Paul's Internet Landfill/ 2022/ Canadian Blood Services Allows (Some) Gay Men to Donate Blood

Canadian Blood Services Allows (Some) Gay Men to Donate Blood

Heads up: I am not putting this entry under an nsfw tag, but it does discuss sexual practices frankly. This may not be your cup of tea.

So the long-standing campaign has succeeded: as of the end of September, Canadian Blood Services will permit some men who have sex with men to donate blood. The promise is that Canadian Blood Services will now screen on sexual behaviour, not sexual orientation. As far as I can tell this is not really true, but it is more true than it used to be.

I am moderately grumpy about this development, but overall I think it is an improvement to the old policy.

Here are the new rules: if you have anal sex within the last three months with multiple partners or a new partner, you are deferred. Otherwise, you can potentially donate (if you pass the other screening criteria).

Who wins under this policy? The heteronormative gays who think they are just like straight people except for whom they marry will be thrilled. Since those are the gays with prestige and money, I expect others who are discriminated against by the policy to be thrown under the bus and forgotten. Maybe CBS has some incentive to avoid alienating the trans community (again, because of straight person solidarity) but I think most other sexual minorities who are prohibited from donating blood will be invited to chew dirt.

Who loses under this policy? Anybody who has anal sex in stable multiamorous relationships lose. That can include straight thruples who would have been eligible to donate before.

Does this make the blood supply safer? I do not think it changes the situation much. Those who were boycotting CBS because of the ban might now donate, which could increase the supply of blood. I expect a large influx of gay men donating when the ban is lifted, but I question how many of those men will continue donating on a regular basis. I continue to maintain that the primary motivation for Canadian Blood Services in modifying the ban is to ensure a steady flow of straight donors, and that their discriminatory policies threatened that flow.

On the other hand there will probably be a few more HIV+ men who attempt to donate blood. Many of these donations will be inadvertent because the donators think that they are monogamous when their partners are not. I expect other donators will will lie, but I do not think this will be common. My guess is that people who are HIV-negative but sleep with HIV-positive people will continue to be banned, even though the modern catchphrase is "undetectable is untransmissible".

Is this decision political? Oh yes. Tinder exists, but Canadian Blood Services does not want to turn away straight people in their 20s who have many sexual partners. That is why the ban is solely for anal sex, and not vaginal sex. There is some medical justification for this; one article I found claims anal sex is 18 times riskier than vaginal sex. Clearly, however, vaginal sex with concurrent partners is a risk factor for transmitting HIV -- the AIDS catastrophe in Africa happened via straight, presumably vaginal sex. There was a longstanding criticism that the gay blood ban did not take into consideration promiscuous straight people, and for the most part this is still the case.

Along the same lines, it is political that promiscuous oral sex is permitted. If it had been banned then CBS would have faced accusations that they were discriminating against gay men by another means. Allowing oral sex is probably okay medically, as it is less risky than vaginal sex for HIV transmission (but is highly risky for other STIs).

It will be interesting to see whether the Canadian Blood Services definition of sex changes. As it stands sex is defined as contact between penises, anuses, and mouths (other than mouth to mouth kissing). The current definition holds regardless of whether condoms are used. This definition is used for a number of the screening questions. But this new anal sex screening question changes that definition of sex. Will there now be two definitions in the questionnaire?

At one point there was also a question about whether you had had an AIDS test in the last N months, other than for giving blood. I do not know whether that question will remain. Similarly, there is a question whether people are on PrEP. These two questions are counterproductive to public health (people should get tested for STIs, and people who have anal sex with strangers should be considering PrEP) but they are good screening questions.

How does this affect me? Not much. I am quite angry at CBS for some recently-adopted trans-hostile policies they adopted (which I thought I wrote out here, but maybe not?). I am continuing to donate for now, but I do not think I will donate much longer. I do not expect the status of my sex life to change anytime soon, but if it did I might self-defer for a while.