We humans

Homophobia in our blood

Jun 22, 2016 /
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Homophobia and mass shootings are afflictions that won’t be solved overnight — but the problematic and outdated restrictions against gay blood donors could be.

Nothing rubs salt in the wounds of tragedy like bigotry or bureaucracy — or both. But that is just what happened last week after the shooting at the gay nightclub Pulse in Orlando. With 49 people killed and 53 people injured in the shooting, members of the LGBTQ community rallied to donate at OneBlood, Central Florida’s largest not-for-profit blood donation center. Sadly, one of OneBlood’s own employees, Rodolfo Ayala-Ayala, was one of the victims.

Initial reports from several respected news sites indicated that OneBlood would be welcoming all blood donors, but hours later on that tragic Sunday, OneBlood tweeted a correction:

“All FDA guidelines remain in effect. There are false reports circulating that FDA rules are being lifted. Not true.”

Guidelines? Yes. Certain segments of the population are banned from giving blood, foremost among them sexually active gay and bisexual men. It’s a ban that has been in place since the ’80s, a ban which many say is as groundless and outdated as sodomy laws.

The tragedy in Orlando has brought to surface a medical directive that some call entrenched homophobia. “We find ourselves in a situation where the victims directly affected by this tragedy and in need of lifesaving blood are the very people banned from donating it,” the grassroots advocacy organization National Gay Blood Drive posted on its website. When a slightly less restrictive policy was issued, Dan Bruner, the senior director of policy at Washington, DC’s longstanding HIV clinic, Whitman-Walker Health, released a similar statement: “The updated policy is still discriminatory and not rooted in the reality of HIV testing today. The deferral period should be no longer than 30 days.”

Is the blood from a gay man really that much more tainted and possibly dangerous than others? It’s an assumption that has been in place for over 30 years — but it also exposes a troubling fear of gay men that may have been in place even longer.

How the ban began. In 1983, as the AIDS epidemic began to grip the nation, the Food and Drug Administration enacted a total ban on blood donations from gay and bisexual men in an attempt to keep the HIV virus out of the blood supply. At the time, it was warranted. More than 14,000 people acquired the disease from blood transfusions before donated blood was tested for HIV starting in 1985.

But the ban has lingered. It was only recently that the FDA began to open things up. Slightly. As of December 2015, the current directive is to turn away gay and bisexual men from blood donations if they’ve had sex in the past year. According to a 2010 study by the University of California at Los Angeles, lifting the ban could increase the total annual supply of donated blood by 4 percent — as many as 615,000 pints per year.

The 12-month abstinence restriction is becoming something of a new international standard. Just this year, France changed its policy from a flat ban on gay men giving blood to a requirement of 12 months of abstinence. The Netherlands largely follows the same policy. Several countries, like Austria and Venezuela, still have a unilateral ban in place, but some countries have done away with the ban altogether. In 2013, Mexico enacted a law that eliminates blanket bans on gay and bisexual men and instead bans blood donations from people with HIV or hepatitis and their partners and people who engage in “risky sexual practices,” regardless of their sexual identity.

As the Washington Post reported, OneBlood’s guidelines haven’t even caught up to the FDA’s most recent standard — it’s still turning away all gay men from donating. (OneBlood’s spokesman Pat Michaels states that the foundation’s system will be changed later this year.) But for the moment, it’s more difficult to donate blood as a gay man in Florida than to buy an assault rifle.

Discrimination or precaution? The screening of sexually active gay men seems especially egregious when one considers the larger population and their sexual lives. What about the single straight man going out on a different Tinder date three times a week? What about the bisexual woman in a polyamorous relationship? Both are arguably at risk of contracting the HIV virus and other diseases just as much as a sexually active gay man — especially if they aren’t using condoms. If the defense of the ban is that sexually active gay men are statistically still at high risk, then what about other demographics who have particularly high rates of HIV who have not been disqualified from donation? African-American women, for example, also have high rates of contracting HIV, but are not singled out.

The ban makes even less sense with today’s advances in the testing of blood, which is more extensive, faster and cheaper than ever. Blood donations are tested for HIV-1 and HIV-2 antibody (anti-HIV-1 and anti-HIV-2), hepatitis B and C, syphilis, and even Trypanosoma cruzi, the agent of the tropical parasitic Chagas’ disease. Terrell Foster, a USAF veteran and gay-blood donation advocate, comments in a TEDx talk on the subject, “Our technology has improved significantly since the dawn of the HIV crisis, and today’s tests can detect the presence of HIV just two to four weeks after a potential exposure.”

The need for blood. This exclusionary approach to blood donation would be less of an issue if the blood wasn’t needed. But every two seconds, someone in the U.S. needs blood. According to the University of North Carolina, between 41% and 71% of the United States population will need a blood transfusion at some point in their lifetime.

It’s more difficult to donate blood as a gay man in Florida than to buy an assault rifle.

But only an estimated 38 percent of the U.S. population is eligible to donate blood. Besides being gay, there are 30 factors — ranging from recent tattoos to heart disease to anyone who has taken Tegison for psoriasis — that either make a person’s blood unsafe or make it unsafe for a person to donate blood. Unfortunately, every year fewer than 10 percent of the eligible population of donors actually donate. Many, according to the Red Cross, don’t donate because of a fear of needles. (For a handful of others, donating blood has even joined the conspiracy theory list along with contrails and vaccines. Sara O’Brien, the external communications manager of the American Red Cross for the Northern California region, says some people believe that the Red Cross inserts a government microchip when taking blood.)

Another problematic aspect of the policy is that being hyper-vigilant about HIV and other known issues can actually obscure the fact that other viruses could be posing a greater threat. The Zika virus, for example — one of a new crop of infectious diseases — is posing a risk to the blood supply. A big concern is that a major new blood-borne disease in the U.S. could have an impact similar to the AIDS epidemic in the early 1980s. “With respect to known infections transmitted through blood transfusion, we’ve come a long way through donor screening, but there are new and emerging infections you don’t realize until they are on top of you,” Lynne Uhl, chief of the division of laboratory and transfusion medicine at Beth Israel Deaconess Medical Center in Boston, told the Wall Street Journal.

The business of blood. Blood donation is — in a very American way — a business. A $4.5 billion business, to be exact. The American Red Cross supplies just 40 percent of the nation’s donated blood. Some countries have a nationalized blood system, but the US relies on a patchwork of blood centers like OneBlood and hospital blood banks.

Blood is sold by the pint on the open market — at a high cost. In a 2013 report by Channel Five News in West Palm Beach, Ben Bowman, CEO of General Blood, a national for-profit blood brokerage firm, was refreshingly transparent about the business of blood. “It depends on where you live,” he says. “In Miami-Dade/Broward you’re probably looking at about $200 for a pint, whereas one of our associates just got back from Seattle and said parts of Seattle are paying $600 for the same pint.”

Essentially, in the for-profit blood donation industry, gay male blood is treated like “bruised apples.” “The current stigma surrounding gay men and our blood makes our blood less valuable, and thereby less profitable to those in the business of selling blood,” says Foster.

Homophobia is next to cleanliness. Advocates for a wholesale lift of the ban point out that today, since all blood is tested and HIV tests are virtually instantaneous, there’s no sense in the restriction. This ban essentially excludes a segment of the population for no real reason except cultural bias. It exposes an inner queasiness society still has with gay men — a vague conviction that gay men are somehow “unclean.”

Unclean. That word has been used for a lot of racist/phobic feelings, used to rationalize a myriad of other prejudices, against blacks, Jews, Middle Easterners, Indians and even women.

David Pizarro, an associate professor of psychology at Cornell University, has done extensive research into the link between moral judgment and emotions. Among his focuses is how our emotional reaction to feelings of disgust creates judgment of others, and how being easily disgusted correlates with being socially conservative. He has documented an entrenched attitude toward gay men in particular. In ongoing work, Pizarro and his colleagues have shown that manipulating disgust with a noxious odor leads to more negative attitudes toward gay men. “We asked participants to simply give us their opinion of a variety of social groups,” he explains in his TED Talk, “The strange politics of disgust.” “When the room smelled gross, what we saw was that individuals actually reported more negative attitudes toward gay men. Disgust didn’t influence attitudes toward all the other social groups that we asked, including African-Americans, the elderly. It really came down to the attitudes they had toward gay men.”

Tellingly, LGTBQ people were recently reported to have surpassed Jews as the segment of our country’s population most victimized by hate crimes, more than any other minority group.

The blind eye. Along with this institutionalized disgust, there is simply a lack of perception that the restrictions on gay blood are a problem. “I can’t tell you how many people I’ve encountered on the road to this presentation who had no idea that this was even an issue; they simply didn’t know,” says Terrell Foster about his recent TEDx talk. But the awareness is growing. In October 2015, artist James Eagle created Blood Mirror, a sculpture shown at the Trinity Church in New York, that spoke about the “blood inequality” in our culture.

Earlier this month, college student and activist Jay Franzone declared that he would abstain from sex for a year to highlight the antiquated policy. “When our community is attacked, we want to help,” says Franzone. “We want to be there. But we can’t because we’re gay. Discrimination is still alive and well in outdated federal policies.”

It wasn’t until the Orlando shooting that the world woke up to the issue, as gay men trying to help their community were turned away, or discouraged from even trying. Perhaps the exposure of this discrimination will prove to be one positive outcome. Sometimes it takes tragedy to open eyes and minds. Maybe now the nation will see how homophobia lurks in places we’re not even aware of — even right there in our veins.