What if you could potentially save nearly two million people with a simple regulatory policy change?
That question, according to a recent study by Ayako Miyashita and Gary J. Gates for the UCLA School of Law’s Williams Institute, is not rhetorical. Ending the Food and Drug Administration’s (FDA) longstanding ban on blood donations by men who have sex with men (MSM) could result in an estimated 360,600 men donating an additional 615,300 pints of blood each year, an increase of 2 to 4 percent.
The FDA notes that its ban on blood from MSM donors emerged from policies early in the HIV/AIDS epidemic, though the current policy was formulated in 1992. This ban includes any man who has had sex with a man since 1977, which embraces Baby Boomers, Gen Xers, and the Millennial Generation. However, the FDA also acknowledges that:
The Health and Human Service’s Advisory Committee on Blood Safety and Availability (ACBSA) met to discuss the FDA MSM deferral policy on June 10-11, 2010. . . . The committee found the current donor deferral policies to be suboptimal in permitting some potentially high risk donations while preventing some potentially low risk donations [emphasis ours], but voted in favor of retaining the existing policy, and identified areas requiring further research.
Potential responsible MSM donors are faced with the ethical dilemma: Lie about prior sexual practices when donating blood or abstain from blood donor drives. That we use the term MSM to classify this population suggests some of the ambiguities and complexities of sexual identity, which further complicates the issue. In epidemiology, behavior (MSM) trumps socially constructed identity (gay or bisexual men). Further complicating matters is the question, What is sex?, which in the case of some sexual practices, as I pointed out here last spring, is not a settled matter.
Moreover, Miyashita and Gates note that:
In recent years, both the United Kingdom and Canada have made changes to their laws shifting from an indefinite deferral of MSM to a twelve-month and five-year deferral, respectively. In Mexico, new regulations have established criteria for blood donation based on risk factors for transmission of blood-borne diseases.
Blood has both a physiological dimension and a cultural dimension. As a physiological phenomenon it may be studied empirically, with an evidence based developed for sound policy. As a cultural phenomenon, blood exercises an imaginative power that is diffuse and pervasive.