I used to be an extremely regular blood donor.
I donated a couple times in high school, and once I went to the University of North Carolina for college, became a frequent donor at blood drives in my dorm. One year, I even donated blood on the floor of the Dean Dome during a major annual drive. I also became a regular platelet donor, a longer and more complicated process, but one that’s a critical need in the healthcare system. Over the course of two years, I donated more than 60 units of platelets.
And yet: It’s been almost a decade since I was eligible to donate blood or platelets.
I became ineligible when I came out as gay and had sex with a man for the first time. Since the 1980s, the Food and Drug Administration (FDA) had prohibited men who have sex with men from donating blood. My undergrad self understood the rules, but also knew the policy didn’t make sense. I happened to be in Washington, D.C. on an internship in the summer of 2010, and went with my friend Marjorie to an FDA hearing on the policy. I spoke during public comment, and even gave several media interviews about the policy. Shortly after, a friend asked if I thought the policy change was “discriminatory.” At the time, I said no. I understood some of the history of the HIV epidemic and believed the policy to be outdated, sure, but wanted to believe it was grounded in science. I convinced myself that there was a distinction because the policy change that prohibited donations based on a sexual act, and not simplify identifying as gay.
I’m no longer so forgiving.
I wrote an opinion piece for qnotes about this policy in 2016. At the time, the Food and Drug Administration had changed the policy from a lifetime deferral for men who have sex with men to a one-year deferral — which means you can donate after a year of celibacy. Blood screening and safety technology has radically improved, and the advent of PrEP means an HIV negative donor on the medication can donate with almost complete certainty they are HIV negative.
Six months after I wrote that piece, the Pulse shooting happened. That moment pained me. There were calls for changes to the policy given the urgent need for blood to treat the victims. That moment illuminated for me that the roots of the blood ban aren’t based in science, but based in stigma and shame. The same stigma and homophobia that causes individuals to kill based on sexual orientation or the color of someone’s skin is also found in a policy that bars gay men from donating because of the stigma that gay sex is “dirty” or “filthy.” The science simply does not stand behind this policy.
And here we are four years later, another change.
We are in the middle of a public health crisis and a desperate need for blood donors. On April 2, the FDA again announced that it was revising the policy again, changing the deferral period from one year to three months. In many ways, it feels like a big win. Compared to a lifetime deferral that was in place a decade ago, this change feels like we’ve come a long way.
Yet it’s also a slow drip. Many countries across the globe, including Italy, Spain and Mexico, have risk-based deferral systems that have been in place for years. Especially with PrEP, there’s no grounding in science to have a blanket deferral period in place for all men who sleep with men.
It’s unfortunate it took a pandemic to change a policy rooted in discrimination. I hope it takes less than four years for the FDA to finally end this prejudiced, blanket ban once and for all.
Lee Storrow is the executive director of the North Carolina AIDS Action Network.