When it comes down to saving a life, blood donation is one of the most–if not the most beneficial aid for patients. According to the American Red Cross, someone in the US is in need of blood approximately every two seconds, but less than 10 percent of our nation donates.
There is, however, a community that is eager to donate, but has been long kept from becoming donors. In the 1980s, the HIV/AIDS epidemic was so prominent that the all gay and bisexual men were sentenced to a lifetime ban from donating blood by the Food and Drug Administration (FDA). At the time, this was viewed a necessary and logical move by the healthcare community, as the FDA really didn’t know what exactly they were dealing with.
Accelerating the panic, in 1984 Indiana high school student Ryan White, a hemophiliac, contracted HIV through a blood transfusion. With little known about the virus at the time, White became an outcast, not being welcome at school and shunned by his community. He was among thousands of hemophiliacs who contracted HIV through blood transfusions. In 1985, the FDA had decided to make their move, and that was to ban all gay and bisexual men from donating blood. (Read more here.)
However, despite the ban, HIV/AIDS does not effect a singular group of people–anyone can contract it.
With regard to the LGBT (lesbian, gay, bisexual, and transgender) community as a whole, we have reached a pivotal moment in history. From equal marriage rights to adoption opportunities, and just the fact that their rights are being discussed, the LGBT community is seemingly moving towards full equality. So why is it that gay and bisexual men still don’t have complete freedom when donating blood?
In recent years, as tension has grown over this topic, the FDA decided to repeal the lifetime ban. In May of 2016, a new regulation will be implemented making it so MSM (men who have sex with men) are not permanently banned, but only deferred until they have not had sexual contact with another man for at least a year.
Although this new regulation is a step in the right direction to some, many people feel that there is still discrimination at play, and furthermore perpetuating the archaic notion that HIV/AIDS solely afflicts the homosexual and bisexual community.
There are movements such as National Gay Blood Drive, where gay and bisexual men show their dedication to becoming donors by bringing an “ally” to donate in their place at an annual drive. Although the National Gay Blood Drive is pleased in seeing change, they still say it’s discrimination and many agree. They are pressuring the FDA to pursue deferral on a case-by-case basis, not based on an entire demographic.
“…The revised policy is still discriminatory,” they state on their homepage. “While gay and bisexual men will be eligible to donate their blood and help save lives under this 12 month deferral, countless more will continue to be banned solely on the basis of their sexual orientation and without medical or scientific reasoning.”
Many are now wondering, why shouldn’t a heterosexual donor be subject to the rule of celibacy as well? Any one of us could contract an STI as easily as the next person. The argument has long been that everyone, regardless of sexual orientation, is subject to lethal sexually transmitted infections (STIs).
“The current deferrals are not based on sexual orientation but on specific, potential, risk behaviors which may result in the transmission of infection through blood transfusion,” said Dr. Randal Covin, Medical Director for Blood Bank of Hawaii. Donors, regardless of orientation, gender, or race, can be flagged due to possible exposure to risk factors that could effect themselves or patients receiving their blood.
Keali’i Ballao, Academic Support Specialist at UH Maui who has experienced blood donation deferral first-hand.
From the other side, Keali’i Ballao, Academic Support Specialist at UH Maui, has experienced deferral at a blood drive right here on UH Maui’s campus, which was facilitated by Blood Bank of Hawaii. Just this past February, Ballao was “permanently deferred” from donating blood after disclosing his orientation and sexual history.
“I thought it was something good I could do for someone else,” he said. Never having donated blood before, Ballao thought the blood drive on campus would be the perfect opportunity to help. With it being conveniently at his workplace, he knew this was where he would feel safest during his first donation.
Ballao signed up and headed over to the drive, where he was asked to fill out a questionnaire prior to donating. Before heading in to donate, he noticed the nurse highlighting several of his answered questions. When he sat down to go through with the donation, a nurse went over one question that Ballao had misinterpreted and answered.
The question asked if the person donating was female, and if they were female, have they had sex with a man who has had sex with other men. Ballao laughed it off, clarifying that no, he wasn’t a girl, but if the question was meant for him then yes, he had been with a man.
The nurse then pulled out a binder and flipped open to a section Ballao read as “The Deferment Process.” The nurse proceeded to read him the regulations as stated in the binder, and further declared that he had been permanently deferred from donating blood.
The juxtaposing combination of “permanently” and “deferred” immediately confused Ballao.
“Permanently deferred?” he repeated. “I’m thinking, like, that’s a weird statement because deferred means temporary.” The ambiguous language began to frustrate Ballao. “Then I’m just like, ok, so, I can’t donate blood because I’m gay?”
Dr. Colvin explained the verbiage, stating that “‘Permanently deferred’ means the donor is not eligible to donate blood for others permanently. This, however, can be subject to change if the requirements for donation are changed. Therefore, someone permanently deferred can be reinstated if the requirements change.”
However in that moment, Ballao just wanted a straight answer. The actual definition and reason was still very dubious to him. He was hurt, feeling that this was a moment of pure discrimination. Not wanting to take out his frustration on the nurse, who was just doing her job, Ballao walked out.
Coming from an accepting family and growing up on the sheltered island of Maui, Ballao had never felt prejudice because of his sexual orientation before.
“I went from being nervous about donating blood, to being stunned about what was going on,” he recalled. “It was almost like slow motion….I was almost embarrassed because my colleagues were there. Everyone’s there. Everyone was talking about how they donated blood, and what it’s like, and the feelings you get when you’re donating it. And then they see me, and I just walked right out.”
Ballao now wonders if the screening process is the real issue. If the blood is extensively screened and tested, why are they deferring people based off a questionnaire?
“Tests are not available for all potential infections such as malaria,” said Dr. Covin, further explaining that not all blood-related infections can be detected by testing. Blood banks need to rely heavily on the honesty of donors.
“The questionnaire is designed to ensure it is safe for the donor to donate (donor safety) and to ensure the blood is safe to transfuse to someone else (patient safety). While the importance of the questionnaire is often overlooked because of all the testing that is performed,” Dr. Covin said, “the questionnaire is one of the most important measures blood banks have in ensuring the safety of the blood supply.”
According to Dr. Covin, a substantial percentage of ineligibility (90 percent, to be exact) is found through using their questionnaire. Even though the blood is tested, it is still not a completely reliable process because many infections are not detectable for a certain window of time.
“We also use our questionnaire to ensure that people who are at risk for those infections do not donate until we know they were not infected,” he said. “The questionnaire is required by federal law and it is a requirement that must be completed at every donation, on the day of donation.”
Now, to clarify, the Blood Bank of Hawaii (BBH) is not the ones calling the shots here. Blood banks are under the strict authority of the FDA, so these regulations must be upheld by law as BBH states clearly in their explanation of MSM deferral.
“Blood Bank of Hawaii, along with the American Association of Blood Banks, America’s Blood Centers, and the American Red Cross have been asking the FDA to revise their policies on the deferral for a number of years,” Dr. Colvin said, “and we support the FDA’s change in policy.”
While full donor equality is still being sought out, the new policy is a step forward, and by all means a progressive move for lifting a ban that lasted for 32 years. Nonetheless, Ballao, along with many, seek further change in policy.
“If they don’t change anything,” Ballao said, “it will continue discrimination.”
