FDA Continues To Bar Many Gay, Trans and Bi People From Blood Donation

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For the first time since 1985 and the height of the AIDS epidemic, the FDA has made a major adjustment to its policy banning blood donations from men who have sex with men, but the real impact is limited.

Instead of a lifetime ban (called a permanent deferral), the FDA now recommends that blood donation centers and other entities require men to wait 12 months after their last sexual encounter with another man before donating. This rules out gay and bi men in sexually active, monogomous relationships with other men, those who only have protected sex, and those who for other reasons are at low risk of transmission of HIV.

The guidelines also include women who have sex with men that have had sex with men in the last 12 months. BiLaw, an organization of bisexual law professionals, noted in a July letter that this line of policy is particularly stigmatizing to bisexual people and urged for its removal to no avail.

Meghan Maury of the LGBTQ Task Force put it bluntly: the updated recommendations remain “phenomenally far away from what any of the science tells us about transmission risk, about testing, and about the available pharmaceutical and condom options.”

The Task Force released comments in June urging the FDA to lift the blanket ban on MSM and other groups entirely.

In the new FDA documents, there is no change to recommendations for lifetime bans on individuals who have ever engaged in sex work or non-prescription injection drug use. This policy increases stigma for current and former sex workers and those who use injected drugs, who are more likely to be LGBT, with trans folks at particularly high risk.

For example, trans individuals who have used hormone treatments without their own prescription fall under the ban, Maury explained.

“Those provisions say things to me as a person who was an injection drug user 20 years ago, it feels as if the FDA is saying ‘once a junkie always a junkie,'” they said. “It says that people who have engaged in sex work are marked for life. It’s stigma. It’s not related to science in any way. The MSM provision is the same, it’s just the stigma that we don’t trust men who have sex with men to not have sex with multiple partners without condoms.”

The FDA’s guidelines regarding blood donation by trans individuals have never been clear, and the new version doesn’t help much. Trans people are likely to still experience discrimination at blood centers, regardless of their sexual history. Buzzfeed reported earlier this year that some places have a blanket policy of rejecting any transgender donor. And trans women who have had sex with cis men, for example, will fall into the same restrictions as cis men. There is a positive change in the new regulations: the guidelines state that “In the context of the donor history questionnaire, FDA recommends that male or female gender be taken to be self-identified and self-reported.” It will be important to watch to what extent that recommendation is honored in practice.

Given the one-year deferral requirement for MSM and women who have sex with MSM, it seems unlikely that the adjustment in policy will majorly impact the supply of available blood, though it may at least help reduce stigma against men who have sex with men.

There are many categories of people who can’t give blood, and some estimates say that less than half the population is actually eligible. I myself can’t give for at least three years because I lived in Nicaragua, which has the presence of malaria, even though I never contracted malaria. However, these other limits are irrelevant to the fact that the FDA continues to uphold discriminatory and hypocritical standards when it comes to which sexually active people can give blood. After all, straight people do not have to identify their number of partners before donating even though a high number of partners increases the risk of HIV transmission.

So groups like The Task Force and the National Center for Transgender Equality will keep fighting for FDA guidelines that better account for medical science and modern technology, Maura said. And, they added, good work is happening to help reduce stigma against and increase resources for the same intravenous drug users, sex workers, and LGBT people who are affected by this policy.

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Adrian is a writer, a Texan and a Presbyterian pastor. They write about bisexuality, gender, religion, politics, music and a whole lot of feelings at Autostraddle and wherever fine words are sold. They have a dog named after Alison Bechdel. Follow Adrian on Twitter @adrianwhitetx.

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    • Yeah dude I dunno! I haven’t been able to give blood in a long time so I don’t know how the questionnaire and stuff actually plays out in practice. Anecdotes are very welcome!

      • like, i’ve been giving blood at least once every 3 months since i was like 19 and so i stopped reading the questionnaire like a year into doing it. so there is a very real possibility that i misread the question about sleeping with MSM or just like…forgot. ooopppps. but also, doesn’t that mean i’m proof that the blood is safe? i’ve got good blood, someone makes sure to tell me that every time i go, whatever the hell that means!

        also, one time the person who helped to register me and start the donation had just matched with me on tinder the night before, so that was cool.

  1. If you’re polyamorous they also make you wait 12 months between new partners, at least in Australia (the one time I got up the nerve to do it!!!).

  2. I’m banned because someone gave me hepatitis A, the kind you get from contaminated food. It isn’t transmitted by blood but the FDA decided we might be mistaken about which hepatitis we had (even though I had a medical test and could provide the paperwork). It’s maddening to hear when there is a shortage of life-saving blood and not be able to do anything about it.

    • Ill be honest, here in the UK the volunteers who advertise blood donation and the people who read the questionnaires seem very uninformed about medical eligibility. Seems as if you tick a box, or ask any question they just assume no, or recommend I phone the helpline. It doesn’t surprise me that they hear the word hepatitis and run a mile. (I have autoimmune hepatitis, but ive still had medical professionals act as though im infectious or as if i ‘caught’ it.)

  3. I heard something about this on the radio last night, but it just said the ban on gay men was lifted. Thanks Autostraddle for providing much more information on the subject!

  4. Thanks for this update, Audrey! So necessary especially in light of people uncritically hearing “ban lifted/changed” and thinking we’re all good to go. Blergh!

  5. Does anyone know, because I’ve wondered, is it:
    women who have sex with (men that have had sex with men) in the last 12 months
    women who have sex with (men that have had sex with men in the last 12 months)?

    I would guess it’s the second, but it’s been unclear to me.

  6. Most blood banks continue to turn down all trans women from donating blood because the CDC still basically classifies us as ‘MSM’ (men having sex with men) no matter who we identify as, how we live, what our sexual orientation is and when we last had sex. Even more disgusting is, they continue to deny this is a set policy while the practice goes on.

    • So to be clear, even lesbian trans women are considered MSM? That’s pretty fucked up, specially since they are denying it.

      • A lot of blood banks don’t even care about the sexual orientation or history of a particular transwoman… we’re pretty much rejected as a class. Again, this isn’t official stated policy but it is absolutely practice.

          • Thanks for that. It’s almost unbelievable, but there it is:

            “In a written statement, [FDA] spokeswoman Tara Goodin told The Advocate, “The FDA’s current donor deferral policy recommends that men who have had sex with other men (MSM) at any time since 1977 are indefinitely deferred from donation of blood based on well-documented observations of much higher rates of transmissible diseases among MSM than in the non-MSM population.”

            When it comes to transgender people, Goodin says the FDA will continue the policy that the sex of the donor is determined at birth, at least as far as establishing the donor’s eligibility.

            “For example, FDA recommends that genetic males be considered as males for donation purposes, even after gender-altering surgery,” Goodin wrote in an email December 31.”

  7. I’m bisexual and a couple years ago I was dating a guy who is also bisexual, and the questionaire asked if I had sex with a man who has had sex with men in the last year, so I checked “yes.” Well, the person who was going to draw my blood was very openly disgusted and thought I must have misread the question, and she was like “it’s asking if your boyfriend has had sex with men,” and I was like, “uh,yeah, I know, he’s bisexual.” She practically yelled, “And you’re okay with that?!” “Yes.” “Well if you slept with him in the past year, you can’t donate blood.” And I said, “Ugh, I just remembered that we broke up a year ago” and I donated blood anyway. But yes, the stigma is very real (also, they assumed I was straight). And it was just an awful experience. So I lie about my sexual history all the time now, because they test the blood anyway, and because I get STI screenings regularly. But it’s a bunch of bullshit. Take the blood from the people who want to give blood.

    • You probably know this because they would tell you this when you get tested, but just in case anyone else considering lying about their sexual history doesn’t know: there is about a three month period (the window period) during which HIV doesn’t show up on tests. Don’t lie about having had unprotected sex in the past three months. Honestly, I don’t think you should be allowed to give blood after having unprotected sex with any non-monogamous dude in the past three months because straight men can also have HIV.
      Really the non-monogamous/non-tested partner in the past three months should be the cut-off regardless of gender.

  8. I have actually never been able to give blood in the US thanks to spending the first four years of my life in Berlin, Germany (I recently heard that it has something to do with an outbreak of “mad cow” disease in Germany in the 80’s, but I haven’t tried to confirm this). That, at least, make some sense, but the FDA thinking this update solves everything is beyond absurd (and bloody annoying). Come on, FDA, it’s the 21st century and all that. Wakey-wakey!

  9. This seems like two steps forward (if that much) and one step back.

    Well, this policy changes nothing for me, sadly. I get the stigma thing (like you alluded to), even for stuff that happened years ago. On the plus side, your last paragraph was optimistic and uplifting, so thank you for that! :-)

    • It isn’t just stigma. Like 10% of men who have sex with men have HIV and most people with HIV don’t know they’re infected. The duration of the ban makes no sense because the window period where HIV doesn’t show up on the tests is 3months no matter how you got it, but it’s not like MSMs used to have high rates of HIV 20years ago and now they don’t. They constitute 50% of the HIV-infected population.

  10. Perhaps we should just let all potentially infected people donate blood but then just throw it out without telling them……then we could skip the testing too. Win-win!

  11. “the updated recommendations remain “phenomenally far away from what any of the science tells us about transmission risk, about testing, and about the available pharmaceutical and condom options.”

    Despite the availability of condoms, the rate of hiv amongst msm is vastly higher than the general population. I’m not sure the current ban is what makes the most sense, but let’s not act like it isn’t based on a legitimate concern.

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