Blood, Sex, and Fears: The Legacy of the FDA “Gay Blood Ban”

As a boy growing up, I learned early to eat liver. With enough servings, I even learned to like it. Every time my dad gave blood, my mother cooked liver and onions for all of us because doctors recommended replenishing the body’s iron after giving that gift of life to others. With his type O blood, my dad was a universal donor and his blood was valued. I have always been proud of my father for his willingness to give blood regularly to help others. As soon as I was 18, I too became a regular blood donor and gave multiple times every year until 1983. In 1983, the Food and Drug Administration became worried about taking blood from men who have sex with men (MSM) – the danger was that they might be HIV positive and unaware of their status, and unwittingly donate infected blood. As a gay man, I heard loudly and clearly once again that being gay made me a pariah and a threat to my community; my blood was no longer wanted.

With the introduction of HIV testing, I went in for tests frequently, waited the two weeks for my results, and breathed a sigh of release at every negative. I became aware of what behaviors were higher risk for HIV infection and learned to live lower risk. I also continued to stay away from blood drives because they asked about my sexual orientation and gave the choice to lie or to be instantly denied. Lying about being a gay man lie takes a heavy toll: forfeiture of a large chunk of human soul.

As the years passed, HIV testing became easier and results became available more quickly, but the availability of rapid test results did not change the rejection of MSM as potential donors. As an HIV negative gay man who is married to another HIV negative gay man, my risk for HIV infection is no greater than that of my heterosexual brothers. Finally, in December of 2015, the FDA relaxed its restrictions on blood donation by MSM.

There remains a single caveat: you are only allowed to donate if you have not had sex with another man for the past 12 months. In the face of remarkable scientific advances around testing for HIV presence in blood, this “assessment of risk” simply treats sexually active gay, bisexual and queer men as pariahs.

Please note that the technology has long been in place that could have ended this ban long ago. In 2006, the American Association of Blood Banks first recommended the current requirement of one year gay celibacy requirement. Even as blood testing accuracy and rapid turnaround continues to accelerate, the FDA remains hamstrung by unconscious bias, or is it homophobia? Even as blood banks complain of insufficient donations, that bias remains on prominent display. Until we use science rather than historic stigma to make decisions about accepting blood donated by MSM, we will continue to leave the generosity of the citizens of our community untapped. And we will continue to publicly stigmatize men unnecessarily.

The day the FDA implements a scientifically valid strategy for keeping the blood supply safe, I will give blood and sit down to a dinner of liver and onions to celebrate! I will celebrate my father and and I will celebrate my ability to give of the gift of life to the community. I will celebrate the maturation of US blood policy with its use of science and its abandonment of bigotry toward the gay male branch of our human family.

175p CallahanEdward J. Callahan, PhD
University of California, Davis Health System
Associate Vice Chancellor for Academic Personnel
Professor of Family and Community Medicine
Chair, Vice Chancellor’s LGBTQI Advisory Committee