On April 2, 2020, spurred by widespread blood shortages caused by the COVID-19 pandemic, the FDA revised its blood donation deferral for men who have sex with men (MSM). The previous policy was established in 2015, and at the time turned a decades-long, no exception blood donation ban on MSM into a policy that restricted a man from donating blood if they had sex with another man within the past twelve months. The FDA’s recent revision to the policy relaxes the restriction to three months and has been praised as a “victory” for gay and bisexual men. While it is progress towards a full repeal of the blood ban, I am not so convinced.
In 2018, I wrote an article for GLAAD criticizing the FDA’s twelve-month deferral for MSM. In light of this policy update, the crux of my argument still stands. The MSM blood donation deferral, regardless of length, is based on and perpetuates the stigmatizing idea that HIV is a “gay disease.” Since the beginning of the AIDS epidemic, gay men have been wrongfully blamed for the transmission of HIV. The FDA based their deferral policy precisely on this view, backing up their recommendations with the “high rates of HIV in the [MSM] population.” Though the prevalence of HIV among MSM is higher than that of the general population, sexual orientation is not an inherent risk factor for HIV transmission.
BREAKING: FDA says it will loosen some of the restrictions that have blocked gay men from donating blood.
The agency is changing the recommended deferral period from 12 months to three months. https://t.co/0Xo95Fo34t
— ABC News (@ABC) April 2, 2020
In reality, risk factors for HIV transmission including behaviors such as having unprotected sex and having multiple sex partners are identical regardless of someone’s sexual orientation. Behaviors that minimize risk for HIV transmission include using safer sex practices and being on pre-exposure prophylaxis (PrEP). The FDA’s blood donation deferral ignores these facts, treating gay and bisexual men as a homogenous group with an identical risk for contracting HIV.
Under current guidelines, a monogamous gay man on PrEP who has had protected sex in the past three months with a long-term male partner would not be able to donate blood while a heterosexual male who has had unprotected sex with multiple female partners in the same time period would be allowed to donate. Situations like this exhibit how blood donation deferral policies based on sexual orientation are rooted in prejudices as opposed to scientific evidence. A reduction of the deferral period from twelve to three months does nothing to change this reality. This is why leading public health organizations like the American Public Health Association suggest that the FDA implements blood donation screening policies that are based on sexual risk behavior rather than the gender of a prospective donor’s partner.
The shortened deferral shows us that the FDA is listening to the pressure of activists and health experts alike who have proven the illegitimacy of the ban; however, it is concerning to note other instances when the FDA decided to stay silent. Justifiably, this new policy increases the pool of eligible donors during a time when cancelled blood drives are threatening the blood supply and transfusion of blood-derived antibodies are being explored as a possible treatment for COVID-19. But where was this policy during the 2016 Pulse Nightclub shooting that injured 53 and killed 49? In the aftermath of the massacre at the gay nightclub, LGBTQ+ community members rushed to donate blood in support of their community, but many were turned away due to the twelve-month deferral policy. In light of these events, activists called for the easing of blood donation restrictions on MSM with no success. Not until the current COVID-19 epidemic, when the health of non-LGBTQ+ individuals has become threatened by blood shortages, has the FDA loosened the blood deferral policy.
Sign our petition to urge @US_FDA to #EndTheBloodBan once and for all. https://t.co/8tBWWsBZYX
— GLAAD (@glaad) April 6, 2020
This response is strikingly similar to that of the U.S. government at the onset of the AIDS epidemic, when national leaders delayed addressing the disease due to its assumed isolation within the gay community. Evidently, the current policy change was not instituted to reconcile a history of discrimination, but to fulfill a demand for our blood. Our bodies were disposable during the AIDS epidemic, our bodies were disposable in the aftermath of the Pulse shooting, our bodies remain disposable today.
Though the COVID-19 epidemic has brought heightened attention to this issue, we have a responsibility to continue calling out this form of discrimination, even after our masks come off and we reemerge from our homes. The rights of gay and bisexual people should always matter—not only when our blood is needed for experimental therapies and for the survival of others. Above all, health policy should be based on science, not fear.
Jeremy Wang is a GLAAD Campus Ambassador Alum. He is a graduate student at Brown University studying Public Health. Follow him on Twitter @ChihChaoJeremy.