rights and privileges afforded to married couples. This framework became the foundation for QC’s RTC card.
Launched during Pride Month in 2023, the card provides queer couples with an SPA at no cost. This gives them medical rights similar to ones enjoyed by married heterosexual couples. The ordinance was the first of its kind enacted by any government unit in the Philippines.
A total of 468 queer couples have applied for the RTC card in the two years since its implementation, as reported by the QC government. For Cendaña, a former member of the QC Pride Council before joining Congress, among the many successes of the RTC card since 2023, its greatest impact has been how the application process has helped “normalize” the coming out of couples.
“The act of going to the city hall, registering for your Right to Care card, and undergoing the Orientation and Sensitization seminar, it is a very important step [toward] normalizing the recognition of their partnership, the love between queer couples in our city,” he elaborates in a mix of English and Filipino. “And hopefully, it will send a strong signal to the entire country.”
Now in Congress, Cendaña has since filed a bill to nationalize the RTC card. The lawmaker also reveals that the local government of San Juan City, which approved an ordinance instituting their local version of the card last June 10, has ongoing negotiations with the QC government to ensure that constituents’ SPAs are recognized across both cities.
Hope or compromise?
Despite the benefits of what is considered a landmark legislation, Alibudbud concedes that the RTC card “technically is a band-aid solution for the lack of [equal] rights in general.”
Cendaña acknowledges critics’ fear that the potential RTC Law could become “a gateway that would eventually open [the door to] marriage equality legislation.” Still, he argues that the fact cannot be denied. “Dapat may pantay na karapatan.”
(There must be equal rights.)
The congressman also points out that it has been 25 years since the SOGIESC Equality Bill was first filed during the 11th Congress by the late former Senator Miriam Defensor-Santiago and former Akbayan Partylist Representative Etta Rosales, his predecessor. He sees these past 25 years as ones of “neglect and inaction” from his fellow lawmakers in Congress. “It’s about time for us to recognize na hindi special rights itong hinihingi. These are fundamental rights,” he stresses.
(It’s about time for us to recognize that we are not asking for special rights. These are fundamental rights.)
Ultimately, the struggles LGBTQIA+ couples face in gaining access to healthcare are merely branches of long-standing discrimination. While these prejudices persist, any compromises—the Right to Care card included—will seem to only serve as faux markers of hope for a community which continues to seek the rights they should have had in the first place.
*Names with asterisks (*) are pseudonyms.
This article was published in The LaSallian‘s June 2025 issue. To read more, visit bit.ly/TLSJune2025.
