Stigma, Not Science Keeps Gay Men From Donating Blood
With a donor shortage, why are we still clinging to outdated stereotypes?
As the CDC launches a nationwide COVID study amongst blood donors and the FDA explores convalescent plasma as a potentially effective treatment for the disease, blood donors are possibly more important than ever before.
Even when we’re not battling a pandemic, thirty-two thousand pints of blood are used in medical treatment each day — saving 4.5 million Americans’ lives each year. Donated blood has a shelf life of only six weeks (and studies say even fresher blood is better), so blood donors are always in very high demand. This is why the World Health Organization annually recognizes June 14th as World Blood Donor Day.
I will not be donating.
Usually, I’m a productive contributor to society. I’m the Chief Revenue Officer of a large software company, I’m the Chairman of the Board of a homeless services organization, I’ve established a scholarship fund at my alma mater, and I give countless dollars each year to charities and political campaigns.
However, because I’m married to a man, the FDA has determined that I’m not fit to donate blood to those in need.
The policy’s roots date back to 1983. Amidst the height of the AIDS pandemic there was no known treatment — or even test, really — to determine who would contract the disease. Recognizing that men who had sex with men (MSM) seemed to be contracting it more than anyone else, the FDA implemented a lifetime ban on blood donations from them.
In 1985, of course, blood testing for the virus became viable, and each unit of donated blood has been tested ever since. Today, there are 14 tests — 11 of which are for infectious diseases — performed on blood donations, and the Red Cross reports that the tests are so sensitive that there is now only a window of 7–10 days between the time of HIV exposure and the ability to identify the infection. The test for HIV is so accurate that it is estimated that only one in every 3.1 million HIV positive samples would be erroneously categorized as negative for the virus.
Based on this knowledge, the FDA revised its guidance in 2015, now declaring that MSM can be eligible donors if they refrain from any sexual contact for at least 12 months before donation. Next, when hospitalizations due to coronavirus peaked earlier this spring and a shortage of blood was forecast, the FDA determined that they could temporarily relax that policy to require only three months of celibacy.
With the Red Cross requesting donors to give blood every seven weeks, both the three month and the twelve month waiting period are still so impractical as to make them functional bans on MSM donations. Nevertheless, a man who was so moved by the COVID-19 crisis that he decided to become celibate on the day the relaxed guidance was announced would do so knowing that the crisis was forecast to pass well before the 90 day waiting period had elapsed.
While these “relaxed guidelines” were also rolled out as some concession to the LGBT community, they still put MSM on unequal footing with their straight counterparts.
Indeed, the Center for Disease Control reports that about one in four new HIV diagnoses are in straight-identifying folks, and that number doesn’t even count the straight folks who inject illegal drugs.
And though the government data tell us that 14% of people with HIV don’t know that they have it, these straight-identifying blood donors aren’t asked to undergo any phase of celibacy before making a donation, nor are they asked to identify how many sex partners they’ve had over the last 10 days or whether they used protection with each of them.
While MSM are more likely to take daily PrEP medications that have been shown to reduce the risk of contracting HIV by 99%, the blanket ban on MSM donations doesn’t consider this as a potential screening question. It similarly makes no exception for men in monogamous relationships (despite the fact that FDA estimates “that the rate of partner infidelity in ostensibly monogamous heterosexual couples” who were eligible to donate is about 25%).
Proponents of the MSM restrictions say they are simply trying to limit donations from higher-risk groups — but they seem not-at-all concerned with the high level of risk that geography plays in HIV transmission. Geographically, 50% of new diagnoses occur in just 48 of the U.S.’s 3000+ counties, San Juan or DC. Yet we aren’t imposing any special rules on donors from those easy-to-target areas — the FDA just trusts that the blood testing protocols that are in place are safeguard enough.
It’s clear to me, then, that our nation’s current policy on blood donation from MSM is one motivated by stigma, not science, and an MSM-specific waiting period should be lifted immediately.
Ultimately, the FDA is a branch of the Department of Health and Human Services — whose leader is a cabinet-level official as part of the Executive branch of our government. These are all public servants, accountable to the U.S. citizenry. So this fall’s election can be about more than just who sits in the oval office — it can also drive change in these very practical, tactical policies that affect our daily lives.
It’s too easy for government officials to overlook and ignore these issues when the American population can’t see how these rules and regulations directly impact our community. However, in times like today, it’s crucial that we shine a light on the inadequacies of our system and question why outdated policies remain intact — especially since we’re so greatly in need of change.