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How to Solve the Blood Shortage | Guest Insight

The FDA’s blood donation rules stigmatize sexual minorities for no good reason—and it may cost a million lives each year.

Benjamin Gossart is an undergraduate student at Northeastern University in Boston, Massachusetts. He is a candidate for a Bachelor of Science in Biology and Political Science with a concentration in identity, culture, and politics.

The shortage of blood in the United States has turned into a grave emergency as the COVID-19 pandemic stretches on. At the outset of the pandemic, many blood drive centers were forced to shutter their operations to reduce the spread of COVID, exacerbating an existing crisis. Even absent the pandemic, only 38% of the population is eligible to give blood for a variety of reasons. Of that eligible population, only a dismal 10% choose to do so.  And the need for blood—pandemic or not—is dire. According to estimates, a patient in the United States requires an RBC transfusion every 2 seconds.

Yet, the Food and Drug Administration’s present policy practically bans over 4 million gay and bisexual men from donating blood unless they are abstinent for 3 months prior to donating. During the HIV/AIDS epidemic of the ‘70s and ‘80s, the FDA—uncertain as to how the virus spread and fueled by a moral panic over homosexuality—issued a blanket ban on blood donations from all men who have sex with men (MSM), women who have sex with MSM, and any transgender person categorized as MSM. Though the ban has been adjusted to the aforementioned 3-month abstinence, it still essentially demands that any men who aren’t straight shelve their identities. To put the absurdity of this policy in perspective—a monogamous man who has protected sex with his male partner is barred from giving blood while his straight counterpart who has unprotected sex with multiple partners is completely eligible.

Even as lasting deferment periods continue to stonewall potential blood donors, policy has not kept pace with the science. Organizations already test and reject any blood donation containing transmissible viruses and diseases such as HIV/AIDS. Modern assays developed last year continue to improve with increasing accuracy, speed, and even generate fewer false negatives. Ironically, those tests reveal that this policy seems to have no effect on the positivity rates of HIV, HBV, and HCV in the blood supply at all. These policies do, however, affect the sexual minorities stigmatized by them.

The otherization and alienation of minorities is a common theme in pluralistic societies. Even in liberal democracies, where all are equal according to the law, “us vs. them” dynamics inform electoral politics, foreign affairs, and even seemingly science-backed public health policy. Investigations by watchdog organizations show the FDA has repeatedly dismissed or ignored conclusion-changing data regarding its policies that harm both the queer community and the population-at-large. Indeed, the FDA’s current policy effectively deflates the available blood supply by 2-4% and may cost over one million lives every year.

This stigmatization of a minority—which stems primarily from public and institutional ignorance—ironically harms the majority of all Americans. A healthy civil society requires the equitable inclusion of all its members or else it runs the risk of injuring itself or undermining the very tenets of liberal democracy.

The FDA has the power to change this rule on its own. It does not need to wait for compromise, the resolution of gridlock in Congress, or democratic mandates imposed on newly-elected presidents. To make this change would empower stigmatized sexual minorities, refute antiquated stereotypes, bring us closer to the promises of liberalism, and solve an incredibly daunting public health crisis with little more than the stroke of a pen.

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