The FDA blood ban is still rooted in stigma and bias

The U.S. Food and Drug Administration (FDA) recently announced it will shorten — but not eliminate — the de facto ban on gay and bisexual male blood donors. While this policy shift is a step forward, the basic underlying policy is still flawed and continues to perpetuate discrimination against LGBTQ people. Any blanket policy directed toward a specific identity or community — and particularly one that has been stigmatized and marginalized for decades — is misguided and rooted in lasting bias. 

Starting in the mid-1980s, the FDA issued an indefinite and permanent ban on blood donation from any sexually active gay and bisexual men. Grounded in fear and stigma, this ban persisted until 2015, when the FDA revised the permanent ban to instead require gay and bisexual male donors to be abstinent for one year. 

Citing “unprecedented challenges to the U.S. blood supply,” the FDA announced a new policy yesterday that eases the 12-month prohibition introduced in 2015.  The new policy will now prohibit men who have had sex with men within the past three months from donating blood. 

The Human Rights Campaign objected to the FDA policy in the 1980s and continues to object to all of its vestiges today. At no time in our nation’s history has it been more critical to prioritize science and facts over fear and bias. And given the current crisis and shortage of blood donors, the FDA solution is not a real solution or one driven by science. 

A truly bias-free deferral policy should be based on information that is within the personal knowledge and control of the prospective donor—and not on the sexual orientation or gender identity of the donor, or the sexual orientation, gender identity, or activities of one’s sexual partners, or on perceived monogamy.

We have long advocated for a policy that evaluates donors based on the individual risk behaviors of every donor, rather than on identity. Under the new guidelines, a person who has had unprotected sex only days before can still donate blood, while a gay or bisexual man who has had sex with another man within three months of the date of donation — despite using condoms and taking HIV prevention medicine like PrEP — cannot. This difference is unfair, unscientific, and based in bias. 

As our country reels from the effects of coronavirus, the integrity and safety of the blood supply in this country must be preserved, strengthened, and maintained. Yet continuing to enforce the de facto prohibition on blood donation by sexually active gay and bisexual men does not reflect the best science available. Modernization of the policy is essential to ensure that the blood supply remains as safe as possible while maximizing the donor pool. This must be a time governed by science and measured unbiased thinking.

As the FDA advances a medically unsound solution, President Trump compounds the problem by refusing to reopen the Affordable Care Act exchanges. Over 20 million Americans and almost one-in-five LGBTQ people lack health coverage. LGBTQ people are particularly vulnerable during this pandemic, given that they disproportionately lack health insurance and face a higher risk of having various illnesses that either increase the risk of contracting COVID-19 or amplify complications after contraction.  

And rather than addressing the lack of access to health care, President Trump is denying access to the exchanges. This makes the LGBTQ community, and every marginalized community across this nation, more vulnerable. At this critical moment, Americans need the exchange reopened, and President Trump must act. 

This is also a moment to acknowledge and underscore the urgent need for our health care system — writ large — to be empowered and strengthened. Both the president’s actions and the FDA policy fail to meet that need.  It is clear that utter disregard for the most marginalized is informing the ACA determination, and the deep roots of HIV stigma and homophobia are still informing the current FDA blood donation policy.

To be clear, the ACA decision is a fatal flaw at the most critical time and the FDA decision is not a victory. Unfortunately, our work to strip bias, discrimination and stigma from our federal policy is far from over.

Alphonso David is the president of the Human Rights Campaign.