FDA plans to relax blood donation restrictions on some gay & bisexual men. What to know

Many gay and bisexual men in monogamous relationships could soon be able to donate blood without a deferral period for the first time since the U.S. banned those populations from donating at the height of the AIDS crisis.

The U.S. Food and Drug Administration announced in a Friday, Jan. 27, news release it plans to once again relax restrictions on gay and bisexual male blood donors, known as men who have sex with men (MSM). The change could happen as early as the end of April, FDA commissioners said in a Friday news conference.

The new draft guidance focuses on sexual behaviors and calls for a switch to “individual risk-based” screening for potential donors regardless of gender, moving away from time-based deferrals for MSM, known widely as “blood donation bans” on gay and bisexual men and often trans-feminine people.

In the early 1980s, the U.S. banned MSM from ever donating blood, the Associated Press reported. The policy was changed in 2015 and instead required MSM to abstain from sex for a year before donating.

The agency eased restrictions in 2020 when the U.S. blood supply dwindled during the early days of the COVID-19 pandemic. At that time, federal officials shortened the deferment period, meaning the amount of time they had to abstain from having sex with another man, for MSM to three months, McClatchy News previously reported.

The period was also shortened to three months for women who have sex with men who’ve had sex with men and for people with new tattoos or piercings.

New blood donation rules

The new guidance, which will be open to public comment for 60 days before being finalized:

• Lifts the time-based restrictions on monogamous men who have sex with men and women who have sex with MSM.

• Revises questionnaires to ask all prospective donors about new or multiple sexual partners in the past three months, regardless of gender.

• Allows those who meet the eligibility criteria to donate, regardless of gender and sexual orientation.

Under the proposal, the updated criteria for those who can donate is someone “who does not report having new or multiple sexual partners” and who does not report having anal sex in the past three months, the news release states.

The updated guidance is more inclusive of prospective donors regardless of gender, though restrictions are still in place for people taking HIV preventive medications such as PrEP and people who have multiple sexual partners.

The new guidance does not go into policies for transgender donors, though previous updates allow transgender people to self-report their gender and allows their eligibility to be evaluated based on the criteria associated with the gender they report, according to information from the American Red Cross.

Reactions to the change

The new guidance received some pushback due to the emphasis on anal sex without accounting for risk-reducing practices, such as consistent condom use or the use of preventive pills, and without making exceptions for people who can show a negative HIV test, The Washington Post reported.

But many also celebrated it as an important first step toward more equitable blood donation policies.

“This proposal is an important step forward!” Florida Rep. Carlos Guillermo Smith, a Democrat from Orlanda said on Twitter. “THANK YOU to the gay/bi men in Orlando who participated in the ADVANCE study that helped make this happen. Many of you felt the impact of the ban when you tried to donate blood after Pulse. This change is proof that advocacy matters!”

While the new guidance doesn’t account for some nuances and populations, officials said they “wouldn’t be surprised” if future studies took them into consideration going forward.

“We are willing to look in the future to see if there are additional advancements we can make to allow more individuals to donate but we have to have the science in order to be able to do that,” Dr. Peter Marks, director of the Center for Biologics Evaluation and Research at the FDA, said during Friday’s news conference.

During the news conference, Marks said of the proposed changes that “this is a first step in the right direction.”

It will more closely align the U.S. with countries that have similar HIV epidemiology and have already implemented the policy, such as Canada and the United Kingdom, Marks said.

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