Although 2015 marked progress for gay rights in the US, a glaring nationwide inequality remains and activists say FDA’s proposed changes don’t go far enough

When tornadoes swept through Tennessee in 2011, Ryan James Yezak’s co-workers at an office in Nashville rushed to help the injured by donating blood. Yezak wanted to join them but could not: he is gay.

US moves to relax ban on gay men donating blood Read more

At the end of a year of remarkable progress for gay rights in the US, in which the supreme court made same-sex marriage legal throughout the land, a glaring nationwide inequality remains. Sexually active gay men are banned from giving blood.

The Food and Drug Administration (FDA) has proposed policy changes that are likely to be implemented soon, but some activists say they do not go far enough.

Among them is Yezak, who founded the National Gay Blood Drive campaign after his experience in 2011. When his colleagues went to donate and, after checking the rules, he did not, “it created a very uncomfortable situation in the office,” he said.

“It was the first time I wanted to do something [like this] and I couldn’t because of my sexual orientation.”

In 2013 and 2014 the National Gay Blood Drive mobilised hundreds of gay men to be turned away from donation centres. It was a symbolic gesture, and the men were accompanied by “allies” who gave blood in their place.

The issue, Yezak said, has “not gotten as much attention as marriage or employment discrimination. This has been one more under the radar that people have been working on.”

Since the mid-1980s, when the nation was gripped by the Aids crisis, the FDA has banned men from giving blood if they have had sex with another man even once since 1977. It reasoned that men who have had sex with other men (MSM) are “as a group, at increased risk for HIV, hepatitis B and certain other infections that can be transmitted by transfusion”, and said its stance was based on scientific risk analysis, not discrimination.

The federal agency’s highly conservative approach is also evident in its bans on donations from anyone who spent three months in the UK between 1980 and 1996, or who has lived in a European country for five years since 1980 – a response to the continent’s very rare cases of Creutzfeldt-Jakob Disease.

According to the American Red Cross, only 38% of the US population is eligible to donate, despite supplies often running low.

The exclusion of MSM has come under increasing pressure as the fear of widespread Aids infection has receded since the 1980s and the accuracy of tests has increased, to the point that the FDA estimates that the risk is about one infected unit per two million transfusions.

In May this year, after several years of study, the FDA issued new draft recommendations. Among them was a reduction of the MSM ban from lifetime to one year since the last sexual contact, which the agency says better aligns the treatment of gay men with other groups it considers at increased risk of HIV and other infections, such as those who have recently got a tattoo or body piercing.

England, Scotland and Wales lifted their lifetime bans on donations from MSM in 2011, switching to a 12-month deferral period that will be reviewed in 2016.

In Canada, plans are afoot to reduce the restriction from five years to one.

Rules banning gay and bisexual men from giving blood to be reviewed Read more

The year’s deferral is designed to provide a “window period” so recent infections will not be missed by tests, though critics say the time is excessive given modern testing abilities and so long it amounts to a de facto ban anyway.

“Since the comment period closed on 14 July 2015,” an FDA spokesperson said, “the agency has been carefully reviewing and considering all comments in finalising the guidance. While we are unable to commit to a specific timeline, we consider finalizing the guidance to be a high priority.”

While Yezak views the changes as progress, he and other advocates believe they are still discriminatory.

“We have lobbied FDA and submitted comments and are awaiting their final action on the new policy,” said a spokesman for the Human Rights Campaign, a LGBT rights organisation.

“If, as expected, the final policy is what they proposed, we will continue to advocate for a risk-based policy that does not stigmatize gay and bisexual men. The policy also continues to be problematic for many transgender individuals.”

If the current rules are interpreted to define sex as assigned at birth, a transgender woman who had sex with straight men would be forbidden from donating but a transgender man who had sex with men would not.

The new draft guidelines state: “In the context of the donor history questionnaire, male or female gender is taken to be self-identified and self-reported.”

However, some transgender advocates fear continued confusion and exclusion because the rules also propose that “in instances where a donor has asserted a change in gender identification, medical directors may exercise discretion with regard to donor eligibility”.

The push for reform has reached the corporate world. Twitter, for instance, said last month that it would not hold on-site blood drives in its offices in places where it considered donation policies to be unfair.

CBS News reported that in July, Colin Crowell, a Twitter vice-president, wrote to the FDA to convey his “deep concerns that both the current and proposed regulations restricting blood donations by men who have sex with men unreasonably removes viable donors from the process and discourages ethical companies from supporting and participating in blood drives”.

Rather than a blanket policy that excludes gay men who use condoms in monogamous relationships but not straight men who may have had unprotected sex with multiple partners, Yezak would like to see individual risk-based assessment for all donors.

Such screening would “completely based on your behaviour”, he said.