Homophobia in our Blood Drives?

In his senior year of high school, Nicholas Cuneo helped organize a blood drive in his school’s gymnasium. Weeks later, when he received his American Red Cross Donor Card indicating that he is “O-negative” (a universal donor), he became all the more motivated to help his community. But now, despite both he and his husband being emergency paramedics who regularly deliver blood to patients in critical conditions, neither is legally allowed to donate his own blood. Today, the Red Cross continues to make headlines as a worldwide blood shortage crisis persists and the World Health Organization tirelessly urges blood donors to come forward while countless victims die from a lack of timely access to safe blood. Despite the shortage, gay men are not permitted to answer the call. Millions pay the price for an outdated and discriminatory federal law.

The United States banned the homosexual community from donating blood in any capacity until 2015. The Food and Drug Administration (FDA) initially put the ban into effect in 1985 at the height of the HIV/AIDS crisis, when transmissions of the deadly virus by blood transfusion were at an all-time high. But even though the ban has since been lifted, the FDA continues to require gay men to abstain from sexual intercourse for one year before donating blood. The requirement is based on studies that indicate that gay men are at a higher risk than the general population of contracting HIV.

But this is no reasonable justification for a blanket ban on blood donations from gay men, since today’s blood screening technology detects HIV exposure with near-perfect sensitivity regardless of sexual orientation. Blood donations are run through 13 comprehensive tests—10 of which screen for HIV, syphilis, hepatitis, and a number of other sexually transmitted diseases. The chances of contracting HIV from any blood transfusion are estimated at one in 1.5 million. Even without testing, highly reliable processes exist that determine a patient’s risk for infection by evaluating sexual behavior and responsibility. Under the current system, a heterosexual man with multiple concurrent partners and an active chlamydia or herpes infection is not prohibited from donating blood, even though such infections suggest recent high-risk sexual contact—while a homosexual man is. The American Medical Association has urged the FDA to ensure that blood donation bans or deferrals are applied to donors according to their individual level of risk rather than on sexual orientation alone. But, this has yet to achieve any tangible change. Numerous other organizations, like the American Association of Blood Banks, America’s Blood Centers, and the American Red Cross, have all advocated for more science-based approaches to blood safety. And because blood is constantly in short supply across the world, the consequences of exempting gay men from donating are drastic.

According to the LA Times, an additional 219,200 pints of lifesaving blood could safely be donated each year if the FDA policy were to be revised. Donated blood also has a very limited shelf life. The New York Times reports that after just 24 hours, donated blood begins to decrease in effectiveness as cell membranes stiffen and concentrations of nitric oxide, a crucial chemical in circulatory health, also decrease. A study by the American College of Emergency Physicians also found that patients who received transfusions of 22-day old blood face a five percent increase in risk of death. The long-term ramifications of transfusing aging blood include clot formation, infection, sepsis, organ failure, and eventually, death.

Furthermore, shortages of donated blood result in higher rates of death among the people who need it. A 2014 UCLA study estimates that lifting the restrictions on blood donations for sexually active gay men in America would increase the country’s blood supply by two to four percent, which could potentially save millions of lives. The ultimate impact of the ban is simple—a lack of available blood forces hospitals to use older, unsafe donations to treat their patients.

While numerous LGBTQ advocates welcome the introduction of a deferral period to replace an indefinite ban on donation, many remain firm in pushing for complete equality in blood drives. Mark King, who tested positive for HIV in 1985, says that deferral periods are holdovers from the era of panic over AIDS. “They are just the latest chapter in a narrative that casts gay men as untrustworthy, promiscuous vectors of disease,” he told NBC News. “We know scientifically we pose no greater threat than anyone else, but fear is a really powerful thing—especially fear of HIV.” Britain has reduced its deferral period to three months, and countries like Spain, Mexico, and South Africa have gotten rid of restrictions for sexual minorities altogether. The United States should follow suit. Millions of lives depend on it.