Public fear and anxiety are at an all-time high due to the coronavirus (COVID-19) outbreak. During this pandemic, blood drives have been cancelled due to social distancing policies. This has made blood product donations scarce and urgently demanded. In the United States, members of the LGBTQ community want to help those who need blood, but they are often prohibited from doing so by the Food and Drug Administration (FDA), a federal agency responsible for maintaining the safety of biological products. Sarah Kate Ellis, president and CEO of GLAAD, an organization that advocates for LGBTQ rights, believes that “[the] FDA needs to put science above stigma” (Artavia, 2020).
One of the main reasons LGBTQ people are not allowed to donate blood in America is HIV and its stigma with gay men. The human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS) started gaining massive attention during the early 1980s. Initially, AIDS was referred to as a gay-related immune deficiency (GRID) because this disease has mostly affected homosexual men. AIDS is caused by HIV, which is a virus mainly transmitted through blood from sharing needles or syringes for drug injection, and body fluids during sexual actions. For 30 years, gay men were not allowed to donate blood due to fear of HIV traveling through blood banks. In 2015, the FDA revised its policy to allow cisgender and transgender men to donate blood if they have not had sexual contact (with or without a condom) with another man in the past 12 months (History.com Editors, 2020). Although this was an improvement, this regulation still perpetuated the negative stereotype that gay men carry and transmit diseases such as AIDS.
In the U.S., anal sex has the highest risk of spreading HIV (CDC, 2019). Although gay and bisexual men are most affected by HIV and thus have a higher risk of transmitting HIV, they were not exclusively responsible for transmitting the disease (CDC, 2019). Heterosexual men also participated in high risk behaviors and the spread of HIV. However, FDA regulations determined that a heterosexual man who is sexually promiscuous and at high risk of transmitting HIV could donate blood while a monogamous homosexual man could not. Additionally, while transgender women who have had sex with men are eligible for donating blood, transgender men who have had sex with men in the last year are not. However, although statistics has shown that rate of HIV diagnosis is higher in transgender men when compared with the general population, transgender women are more likely to be HIV positive than transgender men (CDC, 2019). This contradiction between policy and data suggests inconsistency and discrimination based on sexual orientation and gender.
According to the Centers for Disease Control and Prevention (CDC), the chances of getting HIV from a blood transfusion is 1 in 1.5 million, which is exceedingly rare (Roth & Robbins, 2017). Once a person donates blood, the blood gets stored at a certain temperature. Afterwards, it gets scanned into a computer database and multiple tests are performed to detect for any infections (American Red Cross, 2020). For instance, if donated blood tests positive for HIV, it would just simply be discarded. Some blood donors may lie in their confidential questionnaire before giving blood, but the rigorous protocol that is applied will make sure that the donations that test positive for disease will not be used. This procedure indicates that if the FDA is trying to prevent HIV transmission, someone who is HIV free should be able to donate blood, even if they are sexually active gay men.
When it comes to health issues, the LGBTQ community are largely neglected by the healthcare field, which may explain why gay men are disproportionately affected by HIV. In the United States, many states permit medical professionals to reject LGBTQ patients because of their personal religious beliefs with no repercussions (Michon, 2020). When treating LGBTQ individuals, health providers may use harsh language or intentionally misgender them. Marian, mother of a transgender teen named Julian, recalls her son being deliberately misgendered by a nurse practitioner at a retail clinic in Georgia. Before dispensing Julian’s testosterone injection, the provider expressed revulsion and questioned, “what kind of a doctor would prescribe this to a girl?” A week later, the provider notified Marian to attend a different clinic for Julian’s subsequent injections because of their refusal to supply further care for Julian (Landman, 2018). Medicine such as pre-exposure prophylaxis (PrEP) can help those who do not have HIV lower their risk of getting HIV. However, unfair treatment against LGBTQ people can discourage them from seeking help and protecting themselves. Not having an inclusive environment in which LGBTQ people can trust and have strong communication with their care providers can make them more prone to experience health issues. LGBTQ patients should not have to surrender care because of concerns about how they will get treated by a medical provider. It is important for medical providers to put aside their personal beliefs when working and focus on maintaining the health of their patients, regardless of their sexual orientation and/or gender identity.
On April 2nd, 2020, the FDA revised its rules again to now permit queer men to donate blood if they have remained celibate for at least 3 months (Zaveri & Taylor, 2020). Nevertheless, this new policy is still unfair and discriminating. Gay men are not the only people that can get HIV. When it comes to blood donations, all blood gets tested, so gay men should have the right to donate blood. Although we are making progress, there is still a lot that has to be done to achieve health equity for the LGBTQ community.
American Red Cross. (2020). What happens to donated blood. Retrieved from https://www.redcrossblood.org/donate-blood/blood-donation-process/what-happens-to-donated-blood.html
Artavia, D. (2020). GLAAD urges FDA to lift ban on queer men donating blood. Retrieved from https://www.out.com/health/2020/3/25/glaad-urges-fda-lift-ban-lgbtq-men-donating-blood?
Centers for Disease Control and Prevention (CDC). (2019). HIV transmission. Retrieved from https://www.cdc.gov/hiv/basics/transmission.html
History.com Editors. (2020). History of AIDS. Retrieved from https://www.history.com/topics/1980s/history-of-aids
Landman, K. (2018). Doctors refuse to treat trans patients more often than you think. Retrieved from https://www.vice.com/en_us/article/j5vwgg/doctors-refuse-to-treat-trans-patients-more-often-than-you-think
Michon, K. (2020). Can doctors withhold treatment because of a patient’s sexual orientation or gender identity? Retrieved from https://www.nolo.com/legal-encyclopedia/health-care-antidiscrimination-laws-protecting-32296.html
Roth, E., & Robbins, J. (2017). Busting HIV transmission myths. Retrieved from https://www.healthline.com/health/hiv-aids/transmission-myths
Zaveri, M., & Taylor, D. B. (2020). FDA relaxes blood donation guidelines for gay men and others. Retrieved from https://www.nytimes.com/2020/04/02/health/fda-blood-donations-coronavirus.html