The Christmas and New Year period are inevitably some of the busiest for emergency wards around the country. The combination of large numbers of people travelling and the silliness that inevitably accompanies the silly season leads to accidents.
When people have accidents they need blood.
I happen to be a universal donor, O negative. Yet I’ve never been able to donate for my adult life for one simple reason. I am a gay man. And it’s time we updated our rules to be more accommodating to gay, male, blood donors.
One of the quirks of being a gay man is how normal it is to be treated as if you are dirty and tainted. Some of this is bound up with religious bigotry, but some is sourced in paranoia and fear born during the AIDs crisis in the 1980s. One of the things that’s rarely discussed is the complete failure of health authorities, and politicians to recognise the threat HIV posed early on: it was considered quite hilarious by Ronald Reagan’s press secretary.
Today, the Food and Drug Administration (FDA) in the USA, one of those health authorities that was late to act, reversed a hangover from that terrible time, changing their blanket ban on gay men donating blood.
The ban was implemented during the AIDs hysteria at the height of the epidemic in 1983, when there weren’t accurate tests for HIV and people still thought you could catch it from toilet seats. It stipulated that if a man had had sex with another man after 1977 they could never donate blood. Now any man who has abstained from male to male sex for the past 12 months may donate, which is also the position here in Australia.
While the recognition that gay men are not innately tainted is a swell switch, the change is fundamentally cosmetic: the emperor may not be naked anymore but all he’s done is put on some socks. To donate blood gay men must entirely abstain from sex for a year, even if they’re in a monogamous relationship, use condoms, and regularly get tested for STIs.
This brings the USA’s blood donation policy into line with Catholic and Evangelical Christianity, which both declare that they’re fine with gay people, provided they don’t actually do gay things.
It’s profoundly stigmatising to gay men, some of whom have been with their partners for their whole lives, to be told that their blood poses a public health risk.
The Victorian Aids Council calls the Red Cross Blood Service’s present policy “obviously discriminatory”. I remember when I went to donate blood at university and learned that I was grouped with intravenous drug users and that my blood was considered tainted. It hurt, and it still hurts. The Co-Convenor of the Victorian Gay and Lesbian Rights Council, Sean Mulcahy writes: “The ban sends out an incorrect and irresponsible public health message by suggesting that all gay sex is a health risk while all heterosexual sex is safe.” Because, while there are certainly some gay chappies who do unsafe things, have unprotected sex etc, treating us as if we’re all relentless shag machines is like using Charlie Sheen as the gold standard for heterosexuals.
The FDA has lifted the ban that prohibited gay and bisexual men from donating blood. Post continues below.
But, frustrating though it is, I understand that the Red Cross has an unenviable task. They take 1.3 million blood donations a year and they must test it, and prepare it quickly to save lives around the country. To save money and time they preclude high risk groups from donating, this is referred to as “deferral”. There’s around 300 reasons for deferral, from being a sex worker, to having lived in England at certain times to a variety of other quite obscure factors. Because gay men are at a higher risk of HIV and other blood borne infections some kind of deferral window is necessary, the Red Cross argues, to allow testing.
This isn’t just about gay men’s rights. People need blood. A lot of blood. At any given time the Red Cross has only a few days worth of blood. In 2012, the supply dropped to 2.2 days worth. Around 4 – 5% of men identify as homosexual. That’s a lot of people automatically precluded from donating. And the easiest way to increase that pool is to reduce the deferral window.
Which is exactly what the Red Cross has tried, and been prevented, from doing. The truth is, a 12 month deferral window simply isn’t required to safely test blood (blood is screened for 5 things, HIV, Hepatitis B and C, syphilis, and HTLV). There are window periods where these various infections can be in the blood but undetectable (if you’re interested in knowing more, I suggest this review of Australia’s blood donation policy from 2012) and it’s generally agreed that 6 months provides a substantial buffer for all of them. So six months would probably be a pretty safe deferral window, right?
That’s the position of the Red Cross Blood Service, (and the Kirby Institute for Infection and Immunity and the Victorian Aids Council) a position they formed in 2011. But the rules are set down by the Therapeutic Goods Administration, which overruled the Red Cross and kept the year long deferral period. I asked the TGA why this was and their response was bewildering. Their spokesman sent me an email which stated the following:
“In making its decision, the TGA considered several key pieces of research, including:
– The Blood Service commissioned expert review report handed down in 2012;
– A donor compliance study by the Australian Red Cross Blood Service and Kirby Institute; and
– The most recent annual data about infectious diseases in Australia, also from the Kirby Institute.”
Here’s the thing. That review referred to, and the Red Cross Blood Service AND the Kirby Institute, all support a 6 month deferral period. So why is the TGA using research from bodies that directly disagree with them? I’ve written to the TGA pointing this out and not yet heard back.
So why does this matter? It matters because homosexuals have been treated as a threat for centuries. A threat to public morals. A threat to children. A cause of natural disasters (yes, seriously). But when it’s Corey Bernardi, or George Pell, or another member of the motley crew of hate mongers who’ve built careers on bullying minorities they can be dismissed and laughed at. But prohibitions on blood donation are ostensibly based on science and medicine. They have a gravitas that a weiner like Bernardi can’t fathom. But that means those policies need to be based on up to date science. The length of time it took the FDA to change America’s out of date rules shows how wrong government departments can get it. It’s time we got it right.
Note: if the rules discussed above upset you please do not write to the Red Cross Blood Service. As they explained to me, they’re regulated by the TGA. If you’d like to register your dissatisfaction with Australia’s position or clarify why they’ve got the position they do, write to the TGA: [email protected]