Lifting The Ban

By Joseph Jones

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Earlier this month, Iceland announced it would revisit a policy that although many other nations have adopted as well, has been the subject of controversy and faced criticism from civil rights and LGBTQ rights organizations. Iceland’s Ministry of Health will be reviewing its lifetime ban on gay men donating blood. The country’s Directorate of Health notes that cases of HIV transmission are equal for gay and straight persons, thus the ban no longer applies.

Iceland’s Minister of Health Svandís Svavarsdóttir has also cited Denmark as inspiration for possibly changing the policy to allow gay men to donate blood the same as their heterosexual counterparts. Last month the Copenhagen Post reported that, starting in 2019, Denmark will allow gay men to donate blood on the condition that they haven’t had sex with another man for a period of four months. However, if the donor is in a monogamous relationship, the quarantine does not apply and they will be able to donate regardless of when their last sexual encounter when their partner was.

Denmark is not the first country to address their blood donor donation protocols in recent years. Britain now allows gay and bisexual men to donate over three months after their last sexual encounter, and Ireland changed their lifetime ban to one year after the last sexual encounter. France’s own one year deferral will be the subject of a complained filed with the European Court of Human Rights by a Frenchman after he was prevented from giving blood several times since 2004. The plaintiff’s lawyer highlighted the importance of the case, stating "This is the first time that the ECHR (the court) will make a decision on whether French legislation is discriminatory or not." If the court rules in favor of the plaintiff and determines the policy is discriminatory in nature, it could lead to France changing its policy and a domino effect of other countries following suit.

The United States has its own history of banning specific demographics from donating blood. In 1983, during the height of the AIDS crisis, the FDA implemented a lifetime ban on receiving blood donations from gay and bisexual man. This was done in an attempt to contain the spread of the disease by those considered at high risk. At the time, gay and bisexual men, women who have sex with bisexual men, and transgender people were all considered high risk. As of 1992, 4,408 AIDS cases in the United States were attributed to blood transfusions. In 1985, the FDA introduced a screening test in order to detect the presence of HIV antibodies in blood. However, the test was flawed because the test was unable to identify HIV donor during a window period of the time of infection and when the body begins producing antibodies. This window can stretch up to six months.

But, since then new screenings have been developed and other medical advancements have been made to detect and treat the disease. With our new knowledge of HIV/AIDS, the FDA has loosened their restrictions on Men who have Sex with Men, abbreviated to MSM. In 2015 the FDA issued their guidance “Revised Recommendations for Reducing the Risk of Human Immunodeficiency Virus Transmission by Blood and Blood Products” stating that blood donation organizations must “Defer for 12 months from the most recent sexual contact, a man who has had sex with another man during the past 12 months.”

The change in policy came after pressure from advisory committee’s urging the FDA to reassess the ban. In 2006, the American Association of Blood Banks and the American Red Cross issued a joint statement declaring the lifetime ban of blood from MSM as “medically and scientifically unwarranted”. In 2013, the American Medical Association made a statement of their own coming to their own conclusion the ban was unnecessary stating, "The lifetime ban on blood donation for men who have sex with men is discriminatory and not based on sound science."

After the FDA announced they would allow MSM to donate after 12 months of no sexual contact, the move was heralded by The Human Rights campaign as “step in the right direction”, but the LGBTQ advocacy organization also believed the new ruling did not go far enough because "still falls short of a fully acceptable solution because it continues to stigmatize gay and bisexual men."

In essence the celibacy ban presumes that all gay and bisexual men are infected with HIV/AIDS and that their blood is dirty and contaminated. The ban also continues to persist the ideology that sex between two men is shameful and completely excludes gay or bisexual men who are in monogamous relationships or practice safe sex. There also seems to be a double standard preventing men who have sex with men from donating, while no such ban prohibiting women who have sex with woman from donating.

According to the American Red Cross, every 2 seconds someone in the U.S. needs a life saving blood transfusion. To be more precise, approximately 36, 000 units of red blood cells is needed. Each one individual donation of blood can save up to three lives. But, despite the desperate need for blood, only 38% percent of the population is eligible to donate, and only 10% actually does. The donor pool needs to be expanded in order to compensate for the drastic and constant donor blood shortages.

In 2010, the Williams Institute of UCLA School of Law conducted a study examining all of those banned from donating. The total banned calculated to 2,603,004 people. The institute determined if the ban were to be lifted, it would result in an estimated 130,150 additional donors and 219,200 additional pints of blood. According the American Red Cross, the average blood transfusion is approximately 3 pints. Based on the numbers provided by the Williams Institute, lifting the ban could provide blood transfusions to over 73, 000 more patients than if the ban were to remain in place. While the celibacy ban might allow for more gay and bisexual men to be eligible to donate, there is no guarantee that all will abstain in order to donate.

While the celibacy bans are seen as a continuation of homophobic policies which deem gay and bisexual men as a health risk, they are far more inclusive than blanket lifetime bans, because they allow for a possibility for gay and bisexual men to donate blood, and may someday lead to no bans whatsoever. According to the Gay Men’s Health Crisis, as of July 2013, 21 countries have replaced their lifetime bans with deferral periods ranging from six months to five years. While this is good news to activists, the GMHC recommends donors be screened for high-risk behavior, rather than sexual orientation, and deferrals should be reserved for high-risk behavior MSM people, such as I.V. drug users and commercial sex workers. They also advise that MSM people that engage in low risk sexual behavior such as condom usage and monogamy should be permitted to donate.

After the Pulse nightclub shooting in June of 2016 which resulted in the deaths of 49 gay people, members of the LGBTQ community in Orlando were turned away when trying to donate blood for their wounded brothers and sisters simply because of their sexual orientation. They felt pangs of anger and sadness not being able to help those in need because their government would not allow them to. In the wake of the tragedy, activists urged the FDA to change the policy, but they wouldn’t budge. “The FDA has examined the possibility of eliminating all deferrals for HIV and simply relying on testing of donated blood or reducing the deferral window; however, scientifically robust data are not available to show that this would not lead to decreased safety of the blood supply,” the agency said in a statement to The Guardian.

Recognizing the importance of donating blood compels me to want to make my own donation so that I may be able to save someone’s life. But, my sexuality has always prevented me from being able to donate and I look forward to a day when I may be able to donate without any special stipulations. Despite all the knowledge we have acquired regarding HIV/AIDS, the medical and scientific breakthroughs, and advancements in testing there is still fear and stigma which is the basis surround the bans. These bans are remaining specters of a crisis that the LGBTQ community is doomed to be forever plagued by until the end of time. Eliminating them is one more step on the ladder to equality.