Gender Neutral Blood Donation Comes With Sting In Its Tail

The blanket ban on blood donation by gay men, and bisexual men and transgender women who have sex with men (GBT people), is one step closer to being lifted.

The Red Cross Lifeblood Service has, or will soon, lodge a submission with the Therapeutic Goods Administration (TGA) asking that GBT people in monogamous relationships, or who don’t have anal sex, be allowed to give blood.

If approved, all donors, gay and straight, cisgender and transgender, will be asked the same question about whether they have had anal sex with a new or multiple partners. If they say “no” they can donate.

For the first time since the advent of HIV in the 1980s blood donors will be screened for the safety of their sexual activity, not the gender of their sexual partner.

This proposal policy will open up a new source of safe blood, make the blood supply less discriminatory and bring Australia closer to the prevailing policies in the UK, US, Canada and many other countries.

All those GBT people, and our allies, who have advocated for a fairer blood donor system should feel proud.

However, there is likely to be a sting in the tail of Lifeblood’s position.

From what I understand, Lifeblood will ask the TGA to double the abstinence period for those who don’t qualify under the new policy before they can donate.

Currently, all sexually-active GBT people must abstain from sex for three months before donating.

Now Lifeblood is proposing an abstinence period of six months for those who have anal sex in new or multiple relationships.

Put another way, if you have any anal sex you will need to be in a monogamous relationship for at least six months to be able to donate.

At the same time as Lifeblood has given a green light to GBT people who are monogamous or don’t have anal sex, extra hurdles have been put in the way of those who don’t meet these criteria.

Don’t get me wrong, medical evidence is clear that an abstinence period for anal sex with new or multiple partners is required, but I am bewildered by Lifeblood’s proposal for an abstinence period of six months rather than three.

If approved, the new six-month abstinence period would mean that some people who can currently donate will no longer be able to.

This includes GBT people who had anal sex with their male partner more than three months before donating, who will now have to wait six.

It also includes heterosexual and cisgender women engaging in anal sex.

If, as Lifeblood has repeatedly told us, such people are currently safe to donate, why it is suddenly necessary to turn them away?

Then there is the problem of continued discrimination.

Even though Lifeblood’s proposed policy is ostensibly non-discriminatory, it affects a far greater proportion of GBT people than heterosexual or cisgender people.

It effectively sends the message that there is something so dangerous about gay sex that different conditions must apply.

It’s as if Lifeblood feels it must station extra guards at the gay blood donation gate to assure the public the wrong type can’t sneak through.

 It’s as if Lifeblood feels it must be seen to punish “bad” gay behaviour at the same time as it rewards “good”.

The proposed policy is a clear example of indirect discrimination against GBT people.

For all these reasons, countries comparable to Australia, like Canada, the UK and US, have adopted a three-month abstinence period for those who have anal sex with new or multiple partners, without any greater risk to the blood supply.

The whole point of the abstinence period is to cover the time between when someone may be newly infected with HIV and when it shows up on tests.

The Nucleic Acid Test (NAT) used to screen for blood-borne diseases usually detects a new HIV infection ten days and one month after it has occurred.

So, the three months period currently in place is already much more than enough to reduce risk to the bare minimum.

It is because three months is more than sufficient that the TGA approved a three-month abstinence period for all GBT people in 2020.

So why is the TGA now being asked to increase this period for some GBT people?

Lifeblood’s rationales don’t add up.

It points to an increase in new HIV infections among GBT people, but the reality is that HIV infection rates are simply returning to pre-pandemic levels, as they have in other countries with a three month abstinence period for anal sex with new or multiple partners, and remain so low as to pose no meaningful risk.

Lifeblood has blamed the TGA, saying it is known for its extra caution, even though the TGA has already approved a three-month abstinence period for GBT people.

Lifeblood says it is including sex workers in its TGA submission and they require extra caution, that some people with haemophilia may still have residual concerns about GBT donation, and that (with no clear reasoning) same-sex couples must be monogamous for longer to be safe.

It really feels like Lifeblood is grasping for reasons for a policy it knows makes little sense.

It has become clear from my discussions with Lifeblood that it is desperate to end the ripple effect of the current GBT ban: there are a growing number of businesses and government departments refraining from blood drives until their GBT employees can donate.

It also appears keen to channel as many GBT people as possible into plasma donation which does not require any sexual abstinence period, a path it has been pursuing for several years.

It may also want to reassure countries buying Australian blood products that it is strictly guarding the gates to gay donation.

Those of us who have been campaigning for gender-neutral blood donation can take heart that our efforts are working.

But there is still work to do when Lifeblood supports a policy that indirectly discriminates against GBT people.

The Let Us Give campaign will be making its own submission to the TGA supporting gender neutral donor screening but challenging a six-month abstinence period as unnecessary and stigmatising.

Please sign the petition for blood equality here: https://www.change.org/p/let-us-give-blood-save-more-lives