In 2013, my school held a blood drive. I had just become old enough to donate (with parental permission) and quickly signed up for the first available spot. With my parental consent form in hand, I excitedly turned up at the blood drive, ready to do good. My O- blood type meant that my donation would be especially valuable as it made me a universal donor. As I sat down at the confidential processing booth, I was asked if I would be willing to do a special kind of donation intended for infants whose blood type was not yet known. My pint of blood would go on to help four needy infants. I emphatically agreed.
After having my finger painfully pricked and my name, age, and birthday confirmed multiple times, I was presented with a set of screening questions on a laptop. No, I hadn’t travelled to the UK in the 1980’s, almost two decades before I was born. No, I hadn’t taken intravenous drugs. No, thank God, I hadn’t received a graft in my brain. And no, I hadn’t received money in exchange for sex. No, I had never tested positive for HIV. But then I reached a question that made my stomach sink. Have I ever, even once, had sex with another man?
At 16, the answer was an emphatic no. I was not out to my family, my friends, or even really myself at that point so having a relationship or sex was out of the question. It was nevertheless startling and disheartening to know that I would likely one day no longer be able to provide my valuable blood to those who are most in need. Even more so, the stinging feeling of unfair discrimination seemed unjustifiable. Considering that there is really nothing, to my knowledge, that same-sex sexual encounters inherently do to alter one’s blood, it seemed like nothing more than homophobia masked by a thin veil of science just as many forms of unfair discrimination so often are.
“Prior to the current guidance, FDA’s recommendations were outlined in the April 1992 memorandum, ‘Revised Recommendations for the Prevention of Human Immunodeficiency Virus (HIV) Transmission by Blood and Blood Products.’ Based on the evidence now available, FDA has changed its recommendation from the indefinite deferral for MSM to a 12 month blood donor deferral since last MSM contact.”
When dealing with blood donation, a main concern is the prevention of transmissible diseases, particularly HIV. Because injecting blood directly into the body of another is one of the most effective ways of transmitting blood borne diseases and because the people receiving this blood are often immunocompromised in some manner, it is crucial that donations be free of pathogens. This makes sense. By casting a wide net, the FDA is attempting to reduce the possibility of disease transmission via blood donation to a tolerable level. HIV in particular is tricky as a person can be infected and not test positive for months on end.
But this is where the issue begins. The offensively dehumanizing and reductive term “Men who have sex with men” shoehorns a wide range of sexual behavior and HIV transmission risk into a single category. Two committed HIV negative gay men who have consensual, monogamous sex with each other is treated as if they were the same as a promiscuous gay man who engages with different partners multiple times per week. While this is not a judgment of people’s lifestyle choices, the monogamous gay couple is almost guaranteed to have no risk of HIV transmission. But what if one cheats without the other’s knowledge? That is a fair concern but is cheating not a reality in heterosexual relationships as well? Herein lies the problem.
Certainly male same-sex encounters are by far more likely to facilitate the transmission of HIV, but it is not always the case that two men having sex will be more risky than two heterosexuals having sex. A woman who regularly engages in casual vaginal sex with multiple partners may be statistically less likely to contract an illness per sex act than a similar man having anal sex, but is it not the case that she represents a greater transmission risk than the monogamous gay couple who are at no risk? Does it make sense that she could donate but the monogamous gay couple could not?
Keep in mind also that “men who have sex with men” does not inherently imply anal sex. Again, the particular offending sex act is not defined. It merely includes any male who has had sexual contact with another male. This means a non-monogamous woman who has had anal sex with a man is allowed to donate and is considered a lower risk than the aforementioned gay couple.
The issue lies not in the desire to prevent HIV transmission, but in the language and process used to achieve that goal. Disqualifying men who have had sex with men for 12 months is far different than disqualifying individuals who have received non-state regulated tattoos for 12 months. There is a a sizable subset of the male population for whom engaging in sexual contact with a member of the same sex is a major part of their lifestyle. Asking these men to cease sexual contact for 12 months simply so they can donate blood is unrealistic. No heterosexual couple would be asked to do this, nor would it ever be implied that a monogamous heterosexual couple is a significant risk for HIV transmission through blood donation.
While the shift from a lifetime ban to a 12 month deferral is a step in the right direction, it still represents an unrealistic barrier for many low-risk sexually active gay men who wish to donate their blood and help others. Considering the constant crying that there is a blood shortage, a critical need, etc., it seems plainly wrong that low-risk gay men are not permitted to donate.
