Can you be a victim of discrimination if no one knows you are?
Such is the case for gay and bisexual men, who are still, in 2014, banned from donating blood, even though most people probably don’t know it. This week, an FDA committee recommended modifying the ban, but essentially still keeping it in place. I’m not impressed.
I first found out about the gay blood ban when I innocently went to donate blood about 15 years ago, just after I’d come out. I schlepped down to the blood drive, innocently filled out the questionnaire, and was told at the last minute that I was ineligible. Why? Because I admitted having sex with another man after 1977.
That’s right: one sexual encounter with another man since the Carter administration, and you’re not allowed to give blood.
Of course, if you lie—for example, because you’re in the closet, or because you’re basically straight but there was that one time in college—then, no problem. It’s not like there’s a background check. Thus, perversely, the ban keeps the riskiest donors—men who have sex with men but aren’t open about it—in the pool, while keeping safe, monogamous, or asexual-for-twenty-years gay men out.
Obviously, the ban once made sense. It was instituted in 1983, at the height of the AIDS crisis. There was no way to test blood for HIV, and excluding gays was a prudent move.
But that was 31 years ago. Testing methods can now detect HIV within ten days of infection. And a more relevant questionnaire—say, asking men if they’ve had unprotected sex, period, rather than sex with other men—would render the risk of HIV contamination infinitesimal. Much smaller, in fact, than that of other pathogens. Yet, nothing has changed.
Until this week.
On Nov. 13, after years of deliberation, an advisory panel finally recommended lifting the ban, sort of. Their recommendation is to adopt the policy of Australia, Canada, and the U.K. that has been shown, in long-term studies, not to increase the risk of HIV in the blood supply: namely, a one-year “deferral.” If you’ve been abstinent for a year, you’re good. This proposal was endorsed in 2010 by the American Red Cross, America’s Blood Centers, and others.
Now, I know this is a political compromise, and perhaps LGBT folks should be happy we’ve come this far. But I’m sorry; this is still ridiculous. As a helpful infographic by Gay Men’s Health Crisis shows, a man can confess to dangerous, unprotected sex with a prostitute and still donate blood. But condom sex with his longtime male partner? Nope.
Why “sex with men” instead of “unprotected sex” or “sex with a stranger” or “sex with multiple partners”?
And why one year? I appreciate that it’s a cautious, conservative step to copy a policy proven not to increase risk. But the number is still arbitrary. If detection lag time is 10 days, then that, plus a healthy margin, should be the “deferral” period. I’d settle for a month.
Let’s also be clear that the costs of this policy are not merely the hurt feelings of gay people, or even the ++perpetuation of stigma against sexual and gender minorities++ [[/content/dailybeast/articles/2014/07/11/activists-fight-antiquated-policy-with-national-gay-blood-drive.html ]]. The Williams Institute at UCLA, the leading LGBT research institute, estimates that 185,000 additional people would donate blood if the ban were lifted. That’s a projected 317,000 pints of blood and untold lives that could be saved.
It is true that gay and bisexual men are far more likely to transmit HIV than other population groups. According to the CDC, around 2 percent of men identify as gay or bisexual, but account for 63 percent of new HIV infections. Unbelievably, as of 2011, only 49 percent of HIV+ young gay men (aged 18-24) even knew that they had the virus. So, the statistics are still there.
But those statistics do not account for sexual practices. The possibility of contracting HIV without engaging in unprotected anal or vaginal intercourse is miniscule. The monogamous or safe-only gay man is a far safer bet than the unprotected hetero swinger. And yet, even the proposed new policy focused on the gender of one’s sexual partner(s), not the acts one engages in with them.
Historically, one group has led the charge to protect America’s blood supply: hemophiliacs. Indeed, the National Hemophilia Foundation proudly calls itself the “Guardian of the Nation’s Blood Supply.” And for good, obvious reasons.
In the 1980s, hemophiliacs suffered immensely (PDF) from the presence of HIV in the blood supply. According to the NHF, more than half of the 17,000 Americans with hemophilia contracted HIV, and this at a time at which sero-conversion was usually fatal. They were also stigmatized, lumped in with drug users, gays, and Haitians—all disfavored groups at the time. A young hemophiliac, Ryan White, became the “innocent” face of AIDS—although his family was still shunned by people driven by fear and paranoia to avoid contamination (sound familiar?). It was a tragic period.
The NHF has since led the charge to maintain the gay blood ban. And let’s face it: this is not a raging bunch of homophobes. These are people with a unique stake in blood safety, scarred by traumatic history and demanding that that history never be repeated.
At the same time, a tragic history, and the trauma that follows it, is not an excuse for making policy based on fear rather than science. Assuming the FDA adopts its advisory committee’s recommendations on Dec, 2, I hope it’s a first, rather than a last step. More are still needed, not just for gay men but also for all those with an interest in rationality over fear, science over superstition—including, of course, hemophiliacs.
Without being too grandiose about it, what is at stake is the very idea of science, currently under attack from conservative creationists and leftie anti-vaxxers alike. It’s disturbing that the best we can do is a compromise.