Toward a Fairer, More Sensible Blood Donation Policy

At long last, the federal government is considering moving toward a more sensible—and truly nondiscriminatory—blood donation policy.

In July, the Food and Drug Administration (FDA) announced it was seeking comments on the possibility of changing the ban on donations from men who’ve had sex with another man in the past year to an evaluation of individualized risk for determining blood donor eligibility. 

If an individualized risk assessment based on the potential donor’s actual behaviors sounds familiar, that is because Lambda Legal has been advocating in favor of adopting this approach for years. 

We are thrilled the FDA is finally seriously exploring this nondiscriminatory way of ensuring—and potentially improving—the safety of the blood supply.

Last Friday, Lambda Legal submitted comments, joined by several other advocacy groups, in response to the FDA’s request. 

Our comments advocate for an assessment of the activities in which the potential donor has engaged that present a significant risk of HIV transmission, such as receptive anal sex without a condom, and a much shorter deferral period based on the ability of widely used tests to detect HIV and other blood-borne pathogens just a few weeks after exposure.  

Because scientists know the level of risk presented by various activities with a fair degree of precision, the FDA could determine the specific point along the continuum of risk at which the line would be drawn. 

Importantly, however, eligibility determinations would be based solely on information within the personal knowledge of the potential donor (e.g., Did I have receptive anal sex? Did we use a condom?) and on participation in activities that medical scientists know present a significant risk of transmission.

A donor eligibility policy like this does not require inquiry into the sex or gender identity of one’s sexual partners or perceived monogamy within a relationship. And it would result in deferral of heterosexual donors who have engaged in activities presenting a significant risk of transmission, which the current policy focused on gay and bisexual men does not adequately address.  

At the same time, the policy Lambda Legal is proposing would also result in the deferral—albeit a much shorter deferral—of a significant number of gay and bisexual donors. 

Those within the LGBT community advocating for a change in the blood donation policy must recognize that there is not yet a method of ensuring the safety of the blood supply without excluding a disproportionate number of sexually active gay and bisexual men.  (We say “not yet” because a process for eliminating blood-borne pathogens from donated blood is in development, but probably years away from viability, approval and widespread use.) 

The important thing, however, is that we can have a policy focused on behavior rather than identity—and, therefore, one that is nondiscriminatory.

A nondiscriminatory policy creating a safer blood supply is something that everyone can get behind.  Though the FDA first proposed moving to an individualized risk assessment under the Obama administration, there is absolutely no reason that this proposal should not move forward under a Trump administration. 

The FDA prides itself on acting solely on what the science dictates, and the science points clearly in the direction of a policy based on behavior, regardless of one’s sexual orientation or gender identity.

Politics really has no place in determining appropriate blood donation policy, and improving the safety of the blood supply should be a bipartisan issue. 

While it may take a bit of time to develop a donor history questionnaire that accurately assesses a potential donor’s level of risk, Lambda Legal believes there is absolutely no reason that we should not begin that process immediately.