Prejudice in blood donation sucks, but Canadian Blood Services isn’t the source

Hold Health Canada and others accountable; CBS is doing what they can

As blood shortages become a recurring problem for Canadian Blood Services, their relationship with non-straight donors is called into further question. We know the controversy: restrictions against sexually active gay men donating blood.

Last year, Canadian Blood Services changed their restrictions on male blood donors: instead of five years of abstinence from oral or anal sex with other men, only one year is required. Although this is significant progress, I would like to see more accountability for the prejudice that has prevented gay men from donating for decades.

It would be too easy to completely blame Canadian Blood Services, but to my surprise, Canadian Blood Services themselves took charge in reducing the five-year restriction to one year. Who, then, argued against it? Why did it take so long to shorten the time?

According to the Canadian Blood Services online FAQs, back in 2006, they consulted with experts about potentially lowering the bar (at that time, gay men were barred from donation entirely). “Patient advocacy groups . . . [supported] . . . a five year deferral period but nothing less.” That change happened in 2013, after “extensive review of scientific and epidemiologic evidence,” and “a minimum of two years of data was required for re-submission to Health Canada to support a further change.”

The evidence suggests that Canadian Blood Services, at least, is taking initiative on lowering prejudicial restrictions as much as reasonably possible. The root of the continued ban stems back to the “patient advocacy groups” and Health Canada, and there appears to be little clarification of those group’s reasoning at that time beyond a mention of  “extensive review of . . . evidence.” Does this mean that the one-year deferral change is the best we can do?

It’s definitely not the pinnacle of progress, and continuous work must be done to reduce that number further. We should be able to aim for a time where such a deferral can be dismantled completely. But unilaterally blaming Canadian Blood Services doesn’t help. Like the rest of us, they are obstructed by the rules other have set, and they’re doing what they reasonably can.

However, I would like to see an official apology from the advocacy groups and Health Canada, publicly recognizing their fault — it’s clear based on the recent data that the previous restrictions, at least, were certainly excessive. Whether or not they feel that they had good reason for the past mistakes, they need to recognize how they have perpetuated institutional prejudice.

Outrage can be a positive force of change, but we still have to be careful where and how we direct it. If we want real progress in this regard — progress that lets us save more lives and indulge in less injustice — we must keep the right parties accountable. If we can do that, we’ll be that much closer to a future where the important work of blood donation isn’t undercut by policies borne of fear and not rationality.

The actual frequency of same-sex sexual behaviour is up for debate, but for the moment, let’s assume, based on Alfred Kinsey’s research, that about 13% of men are gay. In 2016, Stats Canada reported the Canadian male population to be about 17,995,000*. That would mean approximately 2,300,000 gay men — 2,300,000 possible donors — face this bleak deferral if they aren’t abstinent.

If one blood donation saves three lives on average, and men can donate every 56 days in Canada, then theoretically, we could save up to 32,400,000 more lives per year if the limit was relaxed.

Even with much more conservative figures — let’s assume 1% of men have sex with men (a number lower than most averages), and given that only 1 in 60 Canadians successfully donated blood last year, let’s assume that only 1.6% of those men end up donating in Canada — that’s still about 60,000 more lives that could be saved every year.

In a future where blood donation is free of inequality, those are the lives who benefit. Hopefully, the groups who aren’t working toward that future stop to consider that.

*Update 09/07/2017: A mathematical error in the final calculations was corrected.