Abstaining from sex is a choice that some people make for all sorts of reasons. But imagine if abstaining from sex was actually a prerequisite for you to perform an act both charitable and available to most of your fellow American adults: donating blood. If you're a gay or bisexual man in the United States, them's the breaks. The Food and Drug Administration requires "men who have had sex with other men (MSM)" to abstain from sex for an entire year before donating blood.
In 1985, the FDA imposed a lifetime ban on blood donations from men who have sex with men. It was a time when health officials still didn't really understand the HIV/AIDS epidemic or how the virus operated. The FDA lifted it's lifetime ban on gay blood donation back in 2105, but it still recommends that blood banks "defer for 12 months from the most recent contact a man who has had sex with another man during the past 12 months" and "[any] female who has sex with a man who has sex with a man in the past 12 months."
Although this policy was put in place during the AIDS crisis, it made headlines last year in the wake of the Orlando Pulse nightclub shooting because many in the LGBTQ community couldn't donate blood to help after the terrorist attack. One gay man, Jay Franzone, was already abstaining from sex so that he could donate blood, which he finally did in January 2017, in an attempt to raise awareness about the silly regulatory policy. But I believe he shouldn't have had to do all that in the first place.
Franzone, an LGBTQ activist who works as communications director for the National Gay Blood Drive, wrote in a New York Times op-ed after finally donating last month, "It shouldn't be a big deal that I gave blood this week, but it is. To do it, I had to give up all forms of sex for a year. The reason: I'm gay. With what we know today about the [HIV/AIDS], it's a stupid reason."
Frankly, I agree with Franzone. While the law is ostensibly meant to reduce the spread HIV, think about it. From my perspective, requiring someone to abstain for a year is not just a crazy thing to ask of a person, but that it's based in HIV/AIDS hysteria, homophobia, and plain old ignorance. It's kind of embarrassing.
It's 2017 now, and we know much more about the virus than when the FDA put its initial blood donation restriction in place. Most importantly, we definitely know that HIV/AIDS doesn't just affect gay men. It makes no sense to me to force gay and bisexual men who know their HIV status and practice safe sex to abstain for entire year before donating, while a heterosexual woman who engages in high risk behavior is free to self evaluate her candidacy for blood donation.
In an interview with Bustle, Franzone says, "They're allowing heterosexual high risk donors and banning low risk donors, who engage in low risk behavior."
I reached out to the FDA for comment on why the one-year ban remains in place for men who have sex with men but does't place restrictions on other orientations. FDA press officer Lyndsay Meyer wrote in an email that the "The deferral policy is a behavior-based policy, not one based upon sexual orientation." She stressed that the FDA-ban recommendation was science-based:
Current epidemiology shows that a history of male-to-male sexual contact was associated with a 62-fold increased risk for being HIV positive, whereas the increase in risk for a history of multiple sexual partners of the opposite sex in the last year was 2.3-fold. According to the Centers for Disease Control and Prevention, about two-thirds of all new HIV infections in the United States occur in men who have sex with men, who make up 2 percent of the total U.S. population.
Meyer also said the FDA had considered other "alternative deferral criteria, such as individual risk assessment for individual risk of HIV, as alternatives to a time-based deferral." However, "evidence shows that self-reporting presents significant issues in the U.S. for a number of reasons, including lack of sufficient data on the effectiveness of donor educational questionnaires and lack of reliability in self-reports of monogamy by partners in any type of sexual relationship. "
As Meyer pointed out, there are other deferral recommendations for donors:
who have had sex in the previous 12 months with any of the following: someone who has had a positive test for HIV, someone who have a history of or have been treated for gonorrhea or syphilis in the previous 12 months, someone who ever exchanged money or drugs for sex, or someone with a history of injection drug use, someone who have received a blood transfusion (whole blood or blood components) in the previous 12 months, and certain donors who have had a tattoo or body piercing in the previous 12 months.
Franzone disagrees with the "science," especially since making men abstain for a year also means they're prohibiting gay and bisexual men from engaging in behaviors that actually pose less (or no) risk of HIV transmission. "Needle sharing [and] injection drug use is listed at a risk 63 times greater than that of oral sex and nearly six times greater than insertive anal sex 'topping'," he tells Bustle. "This science is no science at all."
However, even the 12-month wait period doesn't completely hold as sensical, according to come critics.
Making sure that blood donations are safe is not a perfect science. There are two screening procedures to ensure that HIV and other "infectious agents" aren't transmitted to a transfusion recipient, but there is a window of about two weeks in which something can theoretically be missed, according to Brian Custer, the associate director of the Blood Systems Research Institute, who spoke to Boston's WBUR. The deferral requirements, paired with tests, is the best way to ensure the safest donations. But the year timelines that the FDA made up is straight up random, according to Custer. He said in the interview with Boston's WBUR, "HIV biology isn't linked to a one-year interval. The year is somewhat of an arbitrary date, and we know that."
I did it for myself so I could be able to give blood and give back, but also because little kids are hearing about this ban for the first time and when they hear about it they're hearing that something's wrong with them.
I believe if the FDA is really worried about HIV transmission, I believe they should also require anyone who has had unprotected sex or hasn't had an HIV test within the past year to abstain before donating. The current policy just doesn't make any sense if deferral is about the risk of HIV.
What may be most glaring about the FDA's current policy is that it still contributes to stigmatizing gay and bisexual men. In fact, Franzone's organization was founded because an LGBTQ activist, Ryan James Yezak, was barred from donating blood at work after a tornado a few years ago. Yezak told TIME, "It completely alienated me from the rest of my coworkers, and I felt like a different species."
Franzone says that breaking through this kind of stigma was the whole point of his abstaining for a year. He tells Bustle:
I did it for myself so I could be able to give blood and give back, but also because little kids are hearing about this ban for the first time and when they hear about it they're hearing that something's wrong with them. I did it more to break through the stigma and to highlight this policy than because I think my blood is special.
Franzone was seeing someone when he decided that he was going to follow through with the one-year celibacy requirement. They hadn't been sexually active yet and Franzone says his partner was "supportive as hell."
That is wonderful, but just think about the strain that could put on a relationship and an individual. It's a crazy thing to ask of someone.
Moreover, if even the FDA says, self-reporting isn't always reliable when it comes to someone's sexual behavior, how can you control for a year of abstinence?
Not only do critics argue the FDA blood donation policy is discriminatory and arbitrary, it's also affecting the donor pool. Someone needs donated blood every two seconds, according to the American Red Cross. Baby boomers are the largest group of donors, but the second largest that the American Red Cross targets at all those high school and college blood drives is millennials. However, more and more millennials — especially younger ones — aren't identifying as heterosexual and, thus, may not qualify to donate blood.
"I have a lot of friends who know that I want them to give blood even though I can't and they don’t want to give blood as a protest," Franzone says. "And that's a millennial thing [to want to protest]. But do you want to protest or do you want to save lives?"
Franzone believes the FDA should revise its blood donation policy to be about "condom usage, partner count, and let's be really basic here, knowing your status and getting tested [for HIV.]"
Such a change in policy could have an extra benefit. In the United States, there is an estimated 12 percent of people who don't know their HIV status. Changing the blood donation policy could also mean raising awareness, beating HIV/AIDS stigma, getting more people tested, and then getting more HIV positive people on treatment, which is the key to prevention.
There could be a host of benefits if the FDA changes its blood donation policy, but when it comes to restricting the donor pool and stigma, Franzone warns, "This [policy] could be really dangerous down the road."