Whose Blood is that Anyway?

Last week the Irish Blood Transfusion Service (IBTS) issued a statement announcing the end of its lifetime ban on men who have had sex with men donating blood. Now, don't let this headline fool you. They are ending diddly-squat. Instead, what they in fact announced was a shift in their policy, from a lifetime ban, to a ban on any man who has had sex with another man within the previous twelve months.

So essentially, unless you are celibate, extremely committed to being able to donate blood, or just having a bad year; most gay or bisexual men are still banned.

It is important when looking at the information surrounding this move that we take into account the origins of the ban. And scientific research which forms the basis for this change.


A History Lesson

By the end of 1983 over a thousand people had died in the United States due to AIDS-related illnesses. At the time, HIV or AIDS was not the term used. The disease was exceptionally new, and not very well understood. Evidence at the time led initial researchers to conclude that it originated purely from homosexual intercourse, proposing the name “Gay Related Immune Deficiency” or “GRID”.

It wasn't until 1983 that it was even discovered to be transferable through heterosexual intercourse as well. It was also in this year that it was officially recognised that it could be passed through a sufferer's blood, and thus the United States Food and Drug Authority (FDA) announced a lifetime ban on any man who had sex with another man from ever donating blood.

A reactionary, but widely regarded as necessary, approach at the time. Testing procedures in relation to blood donations were far from as advanced as they are today. And it was decided that in order to minimise the risk of a person receiving a transfusion with infected blood, it was necessary to restrict donations from “high-risk” individuals, ie gay men and intravenous drug users.

Over next ten years, HIV would become far more understood within the medical community. Its true origins and causes brought into the light of day, and most importantly it was confirmed that this was not just a disease affecting, or caused by, gay men. It would become common practice over these years for blood to be screened with ingreasing rigorousnous before being added to any national supply.

Ireland has a sensitive set of issues surrounding this decision. The first being, that is was illegal to be gay in this country until 1993. So already, Ireland had huge steps to be made in terms of gay rights before this issue could even be considered being discriminatory. Also, until 1980, the sale of contraception was completely illegal in Ireland. And still, it wasn't until 1992 that they were permitted to be sold generally.

So, not only was it illegal to be involved in gay activity; the only protection anyone had from contracting the disease was also unavailable to the majority of the Irish population. Other than abstinence, of course. Another, excellent reason for a ban on anyone who was particularly high-risk for the disease.

So, we meander through the 90s, and LGBT rights becomes an ever increasing issue among the populations of many countries. As people fight tooth and nail for every inch of ground gained, the IBTS (Irish Blood transfusion Service) sits safely in the knowledge that despite these strides in social awareness, as well as sexual health awareness not just among homosexuals but also among the previously under-sexually-educated Irish population, they have still minimised as much of the risk of AIDS infected blood making it into their supply.

The basis for this contentment? Men who have sex with men involve themselves in which is empirically thought of as “risky-sex”. Risky sex, (click to see complete definition) on the contingency of screening when donating blood, is considered to be unprotected intercourse of any kind, among other more specific outlines. Essentially gay sex is considered "risky" regardless of its nature, and people who practice it, when giving blood, are put in the same category as people who inject drugs intravenously in terms of the risk factor for HIV contraction.

To put it crudely; being gay (or bi) is considered medically equivalent to sharing a needle with a drug addict.

Any male/male sex is considered “risky”. Basically, the medical community (none-unanimously, I might add) decided gay men are more likely to suffer from AIDS or HIV. And this ban, combined with rigorous testing of the blood that was donated, meant security and safety for anyone receiving these anonymous transfusions.

2015; the Marriage Equality Act passes in Ireland by democratic vote. For the first time, LGBT people breath a genuine sigh of relief. Their fight is nearly over, they have gained not only acceptance, but support, from the majority of the Irish population. An astounding victory for LGBT rights, and for moral statement within the Constitution, one that led every person in the country to think; we're going somewhere.

2016; the Irish Blood Transfusion service announces an end to its ban on blood donors. With a deferral period of one year, for any man who has engaged in sexual intercourse (protected or not, monogamous or not) with another man. The scientific basis for this decision? Well...


Screening Process

Apparently, the margin for error on testing blood is still too high to risk allowing any who may have engaged in “unsafe” sexual practises to be allowed to donate. Essential this year gives time for any HIV-related illness to present themselves. Thus if you haven’t had sex in a year, you're probably okay.

Hold on, let me repeat the most important part of that statement. The margin for error on testing blood is still too high. Did you get it that time? So I ask you, what is the scariest part of this plan? Certainly, it isn't “queer blood” being part of the national supply. And it certainly isn’t that this year-long waiting period is too short. No, the truly terrifying thing is the notion that blood transfusion services don't consider their own tests good enough to justify allowing gay men to give blood.

I don't know about you, but I think this suggestion may make people question how comfortable they feel receiving any blood from anywhere. HIV is far from being the only disease which is communicable through human blood. There are many, many different types of immune deficiency and other viruses, many of which that are statisictally irrelevent towards sexual orientation, that can be contracted through many different means. Not just sex.


Logic vs. Fear

So what’s this all about? Why is it still so “risky” to be gay? I have a thought.

Let's say, for example, that they did completely remove this ban in favour of another method, an example of which I will go into shortly. And, let's say, that there was a case where a patient contracted HIV from receiving infected blood that was passed with a “false-negative” and considered safe for use. The backlash against the transfusion service in question would be astronomical. And, unfortunately, this could fall heavily back onto their decision to lift the ban. This would be a huge blow to LGBT rights. Right-wing lobbyists and propaganda would immediately turn this back onto that decision, and against gay people in general.

Or, are they actually protecting us? Are they taking the biggest step they can on an issue that could be eternally derisive if adequate precautions are not taken? My answer, I hope that's at least what they think they're doing.


The Rest of the World

I said above we needed to look at the scientific research behind this deferral period. Unfortunately, there is none. There is statistical research which suggests that men who have sex with men are more likely to be HIV positive. But that's like saying: statistically, men are more likely to get into car accidents; so they implement a lifelong ban on driving. Or, they must have not been a man for at a least one-year prior to taking their test.

Ireland isn’t going to be alone in using this measure though. In South Africa, the deferral period is 6 months. In the UK, Australia and Sweden it is 12 months. While in Canada and New Zealand it is five years. In Italy, however, the ban was completely lifted, instead, a system known as “Assess and Test” was implemented.

Basically, their model uses;

“risk behaviour” screening questions and blood testing, which applies to all donors, regardless of sexual orientation.

Since this method began there has been no rise what-so-ever in the frequency of infected blood being discovered in Italian clinics. And they increased their donor pool by hundreds-of-thousands.

This the real issue here: Blood donation is essential for medical practices. Without it, many serious injuries and illnesses cannot be treated. Many times over the last thirty years have different countries and cities suffered from blood-shortages. The most famous, very recent event, being the mass shooting in Orlando. Where many hospitals found their supply running low, and despite many gay people desperate to give blood in order to help their wounded compatriots, they were being turned away due to regulations.


Just not up to Scratch

Frankly, IBTS your announcement IS NOT GOOD ENOUGH. It is so far from being good enough that it has sparked further outcry from a minority which is so close to ending its fight for complete and utter equality.

These are not the “stepping-stones to freedom” to paraphrase one of our most famous leaders. This is a step backwards. A further entrenchment of discriminatory ideals which segregate and marginalise those already on the outside of what's considered ordinary society. And despite it appearing a step in the right direction, I feel this move further insinuates that any form of gay sex is inherently “risky” and therefore wrong. Not to mention serving to further stigmatise sufferers from an illness that affects nearly 40 million people worldwide. And has killed over 34 million since the first diagnosis in 1979.

I implore any reading this to research the Italian system and take measures promoting this thoroughly safe alternative to a ban which is based on discriminatory stereotypes and not the best and most comprehensive scientific data available.

Also, think about reform towards examination of the blood screening process or, what's really necessary, is a clarification from the IBTS as to what is meant by this allusion that their clearly legitimate and thorough procedures are somehow not good enough. As I find it very hard to believe that this justifies their minor step in resolving the issue. To end I’ll leave you with a quote from French Heath Minister Marisol Touraine;

“Giving blood is an act of generosity, of citizenship, which cannot be conditioned to sexual orientation.”

Well said Ms. Torraine, well said.

image source: Asia M.I.S, Deviant Art