We Need More Blood Donors: The FDA Ban on MSM Donations Must End

Tomorrow, Boston College Law School holds its last blood drive of the year at a time when the nation’s blood supply is critically low. Due to the disruption of the Covid-19 pandemic, the Red Cross had to declare its first-ever national blood crisis in January. Even prior to the pandemic, meeting the country’s needs was a challenge; 4.5 million Americans require a blood transfusion each year, but less than forty percent of the U.S. population is eligible to donate blood. And less than ten percent donate annually. The BC Law community includes many people who have committed themselves to lives in service of others. But the prospect of donating blood remains a significant psychological hurdle for many. We have had to conduct constant outreach to fill the blood drive schedule. In fact, we still need more donors. If you are able, please sign up to donate here: Boston College Law Blood Drive Registration Page.

Given this state of affairs, it is all the more frustrating that we have had to turn away gay or bisexual men who are eager to donate blood. Despite the urgent need for blood and the difficulty of finding donors, we have had to tell friends, colleagues, and classmates that the Food and Drug Administration (FDA), which is responsible for regulatory oversight of the U.S. blood supply, prohibits donations from “Men who have sex with Men” (MSM). The FDA instituted a lifetime ban on blood donations from MSM in 1985. This was early in the HIV/AIDS epidemic, when the incidence of HIV among gay men was high, the virus was poorly understood, and there were no available screening methods for donated blood.

Times have changed. All blood donations are now screened for HIV, along with nearly a dozen other pathogens. Moreover, the incidence of HIV/AIDS has plummeted since the height of the epidemic, including among MSM. Acknowledging this reality, in 2015 the FDA’s Advisory Committee on Blood and Tissue Safety and Availability (ACBTSA) lifted the lifetime ban on MSM blood donations and imposed a one-year “deferral period” on donations. This meant a gay or bisexual man only needed to abstain from sexual intercourse for an entire year before donating blood. In early 2020, as blood donations plummeted with the onset of the Covid-19 pandemic, the ACBTSA further reduced the deferral period to three months. While this is a welcome change, it still constitutes an unjustified and discriminatory policy. Consider this: under current policy, a gay man having protected sex in a monogamous relationship cannot donate blood but a heterosexual man having unprotected sex with multiple partners remains eligible to donate.

This is a policy grounded not in science, but in stigma. Indeed, science and social power have never been wholly distinct. Despite the contemporary refrain to “trust the science,” as if science were some objective truth or process set apart from politics and policy, medical science has always implicated questions of social and political power, culture, and morality. This is particularly true when medicine interacts with issues of sexual morality and marginalized groups.

The FDA’s inertia on this issue should not be understood as a properly precautionary, scientific stance. It is a reflection of residual fear and moral panic from a dark time, decades ago, when HIV/AIDS was known as “the gay plague.” In AIDS and Its Metaphors, Susan Sontag noted that this was part of the “usual script for the plague.” She added that, “there is a link between imagining disease and imagining foreignness.” For example, when syphilis swept through Europe in the fifteenth century, it was known as “the ‘French pox’ to the English, morbicus Germanicus to the Parisians, the Naples sickness to the Florentines, the Chinese disease to the Japanese.” Uncritical acceptance of this kind of geography of blame is not a thing of the past. Between March and June of 2020, over 2,000 anti-Asian American hate incidents were reported in this country. The rate of these incidents increased when politicians and pundits began to refer to Covid-19 as “the China virus.”

Change to the MSM blood donation policy is likely to come at some point. The Red Cross, the American Medical Association, and myriad LGBTQ+ advocacy groups have called for the ACBTSA to review and remove the ban. But every day that it remains in place, gay and bisexual men are further stigmatized, and the critically low national blood supply is further imperiled. The ban is indefensible. In medical terms, it is not evidence-based. In legal terms, it is arbitrary and capricious. In human terms, it is just wrong.

On Tuesday May 3rd, from 9am to 3:30pm, BC Law will host a Blood Drive for Brigham and Women’s Hospital. To sign-up to donate, please go to BC Law’s Blood Drive Sign-up Page. The blood drive will be in Brigham and Women’s Hospital’s Bloodmobile, parked in the Trinity Chapel parking lot. To learn more about eligibility requirements, go here: Blood Donor Eligibility Guidelines.

Ian Ramsey-North is a third-year student at BC Law. Contact him at ian.ramsey-north@bc.edu.

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