On Thursday, a Department of Health and Human Services advisory committee voted 16-2 to lift the ban against gay and bisexual men donating blood, setting the stage for a protocol change by the Food and Drug Administration when it meets to hear the recommendation on December 2. Because past HHS advisory groups have voted to keep the ban in place, this move is considered a significant step toward lifting a 31-year prohibition. But it wouldn’t be a total reversal; the HHS committee recommends replacing the ban with a twelve-month deferral period; in other words, a gay or bisexual man can only donate blood if he hasn’t had sex with another man in the last year.
Currently, the FDA bans men who have had sex with other men “at any time since 1977 (the beginning of the AIDS epidemic in the United States)” from giving blood based on their heightened risk for HIV. Because it still takes about two weeks after exposure to detect HIV—and up to several months in rare cases—the HHS recommends the one-year deferral period to be safe, following in the footsteps of the U.K., Sweden, Australia, and Japan.
The new rule would be a step in the right direction from a government that has long clung to outdated conceptions of HIV and homosexuality. But by mandating that gay men face a twelve-month deferral, the FDA wouldn’t be shedding those stigmas and misconceptions. They would still be perpetuating the offensive notion that the nation's blood supply must somehow be protected from gays.
Think about it this way. The one-year deferral ruling would put gay and bisexual men on the same footing as these two groups of people: heterosexuals who have had sex with someone who is HIV positive, and heterosexuals who have had sex with a sex worker. Those people are judged entirely based on their risky choices rather than their identity. To lump gay men in with them is to suggest that all gay sex is just as risky, which is not borne out by facts. Under these new provisions, two gay men in a stable relationship—married, even—would never be allowed to donate blood even though they have the same low risk of infection as monogamous straight couples. Heterosexuals who have had multiple sexual partners or don’t practice safe sex aren’t prohibited from donating blood at all.
It’s true that gay men make up a disproportionate percentage of the HIV-positive population. They constitute an estimated 2 percent of the American population, but account for about 56 percent of those living with HIV. But, as William Saletan has pointed out at Slate, black men also make up a disproportionate percentage of the HIV-positive population: The rate of new HIV infection in African Americans is eight times that of whites, according to the CDC. But it would be preposterous—not to mention racist—to ban blood according to race.
In fact, the American Red Cross used to do exactly that, banning African Americans from donating blood. When World War II increased demand, the Red Cross changed its policy, but it catalogued blood and matched donors and recipients according to race until the 1950s. We’ve come a long way since then in terms of race. It’s time to do the same for sexual orientation.
And here's how to do it. LGBT advocates such as the Human Rights Campaign and the ACLU have called for a new system that assesses donors on an individual basis rather than instituting categorical evaluations based on a social group. What would this look like? Mexico might have the answer. In 2012, Mexico abolished its two-decade ban on blood donations from gay men and instead moved to a system that banned donations from those with HIV, hepatitis, or partners who engage in “risky sexual practices.” Those risky practices—for those of any sexual orientation—include contact or exchange of blood, sexual fluids, or other bodily fluids between a person with a transmittable disease and a sexual partner. This policy, unlike what the FDA is considering, shifts the focus away from sexual orientation onto individual behavior. There’s no such thing as gay blood or straight blood. The U.S. government ought to adopt a blood-donation policy that recognizes that.