2020 will inevitably be remembered as ‘the year the pandemic happened’, with all the doom and gloom that summation implies. Following the coronavirus outbreak, more than two million people have died and the average person has remodelled every aspect of their daily life around rules designed to slow the spread of infection. When people think of the few truly positive news stories that came out of the previous year, the announcement of a vaccine finally becoming available will likely be top of the list.
Other positive health-related stories, however, have flown under the radar by comparison. For example, how many of us noticed when, in August, the World Health Organisation announced that polio had finally been eradicated in Africa? Even fewer, perhaps, than those aware that the rules surrounding blood donation in the UK were relaxed in December.
Rather than having to remain celibate for three months before they can give blood, from this summer onwards, gay and bisexual men will be able to donate at any time. The decision was heralded as a “landmark change” by the government, with the founder of pressure group FreedomToDonate describing it as “a pioneering new policy”.
More broadly speaking, blood collection authority NHS Blood and Transport intends to move away from blanket bans and deferrals towards an approach based on individualised risk assessments. In other words, any sexually active person can theoretically donate, regardless of their gender or their partner’s. There is still an intricate maze of caveats focusing on higher-risk behaviours, but reforms on this scale are still a major pivot away from the current three-month celibacy requirement, not to mention the previous insistence on one year of abstinence. In the 1980s, when a lifetime ban on gay men giving blood was first introduced, this latest step towards equality must have seemed impossible.
The United Kingdom, moreover, was not a lone bastion of progress in this field during 2020. For example, the USA may also be on course to abandon blanket restrictions at some point in late 2021. Other countries, such as New Zealand, also switched from one-year to three-month deferrals last year.
Leaving aside the potential of more blood being available for those who need it, what can be said to make these reforms truly groundbreaking is how they reflect on modern societal views of LGBTQ+ people. Bans and deferrals reinforce the idea that non-heterosexual men are perverted and ‘unclean’, and that homosexual relationships are unnatural acts which contaminate the participants and society at large. They also lend credence to the stereotype of gay men as inherently promiscuous, more likely to contract HIV because they are somehow allergic to monogamy.
During the AIDS crisis, these stereotypes became still more pervasive. With even the scientific community having little knowledge about HIV, and without a way to quickly test for it, it was easy to scapegoat the many gay men testing positive and subsequently dying from AIDS, and a lifetime ban on blood donation was introduced. Since the 1980s, however, faster and more reliable testing methods have been developed, and studies have shown — for example — that most sexually transmitted cases of HIV are spread through heterosexual rather than homosexual sex.
In truth, gay men are still a high-risk group, but due to completely different factors (for instance, anal sex carries higher transmission rates than its vaginal counterpart.) For a donor in a long-term relationship with a single non-infected person, however, these factors are non-issues. Yet the implicit treatment of non-heterosexual men as inherently suspect remained, leaving a trail of reinforced stereotypes in its wake. Meanwhile, heterosexual donors who may well have engaged in “high-risk” sexual behaviours faced no such stigma and far fewer obstructions. In short, the new focus on different behaviours regardless of sexuality, as opposed to blanket restrictions on entire communities, are likely to have far-reaching and highly positive implications.
“If countries that are so unsafe for LGBTQ+ people can stomach letting them donate blood, then what does that say about the ‘liberal values’ of the United Kingdom?”
What makes the change even more of a relief is its status as a silver lining after a notably cloudy year for the LGBT community. Lockdown has left many – especially young people – extremely isolated and vulnerable, for example leaving them housebound with homophobic or transphobic families. Additionally, anti-bullying programmes meant to support LGBTQ+ schoolchildren were cut off from government funding in November, and a later High Court ruling effectively banned young transgender people from accessing puberty blockers. Many in the trans community view these as vital healthcare, preventing young people from being “outed” or seeing any gender dysphoria exacerbated by having to go through the “wrong” puberty. In this context, NHS Blood and Transport’s decision appears to be even more crucial.
But if we applaud these changes, are we setting the bar too low? Considering other countries’ governments that have made similar decisions, this is a question which needs to be asked. Countries like New Zealand, in transitioning from a one-year to a three-month deferral, take a tentative but predictable step forward. Yet in April, Hungary also announced the reversal of their lifetime donation ban; in May, the Supreme Court in Brazil voted to follow suit. This seems unremarkable until we consider the fact that Brazil’s President considers himself “homophobic and very proud of it”, and the disturbingly high number of transgender people murdered there in 2020. In Hungary last year, the government banned same-sex couples from adopting children and made it impossible for transgender and intersex people to legally change their gender. If countries that are so unsafe for LGBTQ+ people can stomach letting them donate blood, then what does that say about the ‘liberal values’ of those such as the United Kingdom, where gay adult men can donate blood but other parts of the LGBTQ+ community are starved of the medical support they need.
Of course, the removal of blood donation restrictions is still a welcome reminder of just how much has changed since the 1980s. However, the ease with which such reforms have happened, while LGBTQ+ people remain marginalised and persecuted both in the U.K. and abroad, should serve as a warning that progress is complex and far from linear. If our intended destination is full equality, we still have a long way to go.
For information on the new rules or how to give blood, visit www.blood.co.uk