Blood Libel: America's Ban on Gay Blood Should Go
Americans are more likely to be killed by lightning than get HIV from a blood transfusion. But the lifetime donation ban on gay men hasn't budged.
In 1982, the Centers for Disease Control named a disease that had mysteriously killed five Los Angeles men a year earlier: AIDS. Within a year, every man who had slept with another man since 1977—even once—was banned for life from donating blood.
At the time the ban hit, donated blood was not tested for HIV before transfusion. Doctors didn't even know what HIV was. There were no needle exchange programs, safe sex campaigns, or antiretroviral drugs. Rock Hudson had yet to be diagnosed. The President of the United States, Ronald Reagan, had never publicly uttered the word "AIDS."
Three decades later, we know a lot more about HIV, how to prevent it, and how to figure out who has it. Modern tests used in the U.S. can detect HIV in donated blood within 12 days of the initial infection. Today, Americans are more likely to be killed by lightning than get HIV from a blood transfusion. But the lifetime donation ban on gay men still hasn't budged. Last year, an FDA panel admitted that its blood donation rules aren't perfect, but declined to recommend to lift the ban on gay donors until more research could be done.
In the early 1980s, AIDS was linked almost exclusively with homosexuality—before AIDS was called AIDS, it was called "gay-related immune deficiency," or GRID. The diagnosis arrived at a time when few openly gay people appeared in pop culture or public office, sodomy was illegal in most states, and same-sex marriage was decades away. And the new AIDS threat fit seamlessly into the cultural narrative of homophobic shaming. Rev. Jerry Falwell called AIDS the "wrath of God upon homosexuals." Reagan administration official Pat Buchanan said it was "nature's revenge on gay men." President Reagan himself didn't even acknowledge AIDS until 1987, after it had killed over 20,000 Americans. Rock Hudson was still in the closet when he died of AIDS in 1985.
Today, several demographics are known to be at a heightened risk for HIV infection—intravenous drug users, sex workers, blacks, incarcerated men. But rules for who can donate blood continue to disproportionately affect men who have sex with men. Intravenous drug users, sex workers, and people who have lived in certain African countries are also subjected to lifetime bans, but people who pay for sex or sleep with a drug user are only deferred from donating for 12 months. If you're a guy who has sex with a guy—again, just once—your blood is deemed compromised forever.
With a rule like that, it's no surprise that closeting continues to play a role in the nation's blood supply. After New Jersey governor Jim McGreevey came out as gay in 2004, reporters dinged him for previously staging a spirited blood donation photo op in violation of the rules. And in 2008, a Missouri man who had recently been infected with HIV passed on the virus to two transfusion recipients after he lied about his sexual history before going under the needle. Later, the man admitted that in the days before donating blood, he had engaged in anonymous sex with both men and women while he had been drinking. Scenarios like that one are unlikely—the breach was the first recorded in the U.S. in eight years. But in cultures where gay sex is still stigmatized, even a good samaritan may be more likely to lie than come to terms with the fact that he's had sex with men, and his blood is no longer wanted.
Even some guys who are otherwise out of the closet have copped to lying to donate blood as a political statement. "Like jury duty, donating blood is something I consider my civic duty," a gay blood donor wrote on Queerty in 2009. "And because I’m committed to donating blood, I regularly lie to the Red Cross about my sexuality." The donor declined to include a byline. Back in 2002, Canadian blood donor Kyle Freeman wrote an anonymous email to Canadian Blood Services informing the agency that he had donated blood 18 times despite the country's lifetime ban on donations from men who have had sex with men. "I am a gay man and have been involved in a long-term committed relationship," he wrote. "Both my partner and myself [have] been tested for the HIV virus and are both negative and intend to stay that way. We are both very honest people and are both blood donors." Canadian Blood Services didn't see it that way: It tracked Freeman's IP address, outed him, and sued him for $100,000 for lying on his blood screening questionnaire. Freeman countersued, calling the donation rules discriminatory.
The donation policies of the U.S. and Canada don't prevent gay men from donating, per se—the rules take care to address only sexual behavior, not sexual identity. So celibate men who identify as gay can donate blood, while guys who have had same-sex affairs and nevertheless identify as heterosexual can't. And increasingly around the world, men who have sex with men are permitted to donate blood after a certain period. New Zealand allows men who have sex with men to donate blood five years after their most recent same-sex sex act. Argentina, Brazil, Hungary, and Japan defer men who have sex with men for one year. In South Africa, where the AIDS rates far overshadow America's, the deferral is just six months. In recent years, more countries have converted their bans into deferrals. In 2009, Sweden began allowing men who have sex with men to donate blood after waiting a year; last year, the UK ditched its all-out ban in favor of a 10 year deferral.
But policies which privilege gay men who haven't had sex in a year—or a decade—are socially problematic, too. In our culture, encouraging blood donation hopefuls to stop paying for sex or having sex with drug users are fairly value-neutral requests. With greater research, the FDA may be able to tailor its blood donation rules to more specific sexual behaviors that cut across orientation, like monogamous sex or condoms-every-time sex. Until then, asking gay men to stop having sex with men—in effect, to stop acting gay—will continue to fuel stigma.