The Food and Drug Administration has released a draft of its new policy lifting the permanent ban on blood donation for men who have sex with men (MSM). As was indicated when the change was first proposed in December, having sex with another man no longer bans a man from giving blood for life, but instead for one full year since the last such sexual encounter. This also impacts women who’ve had sex with a man who’s had sex with a man in the past year.
As numerous detractors have already pointed out, the ban on gay and bi men donating blood de facto remains in place with this change, unnecessarily discriminating without a rational public health benefit. Estimates have shown that lifting the ban on MSM blood donation could save as many 657,000 more lives every year, and the effectiveness of blood testing has reduced the risk of HIV transmission through blood transfusion to 1 in 1.5 million. As Human Rights Campaign Government Affairs Director David Stacy pointed out in a press release, the new policy simply stigmatizes MSM because it “prevents men from donating life-saving blood based solely on their sexual orientation rather than actual risk to the blood supply.”
What’s problematic about this illusory relief of discrimination for gay and bi men is that it mirrors exactly how religious conservatives now justify their rejection of homosexuality. Major religious organizations that remain the primary opponents of LGBT equality, like the Southern Baptist Convention, the Catholic Church, and the Mormon Church, have all largely abandoned the belief that sexuality can be changed. Instead, they all now promote chastity and celibacy for people who have same-sex orientations, applying the same shame that homosexuality is a sin with just a lower expectation for what not being gay looks like. Essentially, the message communicated by the FDA is that the only way for gay and bi men to participate equally in blood donation is exactly the same: they can never have any kind of sexual contact whatsoever.
Evidence that the new policy still ignores the science on HIV transmission in favor of stigmatizing gay sex can be found in a very important footnote in the draft: “Throughout this guidance the term ‘sex’ refers to having anal, oral, or vaginal sex, regardless of whether or not a condom or other protection is used.” It doesn’t matter if a condom is used, if only oral sex takes place, if a partner is on PrEP, if a partner is HIV-positive but has an undetectable viral load — or if all of those conditions are in place, all but eliminating the risk of transmission. One such encounter prohibits both men from donating blood for a full year, and only if they have no other same-sex encounters during that year, even if they test negative for HIV in the interim. In other words, there’s no such thing as safe gay sex.
Individual risk assessment, the guidance explains, would be “logistically challenging” and “very difficult to validate and implement” due to “resource constraints.” Instead, the working group that proposed the change thought the one-year deferment for MSM would “better harmonize” with other one-year deferment risks like having sex with someone who is actually HIV-positive or having sex with a prostitute. As the ACLU’s Ian Thompson explained to BuzzFeed, “Deferral decisions should be based on activities presenting an elevated risk, not on the identity of a person or that person’s partner.” In the meantime, the policy shames all gay sex, just like opponents of LGBT equality do.