Thursday, July 29, 2010

Please Don't Give

Months have passed and I am still having a hard time losing the extra pounds that I gained during the last holiday cycle. This has meant that, with the flexibility of summer, I am trying to maintain my regular gym schedule at least until I depart for an extended trip. My time at the local sports club involves a singular vision of trying to improve my gayish figure.

My steely cold determination was briefly interrupted the other day. Two kindly older men stealthily flanked me as I scanned my membership card. If I were still in TexAss, I’d fear that they were on a mission to save my soul. Given that I was in Midwestern Funky Town, I suspected that they were on a mission to save some whales.

“Would you like to make a donation of blood today?” the eldest one asked with a pleasantly grandpa-demeanor. See? Midwestern Funky Town is so nice. “Sorry,” I responded, “I would like to, but I’m gay and they won’t take my blood.”

No sooner had the words left my mouth than a sudden wave of “stop” swept across the gym reception area. You might have thought that I had reached into my gym bag for a rubber chicken, slapped them in the face with it, and then wet the floor. They didn’t have the look of a deer in headlights. They had the look of somebody who saw a deer driving a car while smoking a cigar. Something had just been said that made no sense at all to them.

Surely many people had declined the opportunity to donate blood through the day. I couldn’t have been unique in that way. For the first time, though, they were faced with a totally unexpected reason why I wouldn’t (actually can’t) donate. They looked at me nervously before regaining their composure.

“No, that’s not true!” they exclaimed in unison. “They want everybody to donate!” Many people do not know that there is a ban on men-who-have-had-sex-with-men (MSM for short) from donating their blood. Unless you donate blood (and you should), you don't need to really think about the blood ban or be informed about it. It did surprise me, though, that the volunteers for the Red Cross were as unaware. It was at this point that I realized I was going to have a queer education moment. Man, all I wanted to do was lose a few pounds before heading to Spain. Next thing you know, I have to wade into thorny questions of health policy.

One of the nice men brought out the guidelines for blood donation. “I’m sure you’ve been misinformed,” he said to me sweetly, “All you have to do is answer these questions.” He quickly skimmed through the list and, much to his surprise, found the bit that refuses blood donations from “a male who has had sexual contact with another male, even once, since 1977.” Now, I don’t like to brag, but I have had sexual contact with another male more than once in the era post 1977.

This measure is a hold over from the bad ol’ Reagan days. The Food and Drug Administration, reacting to some real cases of HIV infection from blood transfusion, developed these guidelines circa 1983. It’s hard to remember, but so little was known about the disease and the panic so great that the FDA’s decisions appeared sensible in the mid eighties.

Much has changed since that time. Testing and screening of blood has become much more advanced. Alas, the FDA refused to revisit the ban on gay donors this past June. It seems a darn shame to me as donating blood is one of the easiest forms of community service one can do. Trust me, I’d much rather have a needle in my arm for 10 minutes than spend hours picking up trash on some highway somewhere.

I first donated blood all the way back in high school. Back then, since I was deeply in the closet and not having sex with anybody else, I had no problem answering those questions. Once I came out of the closet and my consciousness was raised, so ended my blood donating days. If the ban were not in place, I'd be more than happy to start donating again (GayProf always plays safe and has himself tested regularly like all good little gay boys).

The FDA reasons that MSM are simply too great of a risk group. I understand the logic there and the FDA authoritatively tosses out some pretty grim statistics about the prevalence of HIV among gay men. There is a pesky problem, though, that HIV is also prevalent in other populations. African Americans accounted for over half of the new HIV diagnoses in this country for the past several years. Likewise, Latinos accounted for 18 percent of new cases. I shudder to think of the FDA announcing a policy that refused blood based on one’s racial background.

About a third (31 percent) of new HIV infections occur from “High Risk Heterosexual Contact” according to the CDC. Young heterosexual women, in particular, are being diagnosed with HIV at alarming rates. Every 35 minutes in this country a heterosexual woman is informed that she has tested positive for HIV. Many heterosexual women continue to naively imagine that “safe sex” for them only involves avoiding pregnancy. They might be surprised to learn that HIV infection was the leading cause of death for black women aged 25–34 years; the 3rd leading cause of death for black women aged 35–44 years; the 4th leading cause of death for Hispanic women aged 35–44 years. Overall, HIV infection is the 5th leading cause of death among all women aged 35–44 years and the 6th leading cause of death among all women aged 25–34 years.

Yo, stratighties -- Use a condom!

If the FDA was really interested in cutting down the odds of blood donations that might be HIV+, then they should start an active campaign targeting the population the least affected by HIV: lesbian-exclusive women. Imagine how differently the world would look if we depended upon lesbians for our nation’s blood supply. They could ask for everything from equal-pay-for-equal-work to a law requiring sensible shoes.

I won’t entirely fault the FDA and other agencies for taking measures that they imagine will reduce the risk of HIV infections in the nation. They also aren’t alone as the same standards are used by Canada and the EU (Yep, even Canada). It seems to me, though, that the ban on gay men provides a false sense of security and continues to erroneously construe HIV as being mainly a gay male issue. The policy also presumes that one’s safe-sex practices (among others) aren’t the real concern. Rather, it takes a short cut by implying that all man sex is scary and dangerous and hetero sex is a-okay (unless you pay for it).

Because acceptance of gay men and lesbians increased exponentially over the past decade, many people assume that the fight for our basic rights is basically over. It is important to bare in mind, though, that being treated as a second class citizen is not just about being denied rights for things you might want in your personal life (equal marriage, partner benefits, the ability to adopt human worm larvae). Second class citizens are also prevented from contributing to the collective whole, like serving in the military or participating in blood drives.

The volunteers were clearly a bit hurt to find out that I was right about the gay ban. To them, donating blood must have seemed like such an obvious social good that it couldn't possibly involve any political concern. It must have been like finding out that your favorite, sweet old aunt had secretly been sending money to the Ku Klux Klan for years.


Belle said...

Yowza! I didn't know those stats - thanks for educating me. I too am refused when I offer to give blood, plasma, whatever. I take meds, and that little cocktail keeps me out of the line. Forever, unfortunately. They were thrilled to find my blood-type and willingness to donate plasma.

Will we never be rid of Reaganesque mindsets?

dykewife said...

i used to be a regular donor. having b+ blood, i was in fairly high demand, however, i figure if the canadian blood services (red cross got sued and was removed from blood collection in canada because of the hiv infected blood products that were distributed even after testing was available) is so replete with blood they can refuse healthy gay men as donors, then they don't need my blood. i haven't donated in years because of that.

when the policy changes, perhaps i'll donate again. then again, i might end up too old for them by that time.

tornwordo said...

I was surprised to find the same ban in place here, progressive socialist land. I think it boils down to people not wanting any icky gay blood that might give them cooties.

FrauTech said...

It'd be really nice if instead they asked about safe sex practices and whether you had sex with someone who you knew to be HIV positive or with someone who's HIV status who did not know. That would rule out plenty of straight people who aren't practicing safe sex.

Really, the red cross should do better at testing for HIV and a whole host of other blood transmitted things. Then they won't have to rely on exclusion or honesty for safe donation.

I used to work at an HIV clinic. Given that AIDs medication is a bit more advanced now than it was a lot of middle class people can get their meds safely through their health insurance. So we were mostly serving lower income or people who didn't have access to health insurance for other reasons (which clearly is still a lot). We had a questionnaire each week and I was always astounded at the answers. Since all our patients were HIV positive, the questions were "Did you have sex with someone in the past two weeks?" most times it was yes. "Did you use a condom?" 95% of the time it was a no. I was stunned that all these people who were HIV positive were out there practicing non-safe sex. You'd think them knowing their own status, and being aware, would have helped. It's a scary world out there.

Old Lurker said...

Oh man. Thorny is right. Given the lamentable dry spell in my love life, I am still eligible to give blood, and I've gotten plenty mad at the screening criteria plenty of times.

Sadly, Canuckistan practically does screen blood by race, although the restrictions are couched in terms of geography, not ethnicity. See questions 6,7,8 and especially 30 on this PDF . Over the years the criteria for question 7 have been getting narrower, and those of question 30 have been getting broader. The actual screening criteria are a little more subtle than the questionnaire indicates, but that's kind of the point: the blood people are unfriendly to all kinds of people, not just the gays.

Frank said...

"Now, I don’t like to brag, but I have had sexual contact with another male more than once in the era post 1977."


dykewife said...

there's a present for you on my blog. i promise you'll like it.

shaz said...

You are so ahead of the curve - see today's NYT piece:

Come Down Under -- Australia allows donation with a 12 month deferral. (dry spell=channel excess energy to social good of blood donation?) Oddly, you get a 4 month deferral for acupuncture as well. I, having lived in the UK in the 80s, am still permanently banned, alas...

Blake said...

I also remember the first time that I realized I would no longer be able to donate blood: sometime around the end of college. (It took me a while to actually put my queerness into practice.).

While I understand their desire to keep as much HIV-positive blood out of the system, not only do I fully agree with all of your observations, but I would also ask: they are testing it all, right? So if they know that at least SOME of the blood is going to be HIV-positive no matter what and no matter who it comes from, and their tests are going to find that blood, where is the sense in excluding only one group, especially in light of all the growing evidence you cite that demonstrates that it's becoming more prevalent in lots of other groups?

It kind of makes me feel a little leery about their own faith in their tests...

susurro said...

you had me until "to a law requiring sensible shoes" and then my big ol' femme frown showed up atop a pair of 3 inch goddess gear. This and you are going to Spain a full month after we got back ... come on!

Seriously tho, I'm glad to see someone link the alarming infections rates amongst AfAm and Latina women to the donation ban, both for the ways it highlights a growing "new" problem and an old one (ie ban on MSM donors). The more we can talk about these things as equally important the better. And hey, I'm sure the 101 class in the gym was not your first choice, but just think what those two guys said to the red cross, the volunteer coordinator, and probably even most of their fam and friends when they got back to the donation station. Sometimes it is those convos that matter the most

Dorothy Potter Snyder said...

What a wonderful piece. I agree with you that the majority are uninformed about social restrictions on those you tongue in cheek call "second class citizens" and assume that there is no more social prejudice here "in the best of all possible worlds", AmeriKKKa". But then, the majority are just living their somewhat limited though well-meant lives without the benefit of much real information about anything.

Far right mad cow commentators like Glen Beck have taken up the banner of Martin Luther King recently, so perhaps we could get Beck to take up the banner of gay rights? What say? Wouldn't that be fun, now!

Robin said...

Hear hear. The gay ban on blood donation is terribly outdated and therefore dumb.

I'm in a slightly different boat. After a blood drive back in college, I received a letter from the Red Cross telling me that they'd found Hep-A antibodies in my blood -- from when my dad a mild case when I was a kid and they inoculated us, so I never had it myself -- and please don't ever try donating again. And I'm O-pos (nearly universal donor), so I'd like to be able to.

Rebekah said...

Like you, I found the ignorance of the volunteers startling.

I've donated blood many times; then about 15 years ago I was turned down.

I had Epilepsy as a child, and all of a sudden, no more donations. Even though I'd done so before. Even though they couldn't show me where it says I can't donate because of it.

I want the blood given tested no matter what; if it is done, why leave out 10 or more percent of the society? They would catch any problems anyway, right?

Well-written piece gayprof. You made me think.