AIDS SOCIETY OF THE PHILIPPINES, INC.

Secretariat: 2/F, OTM Building, #71 Scout Tuazon Street, Bgy. South Triangle, Quezon City 1103
Telephone : (632) 376-2541
(632) 410-0204
Fax : (632) 376-2546
Email: info@aidsphil.org
asp.nfr@gmail.com
Website: www.aidsphil.org

TERMS OF REFERENCE

Title: Technical Expert on the Development on a Comprehensive Health Package for

Transgender Women (Gender Affirming Health Care Package Module)
Location: Manila, Philippines

BACKGROUND:
“Transgender” is an umbrella term that is used by people in a number of different groups, including
but not limited to cross-dressers (those who wear clothing of the other sex some of the time) to
genderqueer people (those who feel that they belong to either both genders or neither genders) and
transsexuals (a term used for people who undergo Gender Confirmation Surgery GCS and/or take
hormones to transition in the opposite sex).
General healthcare for trans people is much the same as it is for others. Everyone has the right to
enjoy the highest standard of physical and mental health. Transgender people have the same health
needs as that of others. However, very few surveys collect data about gender identity. This severely
limits the capacity to identify health risks, protective factors or health outcomes for transgender
people. The cumulative impact of discrimination and relative deprivation is bound to impact
negatively on transgender people’s health.
Data on the prevalence of HIV/AIDS and other Sexually Transmitted Infections among transgender
women remain to be lacking. Furthermore, various reasons deter transgender women from availing
health services which include HIV testing which include their fear of stigma and discrimination from
health care providers and health institutions.
The following salient points seem to be important in considering the delivery of quality services to
transgender women.

 Transgender women are 49 times more at risk of living with HIV compared to the general
population
 Transgender people often face social and legal exclusion, economic vulnerability, and are at
increased risk of experiencing violence. Disempowerment and low self-esteem make
transgender women, in particular, less likely or less able to negotiate condom use.
 More tangible prevention approaches are needed in combination with increased welfare and
employment opportunities to address the specific needs of transgender people.

With these considerations taken into account, the ACER program through it’s Sub-recepient One
has taught of a way to leverage reaching the transgender population in having themselves tested
and knowing their results.
 AIDS SOCIETY OF THE PHILIPPINES, INC.
Secretariat: 2/F, OTM Building, #71 Scout Tuazon Street, Bgy. South Triangle, Quezon City 1103
Telephone : (632) 376-2541
(632) 410-0204
Fax : (632) 376-2546
Email: info@aidsphil.org
asp.nfr@gmail.com
Website: www.aidsphil.org

NEEDS AND OBJECTIVES:

The project is commissioning the need to develop an transgender-focused and transgender-specific

Comprehensive Prevention and Service Delivery Package. Health concerns included access to
medical advice and guidance ranging from the use of hormones to sexual reassignment surgery. It
has also transpired from the previously conducted focus group discussions that most of the
participants shared that they engaged in sexual activities such as anal and oral sex as early as 11-
12 years old. According to them, they experienced anal sex without using condom. Some shared
that most of their sexual partners who are cisgender male do not want to use condom due to less
sensual effect. The average latest sexual contact is less than a week ago. Participants also shared
that they have competition with some other friends in terms of the number of sexual contact.
These findings paint an alarming picture that sexual risky behavior is still prevalent in the trans
population. This serves as detrimental to their health as it predisposes them to HIV/AIDS and other
STIs. This presumption is reinforced by the 2015 Integrated HIV Behavioral and Serologic
Surveillance System which states that 75% of the interviewed population has never been tested for
HIV yet a lot practice condomless sex (58 % of the interviewed population do not use condom when
having sex).
This, however, goes far beyond the traditional health care model to embrace the broader concept of
well-being. In addition to providing a broad array of primary care services, they have placed a high
priority on developing supportive services to address transgender individuals’ comprehensive
needs.
The objectives of the program include:

1. Provide an enabling, supportive and non-threatening space for transgender

individuals through establishing facilities and modes of service that caters to their
general and specific needs through the Comprehensive Trans Health Prevention
Package.
2. Reduce stigma and discrimination through public education and information
dissemination.
3. Develop capacity of transgender individuals and service providers to manage and
address issues and
4. Establish partnerships and service delivery networks with other agencies and
organizations
5. Advocate for trans-inclusive and trans-responsive policies
6. Generate data for trans* focused programs

ROLES AND FUNCTIONS OF THE CONSULTANT:

1. Review of literature using relevant SOGIE and Trans* Health references and other related
training manuals and materials;
2. Meet and discuss with ASP staff and other identified trans health advocates and transgender
women in general to review and solicit capacity building/training implementation
experiences, personal experiences to help identify the strengths and limitations (technical,
operational or structural/management) of these trans health materials and validate personal
experiences by transgender people in accessing health services;
 AIDS SOCIETY OF THE PHILIPPINES, INC.
Secretariat: 2/F, OTM Building, #71 Scout Tuazon Street, Bgy. South Triangle, Quezon City 1103
Telephone : (632) 376-2541
(632) 410-0204
Fax : (632) 376-2546
Email: info@aidsphil.org
asp.nfr@gmail.com
Website: www.aidsphil.org

3. Prepare the draft outline/structure of the Gender-Affirming Health Module Package;

4. Draft and finalize the Package;
5. Facilitate and support the conduct of different consultations and meetings as plotted with
program officers in Manila and in other parts of the Philippines if necessary;
6. Consolidate the workshop and meeting outputs, draft the manuscripts and pre-package the
material;
7. In collaboration with ASP, convene (a) validation meeting(s) to review the draft materials,
consolidate additional comments and suggestions and incorporate, as appropriate into the
material;
8. Finalize the materials, incorporating further suggestions and recommendations gathered
after the conduct of validation meeting(s); and
9. Submit the materials to ASP in camera ready form.

Consultant Deliverables:
1. Compilation on SOGIE and Transgender Health related literatures
2. Documentation of conducted meetings with technical experts and community members,
consultation meetings with TWG and the National Program.
3. Initial draft of the Gender-affirming Health Module Package
4. Final Draft of the Gender-affirming Health Module Package
5. Final copy of the Gender-Affirming Health Module Package

Payment:
The consultant will be paid an amount of USD 3,061.22 (Php 150,000.00) which will be divided into
three tranches subject to further agreement by the consulatant and the contracting organization
(AIDS Society of the Philippines).

TIMELINE:
The consultancy will last for 6 months (May 2018 to September 2018), which includes travels to
different parts of the Philippines if deemed necessary.

Activities/Task Start End

1. Desk Review: May 24 June 15 Home based with
visits in the ASP
- Focus on the desk review of office as requested
different relevant materials on by Program Officer
Transgender Health, included but
not limited to (SOGIE, Clinical
Care, Hormone Therapy, Mental
Health and Well-being,
Reproductive Health, HIV and
other STIs among transgender
people
2. Expectation Meeting/ Consultation June 6 1 day
with the National Program and
 AIDS SOCIETY OF THE PHILIPPINES, INC.
Secretariat: 2/F, OTM Building, #71 Scout Tuazon Street, Bgy. South Triangle, Quezon City 1103
Telephone : (632) 376-2541
(632) 410-0204
Fax : (632) 376-2546
Email: info@aidsphil.org
asp.nfr@gmail.com
Website: www.aidsphil.org

Technical Working Group on HIV Venue: TBA

Prevention Package for
Transgender Women (Gender-
Affirming Care Package/Module)
3. Consultation with the trans June 15 June 16 2 days
communities in the Philippines
(One big Consultation Meeting to Venue: TBA
be held in Manila)
4. Presentation of Initial Findings and June 25 1 day
Initial Draft with the TG-Project
Officer and ASP Team, Members Venue: TBA
of the TWG and National Program
5. Creation of Final Draft based on June 27 July 15 Home based with
recommendations some visits in the
ASP office as
requested by PO
6. Presentation of the Final Draft July 17 1 day
based to TG women and members
of the TWG and the National
Progam
7. Finalization of the Gender- July 17 August Home based with
Affirming Module Paackage 17 some visits in the
ASP office upon
request by PO
8. Validation Meeting and August 23 August 2 days
Presenation of the Final Document/ 24
Module Package (National Venue: TBA
Consultation)
9. Meeting with the TWG and August 31 1 day
National Program for the ways
forward of the National Gender- Venue: TBA
Affirming Health Module Package
10. Reproduction and roll-out of the September onwards Done by the ASP
Module Package to SHCs 2018 Team