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treble, songworm

I donated 2 gallons of blood. Not all at once…

… but over the course of several years, a pint at a time.  I started at around 17, when I became eligible, and continued throughout college until they changed the rules.  Few things in life repeatedly make me as angry as when I’m reminded about blood donation and think about all the additional gallons I would probably have donated since college if I’d been allowed to.  If “one donation can help save the lives of up to three people” and there have been many shortages over the years, isn’t the corollary that some people may well have died over the last few decades who could have been saved by some of the blood I wasn’t allowed to donate

— for no rational medical reason at all?  The rule is that a man who has had “sex” with another man since 1977, even once, can’t donate for the rest of his life.  I put “sex” in quotes because they use the phrase "sexual contact” but don’t define it — even though it’s not a medically relevant term, even though every straight teenager (and later, one President) defines the word much more narrowly than I do.  It's a yes or no question and there are no followup questions.  It’s not like the one where they ask “In the last three years have you traveled outside the United States?”  I once saw the donor ahead of me say “yes” to that, and the blood bank worker asked exactly which country and city they’d visited and opened a binder and consulted a map, presumably showing current outbreaks or something scientifically-based like that, and let them donate.  But as I found out the first time I tried to donate under the new rules, there are no followup questions if you say “yes” to sex.  Not according to the local blood bank staff at the time, and not according to Regional Director of the Red Cross, who I spoke to at length on the phone in response to his letter in the late 1980s when there was a severe enough blood shortage that they were double-checking donors they’d deferred. It turns out that even the sexual equivalent of one weekend in Canada is in the same risk category as the equivalent of regular trips deep into tropics, where malaria is endemic.  And that’s how the rule remains to this day, 2014, in the U.S. and some other countries.

To put it in perspective, a man who has sex with a prostitute can donate one year later.  (A female prostitute, of course.)   A man who has sex with a total stranger is considered low-risk enough to donate the next day, if the stranger was female.

(I suppose a woman who has sex with a male stranger would have to wait one year, in theory, because if he’s a total stranger she can’t be sure he had "never had sex with another man, even once.)   A person who actually contracts syphilis can donate one year after treatment.  But a hypothetical man who had protected sex with one other man 35 years before would be considered too high risk, in case the virus goes undetected by the tests.  I thought at first the policy might be a stopgap until there was a reliable way of testing the blood, but the policy was’t changed after they developed an antibody test for HIV in 1985, and it wasn’t changed in 1999 when the more sensitive Nucleic Acid test was developed, which can detect particles of the virus itself within a couple of weeks of exposure.

I’ve encountered a lot of government policies in my life that I think are stupid, but this remains the stupidest one.  By comparison, the ban on full-sized tubes of toothpaste on airplanes is eminently rational.  The donation ban is more like if the TSA decided that despite all the X-ray machines and bomb-sniffing dogs, they should ban all men of Middle-Eastern descent from airports, just to be on the safe side.  (An imperfect analogy, since restricting altruism out of fear of unintentional harm is not the same as restricting travel out of fear of intentional harm, but each one would single out one population when no one is zero risk.)

That’s why I’m excited that the FDA may at long last be replacing the ban with a more sensible rule.

Their advisory committee recommended a one-year deferral.  Apparently the last time they considered it, four years ago, the committee acknowledged the policy was “suboptimal” but advised making no changes.  (Some think that even the loosened policy would be too restrictive, that it’s overcautious to put a monogamous couple who always have protected sex in the same risk category as someone who’s been diagnosed with syphilis or had sex with a prostitute, or a woman who has had sex with an infected man.)

This is one of the most welcome national politics stories I’ve heard in the last couple of years, for me personally.  Is that surprising?  I get the impression that most people would consider the recognition of same-sex marriage in some states to be more significant than the ability to donate blood.  In the abstract, I imagine that being legally wed must have a much bigger impact on the person’s life than spending half an hour at a blood bank a few times a year — from the point of view of the person doing it.  As long as we’re talking about personal perspective, my own is that I don’t currently have someone I want to marry even if I wanted to apply that label, whereas I’ve had an ongoing desire to donate blood that I’ve just been trying not to think about because it makes me angry.  Now let’s consider the two things from a broader perspective.  Blood donation doesn’t seem at all trivial compared to marriage.  Being married versus just living together affects a couple’s legal treatment in a number of ways, some of which can be worked around by a la carte documents or with domestic partnerships, and it may influence how others view the relationship.  Having blood available versus not having blood available can be the difference between living and dying, as they keep reminding us every blood drive.  (It sounds like the reality in the U.S. is that there’s almost always enough for typical emergencies, but some people may not be able to get non-emergency surgery at times.  There’s either a "major shortage of blood" or the blood supply is “stable”, depending on whether you ask the Red Cross or the FDA.)  It's hard to get more significant than that.

I’m now very hopeful that 2015 will be the year the FDA reforms the 1983 rule.

Comments

This rule has always infuriated me, and I really do hope the more sensible rule wins out.