The FDA should lift its anachronistic sanction on gay male blood donations
“I have nothing to offer but blood, toil, tears, and sweat,” Churchill famously declaimed, in a staunch metaphor of national and human resolve. For over seven million American men, however, the U.S. Food and Drug Association has left item number one off that list.
In a policy that has persisted since 1983, the FDA has maintained a lifetime ban on blood donation by men who have had sex with other men. Before improvements in HIV detection, FDA censorship may have made scientific or actuarial sense, but that erstwhile rationale gave way some time ago. Encouragingly, anti-ban opinion has gradually snowballed with support: A recent letter-writing campaign, spearheaded by the Harvard College Queer Students and Allies and the Harvard Libertarian Forum, is an especially bright embodiment of that trend.
Their voices follow a growing chorus from the field of medicine itself. The American Medical Association, America’s Blood Centers, and the Red Cross itself, to name three particularly weighty examples, have formally endorsed removing the lifetime restriction. Modern technology now permits effective screening of blood for HIV within 10 to 21 days of disease contraction, and although the FDA cites worries regarding this “window period,” a human lifetime is a draconian confidence interval to enforce. A robust slate of nations worldwide—England, South Africa, Japan, and many more—agree, and have no lifetime ban in place.
The proscription, of course, might be justified even in the face of inefficacy. The Hippocratic maxim, “Do no harm,” would seem to justify caution. Except that the ban does do harm. For one, it limits the scope of blood donations. Ending the restriction would not spur a long-term effusion of blood donors, but it would provide badly needed help. One study predicts an increase as high as 1.4 percent in the effective donor pool. That may sound on the paltry side, but with the Red Cross reporting its lowest blood donation level in 15 years last summer, any meaningful increase in donations is sure to translate to real results at the human level. It is a bitter, ironic scene: a medical establishment scrambling to combat a donation shortage, while a dusty government ban outlaws charity to ameliorate it.
And even beyond the utilitarian math, the policy is simply discriminatory. Shorn of its scientific basis, it serves only to limit a historically marginalized cohort from a basic, noble exercise in freedom and dignity. As we wrote on the issue over a decade ago—even then, the ban was a vestige—yet still must reiterate today, “Personal history is the pertinent information; blind predetermination based on orientation is not.”
The picture does have its bright spots, however, albeit not in the FDA’s interdiction itself. The Harvard campus displayed an episode of broad-based fervor and effort, in a campaign that elicited letters for the FDA from roughly one-fourth of the College’s student body. It also marked a potent case study in cooperation among student groups: Its success came as the fruit of collaboration between the Harvard College Queer Students and Allies and the Harvard Libertarian Forum. The spirits of cooperation and working together may sound trite or simplistic. But 1,624 letters say otherwise.
We hope that efforts like the joint one on campus and its national counterparts will engender an end to the FDA ban. In the telling (if understating) words of an independent panel commissioned by the Department of Health and Human Services, the current blanket policy is “suboptimal.” The FDA should make it optimal.