Pride 101: Blood donation bans

In 1983—at the height of the HIV and AIDS epidemic in the United States—the U.S. Food and Drug Administration instituted a lifetime ban on blood donations from gay men (specifically “men who have sex with men” or MSM, a distinction necessitated by a sizable population of MSM who refuse for any number of reasons to be identified as gay or bisexual).

The ban was actually even broader than that; it also included women who have sex with MSM and—irrelevantly in this specific context—transgender people. At the time, HIV was—and was perceived by the broader population to be exclusively—a “gay disease” and was gleefully used by religious hate groups to perpetuate their vilification of—and mock and exploit the deaths of—gay people. The ban was an extreme measure, but as 1980s technologies in HIV detection weren’t very effective it was seen as prudent—with no resistance from leading gay organizations—and it no doubt prevented an even larger American HIV epidemic.

As HIV spread beyond the gay-male population, the infection demographics leveled out and HIV-detection technologies advanced, in 2015 the FDA guidelines regarding blood donations from MSM were reduced from a lifetime ban to a one-year-of-celibacy requirement.

But these requirements served no purpose beyond discrimination; the Insti HIV test—which had been introduced nine years earlier and was considered to be the most accurate and convenient of all technologies, requiring just a small finger prick—had a 99.96% accuracy rate, with results provided in one minute. There was literally no medical or ethical reason to single out MSM for this ongoing ban.

Then in April 2020—as blood supplies dwindled to crisis levels at the dawn of the COVID-19 pandemic—the one-year celibacy requirement was reduced to three months.

Still, the institutionalized discrimination was not eliminated; a man who had protected sex with one other man in the previous three months was not allowed to give blood, but—for instance—a woman who had unprotected sex with multiple men in the previous week faced no such restriction. (For the record, the relatively small populations of people with certain medical conditions, people on certain medications and people who have had blood transfusions have always been subject to other restrictions and bans.)

With often desperately low stockpiles of donated blood in the United States and with advanced testing and medical knowledge, there was literally no reason at the time to keep specifically restricting blood donations from MSM based on outdated demographic medical information and stigmas regarding HIV.

But after decades of discrimination, medical progress, lobbying, and a slow dawning of equality and common sense, we’ve finally eliminated the MSM-only restrictions. In May 2023, the FDA overhauled its screening process for all donors by simply asking a series of preliminary questions about recent sexual activity, drug use and HIV exposure and imposing reasonable restrictions for everyone based on the responses.

After literally four decades, the march to erase unreasonable homophobic stigmas and embrace 21st Century medical knowledge finally achieved its goals, and MSM without legitimate risks are proudly—despite the humiliation and discrimination of the historic bans—stepping up and doing our part as blood donors.

THIS IS WHY WE CALL IT PRIDE.