Out for Blood

A friend recently passed along an invitation to join her in donating blood to support a community blood drive. The American Red Cross, citing system-wide shortages, recently put out a call to arms for platelet and blood donations, she said, and the local organization was offering two free tickets to a New York Mets baseball game to all those who donated. As a community activist and avid Mets fan, my friend thought I would be an easy "yes." I had to explain to her -- much to her surprise and disappointment -- that it was not so simple.

Since 1983, I explained, the FDA has expressly prohibited men who have sex with men (MSM) from donating blood, a decision that was rooted in the combination of fear, ignorance and uncertainty that was rampant during the onset of HIV and AIDS. Even though an HIV test became available and commonly administered in 1985, and AZT was approved in 1987, the ban stood. In 1991 the FDA updated its "donor deferral" policy with no change to eligibility for MSM, a pattern that continued over the next 20 years, through Republican and Democratic administrations alike. In spite of a steady evolution of the public's acceptance -- and the government's support -- of gays, this policy and this issue have taken on the life of a cockroach, a recalcitrant prehistoric pest that simply refuses to die. Yes, the Department of Health and Human Services (HHS) did initiate a study in 2010 to "assess alternative policies that would allow some gay and bisexual men to donate blood." But as Harvey Milk poetically noted, you don't need to conduct a survey to remove oppression. And while Canada recently "lifted" its 30-year ban on gay men donating blood, the "end" of their ban comes with the untenable caveat that Canadian MSM need to be abstinent for five years to prequalify. If that's progress, then I fear I will develop some spontaneous nostalgia for the 1980s, when at least discrimination came across as less of a ruse.

It is indisputable that gay men remain the demographic most susceptible to contracting HIV, and that the virus continues to proliferate and confound in spite of medical advances. But while citing the existence of a disease and the propensity of one group to contract it is one thing, categorically discriminating against an entire segment of the population reeks of guilt by association and does not pass the equal-protection sniff test that the Supreme Court so purposefully illustrated last month. Beyond that, the policy is as dangerously short-sighted -- anyone, heterosexual or homosexual, can contract HIV -- as it is superfluous. The American Red Cross rigorously tests all blood donations for many diseases, including HIV, and people who receive transfusions have a microscopic one-in-1.5-million chance of contracting HIV. The Red Cross tests for other viruses, including West Nile, but you don't see anyone calling for a blood donation ban for anyone bitten by a mosquito since 1977.

The FDA states on its website that the MSM blood donor policy is not discriminatory, and forgive me for not taking the organization at its word. Fortunately, the American Medical Association doesn't, either. Citing the desire to evaluate gay men as individuals instead of a single high-risk category, the AMA recently codified its opposition to the lifetime ban on gay male blood donors in policy. Now there's a novel idea -- and it just may get the ball rolling. As the American Psychiatric Association's declassification of homosexuality as a disorder in 1973 was an instrumental and incremental measure in "normalizing" gays, there is reason to believe that the AMA's policy, with the requisite political and institutional support, could lead to some traction. But while "Gay Inc." (HRC, GLAAD, NGLTF) can never be accused of homophobia, it appears that these organizations, with their focus on marriage equality, may have developed a de facto case of hemophobia. That could be about to change. This week, filmmaker Ryan James Yezak has organized the first-ever "national gay blood drive," which he will film and feature in Second Class Citizen, a documentary about the impact of discrimination based on sexual orientation. It is Yezak's hope that once the FDA recognizes how much MSM could contribute to the national blood supply, they will have ammunition to lift the 30-year ban. Perhaps Second Class Citizen will do for the blood ban what How to Survive a Plague recently did for HIV: stimulate general awareness about a critical issue and, more importantly, provide a necessary wakeup call to the LGBT community.

The current blood shortage is as unfortunate as it is avoidable, but there is a rather simple solution: Let gay men donate. As a community, we need to be having more conversations like the one I had with my well-intended friend, because many people outside the LGBT population have no idea of the donation restriction placed on MSM. And when we have these discussions, people will see that this policy is as discriminatory as it deleterious to our nation's blood supply. We should also reach out to the growing number of legislators who have come to stand beside the LGBT community -- like Sens. Kirsten Gillibrand (D-N.Y.) and Patrick Leahy (D-Vt.) -- and let them know that this type of institutional discrimination can no longer stand. Blood donation may not be as glamorous an issue as marriage, but it's just as vital.

If history has taught us anything, it's that societal transformation often precedes, if not compels, evolution in public policy. Perhaps it's not such a bad thing to be out for blood after all.