Bad Blood

by Mrinali Anchan 

What do you think of when you imagine blood?

Do you think of the latest Hollywood gore fest you saw you saw last week?  

The injured nose you got falling off your bike when you were six?  

Or do you think of sterile needles, methodical beeps and the white blinding walls of a hospital?  

For something that most of us don`t even see on a regular basis, it sure conjures up visceral imagery and feelings within each one of us doesn`t it?

And why not?

I mean we need it to live after all.     

In fact, Canadian Blood Services cites that about 100,000 new donors are needed every year to meet demand. 

So you see, in many cases, blood is the very tightrope between life and death that countless people cling to every day.

And yet in the midst of all this, something is amiss.

While the work that Canadian Blood Services does is vital, it is unfortunately not without fault.

Now unless you yourself have gone through the donation procedure or already know of how it works, you may be unfamiliar with one major segment of the screening process.   

That is to say, if you are a male who has had sex with another male within the last year (abbreviated as MSM), you are ineligible to give your blood unless you undergo a deferral period of one year.

And when you remember the fact that there are those still on the tightrope every day...a day let alone a year can make all the difference.

So it’s time to ask yourself,

Blood.

Is it really in you to give?

My Name is Mrinali Anchan and you`re listening to “Bad Blood”, a “Passion Projects” episode that will be dedicated to understanding why this policy still exists and how its implementation severely stigmatizes the LGBTQ+ community of Canada as well as understanding the people who are currently fighting against it.

Intro music

Now to understand where this all began, we`re going to have to go back in time and have look at the AIDS crisis of the 1980`s.

In the early 1980s, members of the medical community in North America began noticing rare cancers and infections striking otherwise healthy young gay men. Upon first glance, it looked as though these diseases were only impacting members of the gay community which unfortunately led to the short-sighted infamous naming of AIDS as GRID or Gay-related Immune Deficiency in 1981. In 1982 however, GRID was soon renamed to AIDS (Acquired Immune Deficiency Syndrome) and Canada soon began reporting its first cases of AIDS during the March of 1982. It would be a decade where fear, confusion and prejudice against the LGBTQ+ community reigned supreme as AIDS grew from a mystery to an epidemic.

Cultural events such as this and the devastating Orlando Nightclub shootings have left both international and local LGBTQ+ communities confounded as to what the next steps would be in terms of blood donations impacting not only their communities but others as well.

Now I think it’s slowly starting to come together how and why things are the way they are, but to clearly understand the whole picture of how this impacts Canadian Blood Services presently, I felt prompted to contact fellow Bramptonian, Christopher Karas.

Christopher has been heavily involved in LGBTQ+ activism and was first noted in the media when he challenged his then French Catholic School Board at the Human Rights Tribunal when he had wanted to put up posters of his civil rights hero, Harvey Milk and build a Gay-Straight Alliance.    

Christopher has since continued to be involved heavily in a variety of LGBTQ+ issues with the most predominant being his federally approved petition against the one-year deferral period for MSM.

During my interview with Christopher, I got to learn more about how potential donors are being invalidated and how if the need for blood is so great, why these policies exist in the first place.

Christopher: And so, once I had seen that I could hold my school board accountable and do something about that and I realized that I also couldn`t give blood as a gay man I wanted to do something about that.  And I saw what had happened in Orlando, for example, and it shook me to my core, like I couldn`t believe that there was this hate crime that had happened but not only did this hate crime happen a lot of these people that were affected weren`t able to receive blood from their peers or their colleagues, their family who are part of the community. It had to be allies who had greater privilege than them to give them the blood they needed. And I hope that if anything like that were to happen here, that I and everyone else that wants to give blood will be able to because not only did that hate crime have an impact on our community but even to the extent where people who wanted to help and support their peers couldn`t because they were being discriminated at that level as well.     

Mrinali: It goes without saying that members of the LGBTQ+ community are an active and integral part of society that seek to help in whatever way possible. But because of these policies these individuals are forced to be passive observers in the tragedies that occur within their own communities let alone contribute to the blood donation of others. But the problem doesn`t stop there.

Christopher:  For example, the autologous donation, so as a gay man I can`t give blood to actually use it for myself. So it’s not even the selfless donation for another, it’s also I want to be able to give my blood so that I can use it for myself when I go through surgery and I`m not able to do that.

Mrinali:  Even on the most basic of levels are LGBTQ+ individuals denied the right to look after their own well-being.  Unfortunately, MSM are not the only segment of the LGBTQ+ community who are also impacted by the policies of Canadian Blood Services.

Christopher:  And what’s really sad is that we saw the progress of a deferral that was once a lifetime ban that then went down to a five year and now to a one-year and when that announcement was made, they made another announcement to ban trans people from donating their blood and it especially bars trans women from donating blood.  It’s really ridiculous just how much these institutions have barred and made us feel less than in such an egregious way. Not only are they discriminating against us but they are stopping us from helping other people who really need this blood, I can`t stress that enough.    

Mrinali: Our interview eventually took us to one major cause of the deferral policy, the tainted blood incident of 1980`s.

Christopher: You know something that is also really interesting is that a lot of the articles we raise the issue that these policies are in place because of the tainted blood scandal of the 1980`s and that tainted blood scandal of the 1980`s was not mostly because we couldn`t test blood it was mostly because our government under Canadian Red Cross had chosen to purchase blood from a prison in Arkansas. So they`ve put the blame on the community and have stigmatized our community whereas it was really the fault of our government for purchasing blood that was tainted and affecting people. Since then Canadian Red Cross was fined and sued and now Canadian Red Cross is no longer allowed to operate our blood system and now we have Canadian Blood Services that operates our blood system under the regulation of Health Canada and there is also Hema Quebec in Quebec. So there’s a lot of issues at play here and I think it’s not a simple issue but I think it’s one worth challenging and I think people need to think more critically about this because it’s affecting people who need blood. 

Mrinali:  Through Christopher, I was able to further understand the political and social factors at play and was able to recognize the true complexity of the issue at hand.  This caused me to consider what the response of Canadian Blood Services was to this backlash and more importantly, how much of the general public was even aware of the fact that despite the growing need for blood, such a large segment of the population was being barred from doing so. 

This led me to research what Canadian Blood Services’ stance on the issue was via their main websites and other academic articles. I discovered a mass survey on their main website that was conducted in 2014 before the change in deferral period from indefinite to five years.

It was found that over 54% of the general public, before being surveyed, were unaware of the MSM donation policy.

Furthermore, before the current deferral time period change, when the general public was polled on whether changing the original indefinite deferral period to five years, only 49% believed it was a step in the right direction with 37% being unsure.

From this, it is clear that there is a shocking overall lack of awareness with a large segment of the population being unsure of how the politics behind blood donation affects not only the LGBTQ+ community but subsequently anyone who needs blood.

Canadian Blood Services has further been under fire constantly for its rationale that despite actively screening all blood donations, it is still considered “too high-risk” to accept the blood of MSM.

Many from the scientific community have spoken out strongly over this blatant form of discrimination such as Dr. Paul MacPherson, an HIV researcher with the Ottawa Hospital Research Institute’s chronic disease program.

Now I won`t go too deep into science of it all, but basically, Canadian Blood Services does two tests on every batch of donations they receive: a test for antibodies and a “nucleic acid test”. The concern is what’s known as the “window period” — the time between when someone contracts HIV and the time at which it can be detected. For an antibody test, MacPherson states that the window is about 42-50 days. For the nucleic acid test, results can be detected in approximately nine days, according to Canadian Blood Services.

That’s much less than a year.

This is the component of the screening process that strikes MacPherson and other researchers as odd and immediately demonstrates how egregious the one-year deferral policy is.

If the data shows that one-year is excessive then why do we still have it?

Perhaps the same answer lies in the fact that only 54% of people are aware of how blood donation affects the LGBTQ+ community.  

By that, I mean that the systematic discrimination against the LGBTQ+ community that is really just representative of the struggle to shift mainstream perceptions and stereotypes.

As seen with the AIDS crisis, it was demonstrated how vital it is to responsibly understand the social ramifications of scientific findings as further seen in the rash naming of GRID.

Canadian Blood Services has also been criticized for falling behind on the fact that HIV has consistently been found in over half the MSM population and distorting those findings. For example, in 2014, 48.8% of known HIV exposure cases were found to be within the MSM exposure category.

However, it is only in recent memory do they and other sections of the scientific community acknowledge that it is behaviour of individuals that should be screened rather than asking blanket questions that make assumptions about the sexual practices of individuals.

As such, when we as a society have such a limited understanding of HIV and look upon those who have HIV as people with a death sentence, can you truly blame those who have HIV of being afraid of being associated with such a bleak judgment. 

But at the end of the day, if a 19-year-old who has 40 partners and rarely uses a condom can donate why can`t the individual who has been in a monogamous relationship for 20 years and practices safe sex?    

I think we would all like to think that we`ve come a long way. And by many regards we certainly have. But at the end of the day, it is important to always remind ourselves that work is not yet done. There is much that we as a society must do to tackle not only the problems facing the LGBTQ+ community but intersectionality as a whole.

So remember what I asked you earlier?

About whether it was in you to give?

Have an answer yet? 

Because I`d certainly say, yes.  

Outro music - END

 

Special Thanks to Christopher Karas who graciously lent his time to help me and so many others have a greater understanding about how the LGBTQ+ community is affected by the policies of Canadian Blood Services.

For more information about Christopher`s initiatives:  christopherkaras.ca

Works Referenced

Canadian Blood Services. (2015, June). Canadian Blood Services MSM Policy Change Follow-Up   Research. In Canadian Blood Services MSM Policy Change Follow-Up Research. Retrieved November 1, 2016,             fromhttps://blood.ca/sites/default/files/Appendix_1_CBS_MSM_Policy_Change_Research_2014     _Data_            Summary.pdf

Canadian Blood Services. (2016). Donor screening: Men who have sex with men. In Canadian BloodServices. Retrieved November 1, 2016, from     https://blood.ca/sites/default/files/Frequently_asked_questions_-MSM.pdf

Goldman, M., Lapierre, D., Lemay, L., Devine, D., & Sher, G. (2014, July). Donor criteria for men who have sex   with men: A canadian perspective. Transfusion54(7), 1887-1892. Retrieved November 1, 2016, from https://blood.ca/sites/default/files/transfusion_2014.pdf

Government of Canada. (2014, December 31). HIV and AIDS in Canada: Surveillance Report to December 31, 2014. In Government of Canada. Retrieved November 1, 2016, from             http://healthycanadians.gc.ca/publications/diseases-conditions-maladies-affections/hiv-aids- surveillance-            2014-vih-sida/index-eng.php?page=8

Hurley, R. (2009). Bad Blood. BMJ: British Medical Journal, 338(7694), 568-570. Retrieved November 1, 2016, from http://www.jstor.org/stable/20512266

McGregor, J. (2016, September 20). Health committee to study blood donor rules for men who've had sex with men. CBC News. Retrieved November 1, 2016, from http://www.cbc.ca/news/politics/health-committee-msm-   blood-donor-restrictions-1.3770416

Nasser, S. (2016, August 26). Gay activist files federal human rights complaint over blood-donation wait period. CBC News. Retrieved November 1, 2016, from http://www.cbc.ca/news/canada/toronto/gay-activist-files-            federal-human-rights-complaint-over- blood-donation-wait-period-1.3738029

Orsini, M. (2002). The Politics of Naming, Blaming and Claiming: HIV, Hepatitis C and the Emergence of Blood Activism in Canada. Canadian Journal of Political Science / Revue Canadienne De Science Politique, 35(3), 475-498. Retrieved November 1, 2016, from http://www.jstor.org/stable/3233112

Rank, C., Remis, R., Swantee, C., & Wu, K. (2010). Patterns of HIV Testing Among Ontario Physicians. Canadian Journal of Public Health / Revue Canadienne De Sante'e Publique, 101(4), 294-299. Retrieved from            http://www.jstor.org/stable/41996147

Slonim, R., Wang, C., & Garbarino, E. (2014). The Market for Blood. The Journal of Economic Perspectives, 28(2), 177-196. Retrieved November 1, 2016, from http://www.jstor.org/stable/23723490

Young, L. (2016, June 28). Canada’s limitations on gay blood donations ‘ridiculous’: HIV researchers. Global  News. Retrieved November 1, 2016, from http://globalnews.ca/news/2792150/canadas-limitations-on-         gay-blood-donations-ridiculous-hiv-researchers/