Last month the Food and Drug Administration (FDA) “updated” their policy restricting men who have sex with men (MSM) from donating blood. Since the 1980s, men who have sex with men have had a lifetime deferral from donating. After years of calls for change to this policy, the FDA made a change on Dec. 21, 2015, to a one-year deferral, allowing gay and bisexual men to donate after a year of celibacy. This shift in policy, however, is still not science-based and continues to reinforce damaging and dangerous stereotypes about gay sex and gay love.
During my first couple of years in undergraduate school at the University of North Carolina at Chapel Hill, I became a regular platelet donor at UNC Health Care after hearing a speaker in my biology class comment on the need for donated platelets to treat cancer. I’d been a regular blood donor in high school after turning 16 and wasn’t afraid of needles. I saw blood and platelet donation as part of my civic duty and a valuable way to give back to those in need. Over several years, I donated over 60 units of platelets, an amount equivalent to half of what’s needed for one individual undergoing a bone marrow transplant. I set a goal for myself to donate 120 units before I graduated.
At the same time, I was coming to terms with my own sexuality. At the start of my sophomore year, I came out as gay to my friends and family. I wasn’t dating anyone, and my romantic life was all talk and no game. But as the years went on and I became more comfortable with my identity, I knew that it was only a matter of time before I would become ineligible to donate under the policy.
It’s been over five years since I’ve had to stop donating blood or platelets due to the original policy. The recent change, however, won’t impact my eligibility to donate, even though I engage in low-risk sexual behavior and get tested regularly.
The change is a step in the right direction, and will slightly increase the pool of eligible donors. But it still reinforces something damaging about gay relationships — that men who have sex with men are somehow unclean and unhealthy. It ignores the fact that people of all sexual orientations and gender identities are living with HIV. Treating men who have sex with men differently than other groups at increased risk of HIV is a clear indication of a failure to use science- and evidence-based approaches. These kinds of governmental policies reinforce stigma and impact gay and bisexual men’s understanding of their own health and self-worth. And it harms the blood supply, preventing an additional two million people from donating approximately 300,000 pints on an annual basis.1
The United States lags behind other peer countries when it comes to our blood donation policy. Italy and Spain both screen donors for high-risk sexual behavior rather than MSM behavior only,2 and have not seen an adverse impact on their blood supply. Blood is rigorously tested for HIV and other viruses, and with the introduction of PrEP as a new HIV prevention tool, anyone regularly taking Truvada (the only PrEP medication currently on the market), is at an almost non-existent risk of becoming HIV-positive (and subsequently passing the virus on to someone else through blood transfusion).
This policy shift by the FDA is an opportunity for action. When I share my personal advocacy on this topic with friends and colleagues, many of them are shocked to find that this policy even exists in the first place. The FDA should take the next logical step and implement a screening process based on individualized risk assessment. I’d like to think it’s still possible in my lifetime that I might make my original goal of donating 120 units of platelets. There’s no reason, other than stigma and discrimination, that shouldn’t be possible.