OPINIONS

U.S. ban on gay blood donation needs to end

I’ve got some damn good blood. I don’t mean genetically — but hey, shout-out to the ‘rents. I mean physically: That succulent red goo pulsing through my healthy, bulging veins is top-shelf: high in iron, low in cholesterol, disease-free.

But I still can’t donate blood.

I can’t donate blood simply and matter-of-factly because (drumroll please) I am “a male who has had sexual contact with another male, even once, since 1977.”

In 1985, the U.S. Food and Drug Administration instituted a law to prohibit men who have had sex with men (MSM) from donating blood. And, at the time, it made sense. In the midst of the HIV/AIDS epidemic, any measure to limit new infections was justified. Scientific understanding of the transmissibility of the disease was tenuous at best, so an outright ban on blood donation by gay and bisexual men was deemed appropriate.

Almost two decades later, that ban is not only archaic, but discriminatory.

On Friday, July 11, 2014, the National Gay Blood Drive cast a spotlight on the issue. Its slogan: “Who will donate in my place?” That is, since gay and bisexual men cannot legally donate blood, they were asked to find “replacement donors” — heterosexual men and women, primarily — to donate in their place.

If the need to find “replacement donors” seems absurd, that’s because it is — and shedding light on that absurdity is the major success of the National Gay Blood Drive. If gay and bisexual men could donate blood, wouldn’t the slogan, “Who will donate with me?” rake in twice as many blood donations?

While the FDA hasn’t yet seen the light, the American Medical Association has opposed the ban since June 2013. According to AMA Board of Trustees member William Kobler, M.D., “The lifetime ban on blood donation for men who have sex with men is discriminatory and not based on sound science. [The AMA] urges a federal policy change to ensure blood donation bans or deferrals are applied to donors according to their individual level of risk and are not based on sexual orientation status alone.”

Since all blood donations have been legally required to be screened for a host of diseases, including HIV, for years, the ban is obviously outdated. It’s detrimental not only to the queer men it discriminates against, but also to the American public at large.

The American Red Cross frequently declares shortages in the available blood supply for medical use, and is thus constantly soliciting donations. As the frequency and power of natural disasters have increased, it has become even more important to have sufficient blood stored to treat large numbers of victims at any given time. And, as cancer rates in the United States continue to increase, more and more blood transfusions related to chemotherapy or other treatments will be required.

The U.K., Australia and Canada have all revoked their bans on blood donation by MSM. And, as expected, there has been no increase in HIV transmission via blood transfusion.

So, if the AMA has vocalized opposition to the ban, and other nations have successfully removed it, why does it still exist?

Obviously, it’s largely a legislative issue subject to all the foot-dragging of Washington.

But it seems to be more than that. The ban’s survival illuminates the institutionalized homophobia still present and prevalent in the United States. Perhaps, on a cultural level, blood donated by gay or bisexual men is viewed as “gay blood.” Since a non-negligible part of the American population still believes homosexuality is a disease, there’s a fear that a transfusion of blood from a gay man would not only carry HIV, “the gay disease,” but gayness itself.

Frankly, though, that claim holds as much merit as thinking that blood from a black person would cause your skin to darken or that blood from a Parisian would grant you the ability to speak French.

And, in fact, HIV is no longer just a “gay disease” (if it ever was). While it is true that about 60 percent of new HIV infections are in gay and bisexual men, over 20,000 new infections occur in women and heterosexual men every year in the United States.

So clearly, the use of sexual preference history as a filter on blood donors is insufficient and discriminatory towards queer men. It’s also problematic that the ban is based on self-reported sexual behavior criteria: While openly gay and bisexual men are prevented from donating, those anonymous torsos on Grindr are free to donate as long as they publicly identify as straight.

Fortunately, even if straight men or women who donate blood are unknowingly infected with HIV or any other disease, all donated blood is put through an arsenal of tests before utilization in patients, and donors are informed of their infection.

The Red Cross needs blood. (Every two seconds, someone in the United States. needs a blood transfusion.) And, shocking as it may be, gay men have blood. Many, including myself, are more than willing and healthy enough to donate. Lifting the ban on blood donation would allow many of the estimated 1.5 million gay and bisexual men in the United States to donate blood, helping to relieve our national blood shortage.

It’s strange to think that I’m defending my right to be stabbed with a needle and drained of a pint of my own precious blood, but that’s just what I’m doing. Gay and bisexual men should have the same right to “do good” as any other American healthy enough to give blood. And, as is rarely the case, lifting the ban would be a win-win situation: Gay men would gain a basic freedom, and the American supply of blood for transfusions would increase.

If you agree that the FDA ban on blood donation by queer men needs to end, please sign and share this petition to the Obama Administration.

And then go give blood. That is, if you can.

 

Contact Mark Bessen at mbessen@stanford.edu.

About Mark Bessen

Mark is the Desk Editor of Opinions for the Stanford Daily. He is a senior studying English, working on an honors thesis on the contemporary coming-of-age novel. He is particularly interested in the narratives of minority writers in the United States (taking minority to include issues of race, class, and gender/sexuality). Contact him at mbessen@stanford.edu with comments or questions.
  • Will Thompson

    In light of the WHO’s report about the epidemic of HIV in homosexuals around the world, I think the ban on gay blood donations is not only not anachronistic but more necessary than ever. If they could label the gay blood donor’s blood and give patient’s the option to decline gay blood, I think there would be a lot of gay blood spoiled on the shelves in part because of gay patienes who would not want the risk associated with it.

  • Ed Jones

    More Blood History Dr. Charles Richard Drew (1904-1950) was an African-American physician and medical researcher. His research was in the field of blood transfusions, blood storage, and developing large-scale blood banks early in World War II. He protested against the practice of racial segregation in the donation of blood from donors of different races since it lacked scientific foundation.
    In 1941 Dr Drew was chosen to lead the American Red Cross blood bank program. However, a War Department directive stated that, “It is not advisable to indiscriminately mix Caucasian and Negro blood for use in blood transfusions for the U.S. Military.” Dr Drew protested against this blood segregation, which has no basis in scientific fact, and as a result was forced to resign his position. The United States Military did not end segregation of its blood supplies until 1949. Politics and bigotry of blood still continues today.

  • Mark Bessen

    Thank you for this fascinating historical point. It really sheds light on the longevity of this issue.

  • Mark Bessen

    Hi Will,

    Thanks for your comment. Let me clarify: there is absolutely no risk with receiving a transfusion of blood from a gay man. ALL donated blood, regardless of the donor, is screened by a complete panel to test for HIV, tuberculosis, hepatitis, and all other known transmissible diseases.

    Your recommendation that we “label gay blood” is beyond discriminatory. Doing so implies that there is a difference between “gay blood” and “straight blood” and propagates the already rampant homophobia. Imagine, for example, if we labeled blood “black blood” or “Chinese blood” or, to highly the absurdity of your proposal, “ugly person blood.” Which would you choose to pass on if you were in need of a blood transfusion.

    I hope you will please educate yourself on the relevance of the WHO’s report in the context of blood donation in the United States.

  • Will Thompson

    What about the gay guy’s blood who was infected with HIV the night before his donation? How do you test for that?

  • Mark Bessen

    What about the closeted straight man’s blood who was infected with HIV the night before? What about the straight woman’s blood who was infected the night before?

    Moreover, you’re not understanding the distinction between selection criteria based on sexual BEHAVIOR as opposed to sexual PREFERENCE. HIV is transmitted by risky sexual BEHAVIOR, not by “risky” sexual PREFERENCE.

    I agree that there should be filters on blood donor based on BEHAVIOR–i.e., if someone has had unprotected sex in the last 3 months (within the window at which HIV infection may be undetected), it is a good idea to defer blood donation until the test would be conclusive.

  • Demosthenes

    It’s a pretty basic fact that anal sex is a much greater risk factor. My guess is that MSM engage in anal sex far more often than heterosexuals. Even ‘protected’ anal sex is risky due to condom breakage, abrasions, etc. The fact remains that MSM is the most at-risk population for HIV in the US, though African American women are quickly gaining ground.

    I don’t know how long blood is held on to before it gets tested, do you? If it isn’t held for at least a month, the most accurate tests, that can minimize both false negatives and false positives, wouldn’t work. I believe blood banks use ELISA, is that right? You ought to have researched those two factors and included them in your article. The discrimination angle is weak.

    As long as the testing process is okay, then I don’t see why ban should stand. The testing is your strongest argument. It’s undeniable that male homosexual activities put a person at the greatest risk of infection and reinfection.

  • Will Thompson

    Have you not heard that the rate of HIV in men who have sex with men is at epidemic proportions? That is the likelihood of a homosexual man to have HIV is 5x that of the general population’s? Why did the WHO recommend that gay men pre-treat for HIV and not other sexual preferences? Because homosexual men are a bigger risk than the straight population.

    You’re in denial if you think that HIV is not a homosexual disease.

  • Mark Bessen

    I certainly am not in denial that HIV is a disease that is a problem for the homosexual population. But, the fact that 20,000 new infections occur in women and straight men seems to suggest that it is not just a problem for gay men.

    Frankly, ignorant men are a bigger risk than the open-minded population.

  • Mark Bessen

    If you’re interested in the types of testing to which donated blood is subjected, here’s a pretty useful source: http://www.nbcnews.com/health/mens-health/banned-life-why-gay-men-still-cant-donate-blood-f6C10622947

    I’m not an expert on the subject, so I have to defer you there. Thanks for your interest.

  • Stanford Alumnus

    The FDA addresses the core of the matter in its Q&A page on the issue,

    “What about men who have had a low number of partners, practice safe sex, or who are currently in monogamous relationships?

    Having
    had a low number of partners is known to decrease the risk of HIV
    infection. However, to date, no donor eligibility questions have been
    shown to reliably identify a subset of MSM (e.g., based on monogamy or
    safe sexual practices) who do not still have a substantially increased
    rate of HIV infection compared to the general population or currently
    accepted blood donors. In the future, improved questionnaires may be
    helpful to better select safe donors, but this cannot be assumed without
    evidence.”

    For those who lack the sophistication to understand the above it boils down to this: because people lie all the time about their sexual habits (not only gay men), it is impossible to tell who’s telling the truth about being monogamous. So, asking about sexual orientation is the simplest way to exclude a population at high risk of HIV infection.

    The author of this piece forgot about something called “the Pareto Principle” sometimes referred to as the 80/20 rule. A recent CDC survey said that there are around 2% gay males in the US population. The CDC data on HIV transmissions say that around 70% of new HIV transmissions each year correspond to gay men. So applying the 2/70 rule, excluding 2% of the population from the donor pool, excludes 70% of potential HIV transmissions due to the window period. Few things in life are more self evident than this.

    In 2007, a gay organ donor who had tested negative at the time of the donation, transmitted HIV and Hepatitis C to four patients in Chicago. To “play nice”, the hospital staff didn’t tell those who received the organs, one of them on dialysis who could have waited for a different donor, about the origin of the organs which prompted said recipient to sue the facility that provided the organs.

    Those who put forward nonsensical proposals like these so that gay men can feel better with being gay men at the expense of risking the life of innocent people should educate themselves about what happened in the early 1980s when many hemophiliacs died at the hands of contaminated factor VIII. A documentary titled “Bad Blood: A Cautionary Tale” provides an excellent portrayal for those who are too young to remember.

    Having grown up in the 1980s, the memories of the slaughter caused by blood contaminated by HIV to innocent people are still with me, which is why I hope that the FDA continues to use science and logic to ban gay men from donating blood.

  • Stanford Alumnus

    BAD BLOOD: A Cautionary Tale Documentary Trailer:

    https://www.youtube.com/watch?v=_CGpghqSRrE

  • Stanford Alumnus

    Below the science behind the FDA ban. Again, not discriminatory, it is the same kind of science that Google, Facebook and the like use to match ads to online behavior. It is not as accurate as quantum mechanics, but it has allowed to keep the American blood supply relatively safe for 30 years.

    It is one thing to ask for the right to be married, quite another for the right to infect innocent people with HIV/AIDS. The numbers speak for themselves. As I said, the https://en.wikipedia.org/wiki/Pareto_principle couple with the data below makes the FDA policy banning gay males from donating blood one of the soundest public health provisions currently in place in the United States.

    http://www.cdc.gov/hiv/risk/gender/msm/facts/

    In 2010, gay and bisexual men accounted
    for 63% of estimated new HIV infections in the United States and 78% of
    infections among all newly infected men. From 2008 to 2010, new HIV
    infections increased 22% among young (aged 13-24) gay and bisexual men
    and 12% among gay and bisexual men overall.

    Among all gay and bisexual men, white gay
    and bisexual men accounted for 11,200 (38%) estimated new HIV
    infections in 2010. The largest number of new infections among white
    gay and bisexual men (3,300; 29%) occurred in those aged 25 to 34.

    Among all gay and bisexual men,
    black/African American gay and bisexual men accounted for 10,600 (36%)
    estimated new HIV infections in 2010. The largest number of new
    infections among black/African American gay and bisexual men (4,800;
    45%) occurred in those aged 13 to 24. From 2008 to 2010 new infections
    increased 20% among young black/African American gay and bisexual men
    aged 13 to 24.

    Among all gay and bisexual men,
    Hispanic/Latino gay and bisexual men accounted for 6,700 (22%)
    estimated new HIV infections in 2010. The largest number of new
    infections among Hispanic/Latino gay and bisexual men (3,300; 39%)
    occurred in those aged 25 to 34.

  • Demosthenes

    Mr. Bessen, any rebuttals?

  • Stanford Alumnus

    When the pigs fly.

    Few public health decisions are more scientifically sound that the current FDA policy banning gay males from blood donation. It has to be noted that lesbians (or women who have sex with other women) are not banned because again, epidemiologically speaking, being a lesbian, if it is not associated with other risk factors like IV drug use, predicts the opposite: a very low probability of HIV infection.

    The notion that banning gay males from donating blood is “discriminatory” contradicts science and logic. It is also one of the reasons people exhibit animosity against gay males; indeed, in this case, the potential for a window period transmission is real and the most recent precedent is the 2007 case in Chicago.

  • Stanford Alumnus

    http://chicagomaroon.com/2008/11/21/hiv-infected-patient-sues-hospital-after-transplant/

    A University of Chicago Medical Center patient filed suit against the
    hospital and one of its surgeons Monday, charging medical negligence
    after receiving a kidney transplant in January 2007 that she later found
    infected her with HIV and Hepatitis C.

    The patient claims the hospital had known that the organ donor had
    participated in “homosexual sexual activity within the past five years”
    but had withheld this information from her, according to Thomas
    Demetrio, the plaintiff’s attorney. The plaintiff filed suit
    anonymously.

    Privacy laws prohibit the Medical Center from disclosing what it
    told its patients about the donor, and Medical Center officials declined
    to comment on the matter because of the pending lawsuit.

    According to the Medical Center’s website, the University has successfully completed 2,500 kidney transplants.

    The kidney tested negative for both HIV and Hepatitis C when it was
    screened and transplanted, according to Demetrio, but current medical
    tests cannot always detect diseases immediately after infection. In some
    cases, tests can come up clean several weeks after infection has
    occurred.

    According to the Chicago Tribune, the plaintiff didn’t find out she
    had contracted the diseases until early this month. They report that she
    was brought to the hospital for testing after it was discovered that
    three other patients who received transplants from the same donor had
    contracted HIV.”

  • Stanford Alumnus

    Also to address the point that other countries have reversed their policy, below is the FDA reasoning on why said policy does not apply to a country with 300 million people and 17 million blood donations every year.

    The 2007 Chicago case shows that we are not dealing with hypotheticals here, but with the potential or ruining the lives of real people.

    http://www.fda.gov/biologicsbloodvaccines/bloodbloodproducts/questionsaboutblood/ucm108186.htm

    “Isn’t the HIV test accurate enough to identify all HIV positive blood donors?

    HIV
    tests currently in use are highly accurate, but still cannot detect HIV
    100% of the time. It is estimated that the HIV risk from a unit of
    blood has been reduced to about 1 per 2 million in the USA, almost
    exclusively from so called “window period” donations. The “window
    period” exists very early after infection, where even current HIV
    testing methods cannot detect all infections. During this time, a person
    is infected with HIV, but may not have enough virus or have developed
    sufficient antibodies to be detected by available tests. For this
    reason, a person could test negative, even when they are actually HIV
    positive and infectious. Therefore, blood donors are not only tested but
    are also asked questions about behaviors that increase their risk of
    HIV infection.

    Collection of blood from persons with an increased
    risk of HIV infection also presents an added risk to transfusion
    recipients due to the possibility that blood that has already been
    collected and is being stored in a blood bank may be accidentally given
    to a patient in error either before testing is completed or following a
    positive test. Such medical errors occur extremely rarely, but given
    that there are about 17 million Whole Blood and red blood cell donations
    collected each year in the USA, they can occur.”

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  • Demosthenes

    You’ve engaged in a red herring relating to Will’s last argument.. The fact remains that homosexual men are 5x more likely to be infected. Saying that other people are also infected is a deflection. The only group in the US at epidemic levels is homosexual men. You are simply wrong. Feelings don’t come before public health. So, no, “ignorant people” are not at higher risk than people who have anal sex regularly. Even if another population were at epidemic levels that is not an argument for homosexuals, it’s an argument against that population.

  • Joe

    the ban does not discriminate based on sexual preference; it discriminates based on sexual history.