Do Something Amazing – Give Blood?


It must give a person a truly remarkable feeling when they are able to give blood and potentially save another person’s life. I imagine that, despite feeling a bit dizzy and nauseous, there is a sense of pride that they could really be giving something back to the community. Of course, I wouldn’t know anything about it because, unfortunately, I am unable to give blood. Not because I have some rare genetic defect, or even because I have had a cold. I am not able to give blood simply because I am gay, or as the Give Blood website so eloquently states it; “men who have had sex with men”.

Obviously, I knew all this as old news, but beyond the HIV and AIDS issue, I have never totally understood their justification for it. With that in mind, I did a bit of reading on their website to try and understand the full scope of their reasoning. After all, they have a whole page set up to answer my queries. A statement which was issued in November 2011…

Deferral of Men who have Sex with Men from Blood Donation

The permanent exclusion of men who have had sex with men (MSM) from donating blood has changed to a 12 month fixed period deferral from the latest relevant sexual contact following an evidence-based review by the Advisory Committee on the Safety of Blood, Tissues and Organs (SaBTO).

Yup. I knew about that bit.

SaBTO is responsible for regularly reviewing the major criteria for accepting blood donors and for recommendations to the four UK Health Ministers on blood donation policy.
Well, that is good. Regular review is very good. Although I do have to wonder how regular this ‘review’ is, considering the last statement was issued in November 2011.

SaBTO completed a review of blood donor selection criteria related to sexual behaviour in May 2011. Following this review, and based on recommendations from SaBTO, Health Ministers in England, Scotland and Wales announced in September 2011 that the blood donor selection criterion for men who have sex with men in those countries would change.

Previously, men who had ever had oral or anal sex with another man, even if a condom was used, were permanently excluded from blood donation in the UK. The change means that only men who have had anal or oral sex with another man in the past 12 months, with or without a condom, are asked not to donate blood. Men whose last sexual contact with another man was more than 12 months ago are eligible to donate, subject to meeting the other donor selection criteria.


Again, I knew all this already. What I really want to know is WHY?

NHS Blood and Transplant (NHSBT) implemented the change at blood donation sessions across England and North Wales on 7 November 2011. The Scottish and Welsh Blood Services also implemented the change on this date.

At blood donation sessions, all donors are asked to complete a questionnaire called the donor health check, to assess whether they meet the donor selection criteria. This is to ensure that the supply of blood to hospitals is as safe as possible.


Of course, safety is paramount and so it should be but this still doesn’t tell me how or why my blood is less ‘safe’ than anyone elses?

NHSBT welcomes the review and the resulting change as it is supported by the most up to date scientific evidence. SaBTO's review concluded that the safety of the blood supply would not be affected by the change and we would like to reassure patients receiving transfusions that the blood supply is as safe as it reasonably can be and amongst the safest in the world.
Well isn’t that kind. They are reassuring the patients that are, strangely looking at a page which is supposed to explain why I am exempt, in a complete panic that they might get ‘gay-blood’!

Clearly, any transmission would be one too many and the purpose of blood donor selection criteria, alongside other safety measures, is to minimise any potential harm to recipients of blood donations. All groups that are excluded or deferred from blood donation have been assessed as being at a statistically increased risk of carrying blood-borne viruses.

Finally, we get to the nitty-gritty. I have been assessed, without even knowing it, and I am a statistically a higher risk. Oh, I do love a statistic but how exactly? I have been in a committed relationship for just shy of 8 years and married for just under a year. I know people who have been in far shorter committed heterosexual relationships who are still allowed to give blood. Surely anybody that is single carries a higher likelihood of having sex with any number of people? Since I have been in a committed relationship I am statistically far more likely to be ‘safe’ am I not? So then, are they implying that, since I am a gay man, I am more likely to cheat or that my husband is more likely to cheat on me?

The change brings the criterion for men who have had sex with men in line with those for the majority of other groups that are deferred from blood donation for 12 months due to the risks of infection associated with sexual behaviours. We appreciate that it can be disappointing for anyone who wishes to donate blood but is not able to meet the donor selection criteria. The criteria are based on complex assessments of risk and must by their nature be based on evidence and statistics that are recorded at a population level. Such an approach results in assessments of certain groups as being at a higher risk than others of carrying blood-borne infections and can make individuals that are deferred from donation feel they are being placed into a "category" even if they believe their own sexual behaviour and risk-taking would not be a risk to the blood supply.

So essentially, what they are implying here is that gay men are, en masse, a bunch of whores that are far more likely to sleep around unprotected, more so than heterosexual men for instance. Nice! Of course, I do know a few gay guys who do get their fair share of action but in all honesty, no more so than some of my straight friends, both male and female. In fact, I would say it is pretty well balanced on both sides when it comes to the number of people I know who are sexually active. Is there a rule that prevents a straight man who has had unprotected, or even protected, sex with a woman within the last 12 months from giving blood? Nope. Funny that. The last time I checked, blood viruses are pretty indiscriminate and will take host in both male and female bodies. The chances are just as likely that they could pick something up from a woman as they could another man surely?

Or, are they actually implying something far deeper here? Perhaps the organisation feels that a straight man that is sleeping around unprotected is far more unlikely to even want to give blood in the first place? Perhaps it is some kind of a backhanded compliment that the organisation feels gay men are more community-minded and more likely to put themselves out to help someone else and therefore more protections are needed? Ok, so I am probably getting way ahead of myself but you have to admit, the implications of what they are stating are very interesting.

Although some would prefer a system that assesses every individual's behaviour and level of risk rather than applying deferrals to groups, SaBTO's review concluded that there is insufficient evidence available to be able to determine the impact on blood safety of such a system. It is also not certain that all people could objectively assess their own level of risk. Based on published data, the review also concluded that the introduction of extensive donor questions regarding sexual behaviour could lead to a loss of existing donors who may find the process intrusive. The Blood Services are therefore required to follow deferral rules that estimate the statistical risk of certain groups based on behaviour. We are sorry for any inadvertent offence this may cause.

So essentially they have made a broad sweeping (and quite frankly bullshit) generalisation. They have made this generalisation which is certainly offensive - I don’t appreciate being made to feel like some kind of slag – rather than ask someone a few more sensitive questions. They are concerned about losing donors because they may find the process more intrusive? What, more intrusive than having a needle stuck in your arm and blood extracted from your body? Surely, the sort of person that is giving blood is doing so because they want to help and certainly wouldn’t want to put anyone at risk and therefore would be more than prepared to be completely open and honest.

Quite frankly, if it is, “…not certain that all people could objectively assess their own level of risk” why is it better to trust their honesty and their personal recollections and judgement on their sex life in the previous year. For that matter, why a year? Do HIV and Hepatitis disappear in a year? It certainly doesn't. This is the why they screen all of the blood given anyway and if they are screening all of the blood as a matter of course, what difference does it make if a gay man donates. THEY ARE GOING TO CHECK THE BLOOD ANYWAY!

Furthermore, the analysis of the published data has led to an estimate of the statistical risk of certain groups based on behaviour. An ESTIMATE! So essentially, an educated guess then? Does that not then imply that actually, all of the rules about who can give blood are based upon an estimate of statistical risk? It is hardly foolproof, is it? This tells me that they are admitting that there is no sure-fire way of knowing and that they are quite happy to take certain risks over others. This is people’s lives we are talking about here! If somebody needs a blood transfusion I’d say it is pretty likely that whatever has happened is damn serious, potentially life-threatening stuff and they are happy to supply blood that has been taken because an educated guess says it is safe to do so! Wow, don’t I feel safe in the hands of the NHS now. I don’t know about causing an inadvertent offence, I am bloody terrified!

Blood donation works on the principles of kindness and mutual trust and we ask all potential and existing donors to adhere to the blood donor selection criteria by providing completely honest answers to all the questions asked, both for the protection of their own health and that of others. Donor selection criteria that are proportionate and based purely on evidence are necessary to help ensure that donors comply with the health check process. Compliance with all donor selection criteria is crucial in order to ensure the continued safety of the blood supply. Anyone may require a blood transfusion in the future and it is in the best interests of us all to ensure that we strive to maintain blood safety.

It certainly does work on kindness and mutual trust. Anyone who is prepared to be drained of a pint of blood obviously isn’t thinking solely of themselves! Clearly, these are values that, as a gay man, I do not possess and I must be pretty damn selfish. They ask for completely honest answers to all the questions asked and so by default because I am a gay man I am potentially a liar too. So far they have done very little to answer my questions and a lot to really offend me!

Why can I not go and see my doctor who can regularly test me to determine whether my blood is safe? If they are prepared to take blood from a ‘man who has not had sex with a man’ within the last 12 months, why are they not prepared to take blood from a man who has been tested and cleared within the last 12 months? I am guessing that in some cases it can take months for particular viruses to show up in a blood test and this is what guides the 12-month stipulation. Is it not the case that the estimated risk is greatly reduced for a person who has been ‘tested’? It is obviously not sufficient enough a reduction then.

For a page that is there to answer my questions, it really hasn’t helped and it certainly has not supplied me with any concrete justification for the rules. In fact, the far from concrete stability of these rules highlights just how potentially dangerous the whole system is, irrespective of sexuality.

I think I will just keep my glittery, slightly pinker shade of red blood to myself then!

Have you ever given blood? Have you ever received a transfusion? What are your thoughts? Let me know in the comments below...

CONVERSATION

2 comments:

  1. If you have been in a committed relationship past their criteria of 12 months then there should be no bar to your donating blood, they should apply that criteria to all, straight or gay. I would be happy to have your blood if I needed it

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    Replies
    1. Indeed Lorna,

      Despite being in a relationship for 7.5 years my blood is deemed unsafe as I have 'had sex with a man within the last 12 months' (obviously) but if I don't sleep with my husband and chose a female partner to have sex with, in 12 months I will be allowed to donate... What kind of sense is this?

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