By: Sai Siddhaye
The COVID-19 pandemic has left us with a dramatic shortage of blood. The implementation of social distancing measures has shut down blood drives, and the national blood supply has become dangerously low. You would think–given how critical blood donations are to the livelihood of the country–that all healthy and eligible people would be encouraged to donate blood right now, but even amid a pandemic and a national blood shortage, the FDA is still enforcing its discriminatory restriction of blood donations from queer men: the infamous MSM policy.
The restriction of blood donations from men who have had sex with men was established by the FDA in September of 1985, in the midst of the AIDS epidemic. The policy was that even a single sexual encounter with another man made men indefinitely ineligible to donate blood, “due to the strong clustering of AIDS illness and the subsequent discovery of high rates of HIV infection in that population”. This policy was in place until December of 2015, when the lifetime ban was revised to a yearlong deferral period, known as the MSM (men who have sex with men) deferral policy, after decades of pushing from LGBTQ activists.
After blood donations began to drop nationwide following the beginning of the pandemic, FDA officials did make a temporary modification of the MSM deferral policy. As of April 2, 2020, the deferral period has been shortened to three months rather than 12 months, meaning men must abstain from sexual encounters with other men for three months before donating blood. This change was implemented by the American Red Cross in June of 2020.
It is crucial to note that every unit of donated blood undergoes thorough screening tests for HIV, hepatitis, syphilis and other blood-borne diseases, regardless of who the donors are, to ensure that blood transfusions do not infect recipients. It is also important to understand that everyone, regardless of sexual identity, gender, or race, can be susceptible to these diseases. AIDS and HIV are not exclusive to queer men, nor are any other infectious diseases. So why does the FDA only restrict queer men from donating?
According to the Human Rights Campaign (HRC), though “none of these tests…are 100 percent accurate, and they can produce faulty results. For instance, despite current restrictions and testing of approximately 12 million units donated each year, 10 HIV-infected units have slipped through. To ensure the safety of blood and other tissues for donation, the FDA uses scientific data to automatically defer certain populations. Because gay and bisexual men have higher incidence of disease, they are eliminated from the donor pool immediately.” The American Red Cross states that “The FDA selected the 3-month deferral to provide adequate time for the detection of infected individuals”.
Though this reasoning certainly seems logical, the policy is too two-dimensional to specifically screen for at-risk donors. The FDA’s donor guidelines are in place for good reason; most policies target behaviors that pose a legitimate risk of spreading infectious diseases. The three month deferral period applies to people who have a history of syphilis or gonorrhea, have gotten unregulated tattoos or piercings, have engaged in non-prescription injection drug use or shared needles, and other behaviors that have a very high risk of contracting and spreading infections. There is already a policy in place that indefinitely bars anyone who has tested positive for HIV, and a three month deferral period for anyone they have had sexual contact with. The MSM deferral policy differs from these examples in that it imposes restrictions based only on queer identity, not on actual risk of infection.
The FDA’s concern about preventing the spread of HIV has already been addressed by its other restrictions, making the MSM policy increasingly arbitrary. Implying that having sex with other men automatically makes a person “contaminated” not only stigmatizes queer sex, but is also simply untrue. Having unprotected sex creates a high possibility of infection regardless of sexual orientation, but creating a policy that only restricts men who have sex with men–including protected sex–does not address that threat at all. As NBC puts it, “Even with a clean bill of health, a gay man is considered more of a threat to the blood supply than a straight man who was treated for chlamydia, syphilis, gonorrhea, venereal warts, and genital herpes within the past year.” Restricting queer men who do not fall under any of the other deferral categories, therefore, cannot be seen as anything other than discriminatory. Shortening the deferral period from one year to three months does not change that.
The MSM policy, like so many other policies and systemically-ingrained practices, perpetuates the hypersexualization of queer people. Institutionally tying queer sex to medical contamination is one of many ways that queer people have been systemically portrayed as sexually dangerous, prompting discriminatory policies in the name of ‘protecting’ the rest of society. Like the unwarranted racism and xenophobia that Asian Americans faced in the wake of the COVID-19 pandemic, queer people have battled the social stigma that followed the AIDS epidemic for decades. The historical caricature of the “sexually perverted and predatory queer man” continues to manifest itself in discriminatory practices such as DADT and the MSM policy. The bottom line is that blood donation is critical to our national health, especially in this pandemic, and the FDA should be encouraging all healthy people to donate blood rather than arbitrarily restricting them based on their sexuality. The way to repair this is to remove the MSM deferral policy altogether and focus on targeting actual threats of infection so that as many people can safely donate blood as possible. Perhaps there is no way to rectify the harm that the medical industry has done to marginalized communities, but working to eliminate medical bias and prioritizing medical equity is the only way forward.
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