Israel is ending their ban on blood donation from queer men. Why isn’t America?
Israel is ending all restrictions in place that limit men from donating blood in any way simply because they have sex with men. Gay and bisexual men will now be held to the same standard as all other people seeking to give blood.
The policy puts Israel in the growing number of nations that are changing policies around blood or tissue donation regulations to take away past restrictions placed on gay and bisexual men. That has left people to wonder why America is behind on the issue.
Nitzan Horowitz, the out Minister of Health in Israel, proclaimed, “There’s no difference between one blood and the other. Discrimination against gays in donating blood is over.” Horowitz first promised the changes in June.
The policy goes into effect in October.
“This is a landmark moment for the entire LGBTQ community in Israel and a step closer toward equality for everyone,” American LGBTQ advocacy group A Wider Bridge wrote in a Facebook post.
In 2018, Israel removed restrictions allowing any gay and bisexual men to donate blood, regardless on when they last had sexual relationships with men. The country’s emergency medical service Magen David Adom (MDA), which handles blood donations, announced all blood would be screened twice for a two-year trial period, regardless of the donor’s sexual orientation.
Prior to 2018, Israel denied men from donating if they had sex with men in the 12 months prior. That was the United States’ policy as well, until 2020.
Argentina, Brazil, Hungary, Italy, and South Africa are just some countries that now have no restrictions on MSM donating blood — while America is still changing the length of the time period in their restrictions. The United Kingdom removed all restrictions on MSM blood donors this summer.
Other countries with no restrictions include Albania, Argentina, Bolivia, Colombia, Latvia, Mexico, and Poland. France and Canada are just two other countries that have also made changes loosening their restrictions in recent years.
While organizations that are authorized to receive blood donations have their own policies, it’s one federal agency that requires the policies and stands in the way of the removal across the United States — the Food and Drug Administration (FDA).
Before and through the start of the COVID-19 pandemic, the FDA held steady in its refusal to consider changing blood donation policies, even when they acknowledged that they were in desperate need of blood.
Then in April 2020, the FDA announced they would loosen the restrictions for blood donation from men who have had sex with men (MSM). They loosened the restriction to three months after the last time they had sex, reducing the deferral period from 12 months. Women, who were also previously restricted by 12 months if they have had sex with men who have sex with men, could also donate after three months after.
Despite their own guidance, several blood banks said the FDA did not change their internal processing for accepting blood donations from MSM for months, and several gay and bisexual men have still been turned away amidst the pandemic, including out politicians and elected officials.
Since then, advocates have continued to push for a complete repeal of any restrictions on blood donations based on the donor’s sexual orientation.
Since 2013, the American Medical Association (AMA) has recommended moving away from any policy that systematically refuses blood donations from “categories of persons” rather than examining “individual donors on grounds of evidence-based risk assessment.” The organization has called previous FDA policy “discriminatory” and “not based on sound science.”
“The FDA’s discriminatory policies and the inconsistent donation policies from one blood bank to another implicitly encourage potential donors to decide between donating blood or stopping their medication and abstaining from sex,” Dr. Cynthia Brinson and Christopher Hamilton wrote in an article published in LGBTQ Nation in May 2020.
“If the FDA does not stop discriminating against gay men, its policy could inadvertently encourage HIV transmission and undermine our ability to fight COVID-19.”
The FDA’s regulatory ban also affects other areas of blood and tissue donation. There is a shortage in cornea donations, and that is linked to the fact that most men who have sex with men are unable to donate their eye tissue, even in death.
“There is little scientific evidence to justify this fear, as there has never been a reported case of HIV transmission through corneal transplant surgery anywhere in the world,” Dr. Michael A. Puente wrote in an LGBTQ Nation article in October.
Gay and bisexual men have continued to be affected by the policies widely considered discriminatory and misguided. The restrictions date back to the early days of the HIV/AIDS epidemic under the Reagan administration, and continue to factor in stigma around men who have sex with men based on outdated science and stereotypical assumptions about queer men.
The policy affects transgender and gender non-conforming people trying to donate blood as well. Most trans women are considered MSM based on their sex at clinics and blood donation organizations, although under the previous ban, the American Red Cross interpreted it as preventing trans men who have sex with men from donating blood — but not transgender women who have sex with men.
The revised FDA policy stated that “In the context of the donor history questionnaire, FDA recommends that male or female gender be taken to be self-identified and self-reported,” and now many organizations like the American Red Cross do not question anyone’s self-identified gender.
A 2020 letter from Rep. Alexandria Ocasio-Cortez (D-NY) and Carolyn Maloney (D-NY) and signed by 17 U.S. Senators and 30 House members calling the FDA’s restrictions “not based on current science.” Dozens of members of Congress have continuously pushed the FDA to lift their restrictions entirely.
It’s not clear if or when the FDA plans to do so.
President Joe Biden (D) has yet to nominate a new commissioner for the FDA after previous commissioner Dr. Stephen M. Hahn left office in January. Reports this week indicate that the acting commissioner, Janet Woodcock, will not be selected as Biden’s permanent choice due to opposition from Sen. Joe Manchin (D-WV), among others.