Friday, February 06, 2009

Dear FDA, I'll just take my blood elsewhere

TNG reader J. Clarence Flanders submits this piece.

This morning I received an email from the college where I work that went out to everyone at the institution reminding them the school is hosting a blood drive, and encouraging us to donate blood if we could. In addition to reminding us about the event, the email went on to inform us of all the benefits to donating blood, such as the fact that each donation of blood goes on to save on average three lives. I tossed the email in the trash.

I remember in college I was told if I wanted to donate blood—which is a noble cause—that I should just lie about it, when they asked me if I had ever had sex with men. And I did, because I felt the nobility of the act outweighed the stupidity of the discrimination. But the nurse did not find a vein, so I ended up not giving blood anyway—which is good because I hate needles.

I left the university gym where the blood drive took place and decided then and there that I would never lie about it again, if the opportunity came up. It seemed ridiculous to me that in order to do the right thing I would have to lie about who I was to do it.

"If you're a gay male who has been in a monogamous relationship for 30 years, you're still considered a greater risk [to the blood pool] than if you're a promiscuous heterosexual who has had hundreds of partners for 30 years." —Mark Segal, editor of the Philadelphia Gay News

The above quote, which I found in an article on MSNBC's website, articulated my frustration with the Food and Drug Administration (FDA) policy perfectly. The policy, for those that don't know, says men who have sex with men since 1977 cannot donate blood, because they—we—are a high risk demographic. And while that is true, sadly, such a blanket policy only perpetuates the ideology that, according to David Hauslaib of Queerty In-Depth and quoted in the MSNBC article, sees "gay men as walking AIDS incubators."

With the rates as high as they are for queer men of color, I am fortunate not to have contracted HIV or any other STI. It isn't a fact that I gloat about, but it is something I am grateful for (partly because I have a hard time swallowing pills, so the idea of a medicine cocktail does not sit well at all). So I find it extremely insulting and frustrating that in the eyes of the FDA I am assumed to have an illness, even though they test the blood anyway.

Not to mention the sheer fact of (heterosexual) privilege that exists for a straight man, who could very well be a contemporary Casanova, with as many sexual partners as stars in the heavens, and still walk up and give blood, no questions asked (besides the myriad of questions about recent vacation spots, body art, drug use, etc.). They are given the benefit-of-doubt with regard to their status.

Somehow the FDA managed to scramble up enough shaky logic to say they are not being discriminatory with a straight face, by stating the fact that people who have used intravenous drugs or been paid for sex are also excluded. However, that just infuriates me more because it now puts me in a demographic of people with whom I have absolutely nothing in common, not to mention those are actual actions that have been committed rather than actions assumed on the part of the individual.

I know of other queer people who have gone about this more constructively than I have. Many of them volunteer to man the tables or get the food, or in some cases just lie because they know what the policy is for and know that they do not have the virus. I, however, am sick and tired of being sick and tired when it comes to this issue, because this is outright discrimination based on the assumption that gay people as a given are more connected to the virus than others. And that kind of ideology is exactly what stalled treatment when the epidemic first broke out.

At best, the FDA is trying to keep the public safe by employing the "justifiable discrimination" routine. At worst, we have a case of a federal agency exercising undue influence in continuing an ideology based in past hysteria about AIDS.

12 comments:

meichler said...

I'm constantly annoyed by this, too. We have blood drives all the time at the office, and I feel like it's a great time to raise the awareness of this issue. Perhaps I should put up a sign on my office door saying why I don't/can't donate? It would be a great way to raise the awareness of my status as a homo around the office, too...

Unknown said...

A few years ago at my school we decided that this would be something we should raise awareness about. It turned out that most people supported the red cross enough that they wouldn't even sign a statement to the red cross asking them to change their policy, even if they would support gay-rights in most other ways.

Anonymous said...

On the one hand, the policy doesn't bother me, because it is a statistically significant risk and testing isn't 100% accurate. However, what does bother me about the policy is that straight black women are more likely to carry the virus than gay white men, but it is far more acceptable in today's society to discriminate against gays than it is to discriminate against women or blacks.

Corey said...

i understand the frustration with some blood donation policies. i went to Mexico in April 2004. that summer, i went to the red cross and had to plot out my travels on a map so they could be sure I didn't travel to any high-risk areas. they said i was fine, i gave the blood, and left.

a few months ago i tried to give to the Rhode Island Blood Center. i did the same deal with the map, and they also said i was okay and took the blood - only to call me three weeks later and say, whoops, they decided not to take it just in case due to my travels. i can understand them not taking it, but... couldnt they have told me before?

now, having been to the middle east for several months and having had a bad case of hepatitis a, i won't go back. esp. after reading this.

shouldnt they be - idk - encouraging people to give?

Kevin said...

They test all the blood anyways for everything imaginable. I would give in spite of the questions and just lie. I see no ethical problem answering an unethical test in that manner. Plus, it could save a life.

J. Clarence said...

I understand the risk are significantly higher for our demographic; however, it is the fact that it is just a blanket policy that gets me. All of the means that you can contract the virus are questions they ask you about anyway, for example sex without condoms, high risk behaviors, exposer to the virus, etc etc.

So if you pass that extensive, and quite exhaustive, test, I see no reason for an additional "Anti-Gay" measure.

I'm often struck by the fact that so few people know of this clause in the FDA too. And Bitsy you are right, the Red Cross is such a noble institution that we would often turn the other cheek rather than confront the it. And a lot of people buy the it is better to be safe than sorry argument.

Anonymous said...

This argument is just a permutation of HIV stigma. Giving blood is a passive charitable act; your blood not being welcome by Red Cross doesn't deprive you at all. It's your shame of being associated with AIDS as a gay man that's the real problem - you nearly come out and admit it flat out right after a passage constructed to deny such shame, glibly dismissing the reality of an HIV infection to a mere wrestling with pills, then saying that "I find it extremely insulting and frustrating that in the eyes of the FDA I am assumed to have an illness". You're not personally assumed to have an illness (and we of cousse aren't talking about "an illness" but AIDS), they're just taking into account that you're more likely to have come into contact with the HIV as a man who has sex with men. And there's the crux - if you were perfectly secure with being a man who has sex with men, you could reconcile the sad truth that HIV infection is especially high among your group without feeling like it's fodder for an yet another judgement that outsiders can dump on you for being gay.

Worries about being seen as "walking AIDS incubators" and the classic shifting of the spotlight to another maligned minority group further my point.

Once you realize this is more about HIV stigma coupled with internalized homopohobia than civil rights it's hard to take complaints about this saftey measure seriously.

Anonymous said...

Clarence - The American Red Cross (who administers the program) used to type blood (well into the 1970's) by race so their complicity until 2006 was a factor.

The testing is standard of blood and costs them no extra to do. However the US skips some tests that other nations do perform, such as for malaria. Their only cost is generally one of opportunity cost.

Jeremy - I'm sorry but you are wrong on this point. It is not a fear of being perceived as poz, it is not being permitted to be part of the community at large. It is stigmatizing to have to refuse to give blood because the default assumption is one of selfishness.

I understand this better, having lived in cultures which are more communitarian and less individualistic, in which the acts for others are not just lauded but a necessary part of the fabric of society.

Also Jeremy, if we were to use your reasoning, we would have to preclude African-American women (the greatest increases in new HIV infections are in this cohort, and the least likely to know), no matter their sexual orientation. Somehow I don't see that happening... Indeed the best way to secure the blood supply is to only let lesbians and the military donate blood!

Finally, many other countries in the West don't have that limitation and arguably have far better health care quality controls and health care systems. Given the rate of HIV prevalence (UNAIDS latest report, 2008)in the US compared with most of Northern Europe, blood from residents in the US could be just as suspect as the Red Cross sees gay men.

J. Clarence said...

I don't know where you could extrapolate civil rights from this, as this is a policy matter of the FDA, and as you put it "doesn't deprive me at all". But your notion that something can only be considered wrong or need to be changed if it deprives you of something is ridiculous at best, dangerous thinking at worst.

You're right the fact that HIV/AIDS infection rates are so high in my demographic is partly, in fact mostly, our own fault. Doctors don't go around injecting people with the virus, this isn't Tuskegee. And especially as a queer person of color, I stare at the statistics in awe, almost 50%; and I am not going to lie there is the temptation to rationalize the stanch of the FDA as merely being cautious.

However, the FDA doesn't do itself any good when in addition to asking you "have you had sex with men since 1977" it also asks you other questions about your (sexual) behavior that would exclude you anyway, so the question becomes irrelevant and purely discriminatory: "if I do not do those things I wouldn't be of high risk, so why assume that I am."

And you alluded to their point: "you're more likely to have come into contact with the HIV as a man who has sex with men." And wrapped up in this assumption is the notion that as a gay man I am by default going to engage in high risk behavior, be promiscuous, etc; and *that* is the problem.

Anonymous said...

If the FDA bars anyone living in the UK between 1980-1996 and anyone who's lived in West Africa since 1977, or has even had sex with someone who has, what makes you think that black women are so precious a group that if officials really did find blood donation from that group to be enough of a risk (without draining the blood supply too much) that they could never also be deferred?

MSM aren't barred from helping the Red Cross in the plenty of ways other than donating blood.

Also I could only find references to Italy and Spain going a different route than an MSM ban - most other countries keep the life long ban, and a couple have legnthy multiple-year abstinence restrictions, basing their policie on the risk factors calculated by the experts in their respective countries, for their respective populations. I'm not saying the FDA ban is gospel; if it could be less restrictive while still staying safe, that's great, but it's not really an affront to gays the way it stands.

& Clarence I wasn't going anywhere near trying to point out fault - but I think that you brought that up furthers my point, along with "And wrapped up in this assumption is the notion that as a gay man I am by default going to engage in high risk behavior, be promiscuous, etc; and *that* is the problem." It's less about the best policy for blood safety, and more about salving the shame of bearing stereotypes associated with gays (why should you expect much sympathy for a fear of being thought of as promiscuous?).

Hans N. said...

Corey, I just have to ask: what did they do with it? Put it back in your arm? Mail it to you? I'm consumed with curiosity!

meichler said...

All this talk is reminding me of an organ donor who ended up infecting the recipients of his organs with HIV and hepatitis. They tested the organs but they believed after the fact that the donor had contracted the viruses very recently before death and his body hadn't produced antibodies yet.

The whole idea of donating or receiving blood gives me the willies and I'm somewhat glad that I have an excuse for why I don't do so. However, the fact that I'm not allowed still makes me really mad.