Every two seconds, someone in the US receives a life-saving blood transfusion. Yet, the blood supply is at its lowest in decades. The American Red Cross declared the nation’s first-ever blood crisis only one year ago.
Fortunately, the US Food and Drug Administration (FDA) has announced a proposal to change restrictions on blood donations that could increase the donor pool. The new guidance would respect all donors regardless of sexual orientation, uphold the safety of the nation’s blood supply, and allow more people to donate in this critical time.
Bans on donations from gay and bisexual men
Amid the AIDS epidemic of the 1980s, the FDA put restrictions on blood donations by gay men. At that time, this group had the highest rates and risk of transmission. To protect public health and blood supply safety, it issued an “indefinite deferral” for men who have sex with men (MSM) in 1985. This deferral has been referred to as a “lifetime ban” for gay men wanting to donate blood and blood products.
In 2015, thanks to improved blood testing, the FDA lifted the lifetime ban. They changed the rules to allow MSM to donate as long as they abstained from sex for 12 months preceding the donation.
LGBTQ advocacy groups, medical professionals, and others criticized the restrictions as outdated and discriminatory. Organizations, including the American Medical Association, called for new “rational, scientifically-based deferral periods” to be used on all blood donors, not specific groups.
In April 2020, the guidelines were revised again amid blood shortages during the coronavirus pandemic. This time, the FDA reduced the abstinence deferral period from 12 months to three months. This policy again discriminated against gay and bisexual men in long-term, monogamous relationships.
The 2023 proposal includes a new risk assessment that uses gender-inclusive, individual risk-based questions. Some of the changes include:
Sexually active men in monogamous relationships with men can donate for the first time.
Women may be barred for the first time — if they have had a new partner or more than one partner in the past three months and engaged in anal sex.
Both men and women reporting new or multiple partners and anal sex in the last three months will be deferred (not allowed to donate).
Under the new guidelines, any American who denies having a new partner, multiple partners, and anal sex in the previous three months will be able to donate — as long as they meet other age and health-related criteria.
Official FDA press statement
The FDA believes that the new risk-based questions won’t compromise the safety or availability of the US blood supply. It further explained that the latest recommendations for evaluating donor eligibility are based on a careful review of the following;
Available information on the blood testing and transmission
Data from other countries using similar approaches
Ongoing surveillance of the US blood supply
“Our approach to this work has always been, and will continue to be, based on the best available science and data,” said Peter Marks, MD, Ph.D., Director of the FDA’s Center for Biologics Evaluation and Research. “We will continue to follow the best available scientific evidence to maintain an adequate blood supply and minimize the risk of transmitting infectious diseases and are committed to finalizing this draft guidance as quickly as possible.”
Reactions from major health and LGBTQ advocacy groups
LGBTQ advocacy groups applaud the changes announced by the FDA because they will help reduce societal stigmas that gays and homosexuals face.
“These changes are 40-plus years in the making and are a tremendous leap forward to elevating science over the stigma,” said Sarah Kate Ellis, President and CEO of the Gay and Lesbian Alliance Against Defamation (GLAAD).
Another activist group, the Human Rights Campaign (HRC), hails the FDA announcement as an important step. “LGBTQ+ advocates and other health leaders have worked for decades to update policy and move toward adopting an approach rooted in science, not identity,” said Kelley Robinson, President of HRC.
Response from major health organizations has also been positive. A Special Bulletin by the American Hospital Association (AHA) calls the previous FDA restrictions “unfair.” It goes on to say that the AHA is “pleased that the new draft guidelines if finalized, would not only increase the blood supply but correct this historical inequality.”
Social media reactions
Social media reactions to the FDA’s proposed changes are overwhelmingly optimistic.
One post by Nurse Blake, who started the Banned4Life movement, has had thousands of supportive comments in just a few days.
Blake says that in 2013 he was turned away from giving blood for being gay and knew something had to change. So, he started a campaign to raise awareness of the policy.
As a nursing student, Blake started nationwide blood drives and collected signatures for a petition to change the restrictions. “No matter where you are in nursing, no matter what degrees or experience you have, you have the power to create change,” said Blake.
Another organization started by a nursing student, Pride and Plasma, is working to end bans against donations to gay and bisexual men. A post on its Twitter account reminds everyone that the fight isn’t over yet.
The FDA proposal is open to public comment for 60 days. Then the agency will review and consider all comments before finalizing the guideline to be implemented at blood banks nationwide.
Where to find more information
To see up-to-date guidance for LGBTQ+ donors, check the American Red Cross Blood Services page here.