The apology to LGBTQ2S+ Canadians for a former donation ban is a good step, but more needs to be done to repair harm and build trust<\/p>\n\n\n\n
This morning, Canadian Blood Services (CBS) issued an apology to LGBTQ2S+ people across Canada for the harms caused by previous blood donation rules\u2014which historically banned gay and bisexual men, as well as many trans people, from donating blood.<\/p>\n\n\n\n
\u201cToday\u2019s been \u2026 a day many LGBTQ2S+ people have been waiting for for a long time,\u201d Dr. Graham Sher, CEO of CBS said as he delivered this morning\u2019s apology. \u201cWe regret that for many years the former policy contributed to discrimination, homophobia, transphobia and HIV stigma within society.\u201d <\/p>\n\n\n\n
He later said, \u201cWe acknowledge how this policy enforced the harmful public perception that someone\u2019s blood is less safe [due to their sexual orientation].\u201d<\/p>\n\n\n\n
Canada\u2019s blood donation rules have evolved over time, with the latest changes put into place in September 2022. In the mid-1980s, in response to the AIDS crisis, CBS\u2019s predecessor, Canadian Red Cross Blood Transfusion Service, introduced rules permanently barring all men who had had sex with men from donating blood and plasma. <\/p>\n\n\n\n
It wasn\u2019t until the 2010s<\/a> that the permanent deferral policy was modified to a time-based deferral of five years. The period was lessened over time down to one year, then, eventually, three months. In September 2022, CBS removed criteria specific to men who have sex with men, opting instead to screen all donors based on sexual behaviour\u2014regardless of their gender or sexual orientation. <\/p>\n\n\n\n Today, all potential donors are asked whether they\u2019ve had sex with new or multiple partners in the last three months. If they answer yes, they will be asked if they have had anal sex. Donors who have will be asked to defer their donation by three months. <\/p>\n\n\n\n In an interview granted to Xtra<\/em> ahead of the apology, Sher said that these changes were an important milestone. But, he acknowledges, \u201cthe adoption of the policy didn\u2019t erase the harm that the previous policy had contributed to. We knew work must follow, in order for us to continue to build trust.\u201d\u00a0<\/p>\n\n\n\n CBS collaborated with an advisory committee made up of members of various LGBTQ2S+ groups, as well an internal group of queer and trans CBS employees, in order to develop the apology. <\/p>\n\n\n\n Michael Kwag was one of the members of the advisory committee. He is also the director of the Community-Based Research Centre (CBRC), an organization that promotes the health of LGBTQ2S+ people in Canada. <\/p>\n\n\n\n Kwag says that while this apology is historic, and a significant way for CBS to take accountability, it should be seen as the beginning of an ongoing process to make blood donation in Canada more equitable. <\/p>\n\n\n\n Several barriers still exist to giving blood, which affect many LGBTQ2S+ people. People who engage in sex work, for example, are still asked to defer their donations, as are people who have multiple partners and who engage in anal sex\u2014even if those partners are not new. <\/p>\n\n\n\n Anyone who uses PrEP\u2014or who has an HIV-positive partner\u2014 is also asked to defer, regardless of their HIV status, a criterion that affects many queer men. Kwag, a PrEP user himself, points out that he\u2019s a gay man who leads one of Canada\u2019s largest health organizations, and is taking PrEP as a science-backed step to protect his health and his community\u2014yet he is barred from donating blood as a result.<\/p>\n\n\n\n Many men who have sex with men are also still barred from donating organs and tissues<\/a>, he says. <\/p>\n\n\n\n Trans people similarly face ongoing barriers to donation. While binary trans donors can now register to donate with their accurate genders, they can only register using the names listed on their legal identification. Non-binary donors are also still required to choose a binary sex designation when donating, as CBS\u2019s computer system does not allow donors to register with a neutral marker.<\/p>\n\n\n\n Kwag says that beyond donation policies, work still needs to be done in order to make donation centres inclusive and welcoming to queer and trans donors. Even after behaviour-based policies were put in place, he\u2019s heard from LGBTQ2S+ people who have reported feeling singled out at donation centres. One queer donor recently told him that during the screening process, they were told by an employee that they \u201cdidn\u2019t look like someone with HIV.\u201d<\/p>\n\n\n\n Sher concedes CBS\u2019s work is not done. \u201cWhat I hope this apology will accomplish is to be a commitment from this organization, that we are on a journey \u2026 to earn trust to build relationships,\u201d he says.<\/p>\n\n\n\n Sher cities persistent barriers to trans donors, as well as Black and Indigenous donors, as places where policy still needs to develop.<\/p>\n\n\n\n Historically, donors from Haiti and from several African countries were barred from becoming donors due to rates of HIV and malaria in those regions. Later, the rules were altered to a time-based deferral. Today, anyone who has spent time in a malaria-endemic region, including several African countries, is asked to defer their donation<\/a>.<\/p>\n\n\n\n CBS has also faced criticism regarding cultural competency when it comes to communicating with prospective African, Caribbean and Black donors. In 2013, when CBS moved their donor questionnaire online, questions regarding time spent in Africa were accompanied by generic and stereotyping images<\/a> of landscapes and animals in Africa.<\/p>\n\n\n\n