Prime Minister Trudeau: ‘It’s Time to End the MSM Blood Ban’

in Opinion by

Dear Prime Minister,

It’s time.

In March of 1983 the news was broadcast over CBC Radio: “The Canadian Red Cross announced it is advising promiscuous homosexual men, Haitian immigrants, and drug users not to give blood. These groups are all in the high-risk category for a deadly new disease, Acquired Immune Deficiency Syndrome, or AIDS.”

I am writing to urge you to bring an end to the discriminatory MSM blood ban at Canada Blood Services. As you know, in its current iteration, the policy prohibits any man who has had sexual contact with another man in the last 12 months from giving blood.

In order to understand the need to eliminate the MSM (men who have sex with men) ban one must revisit the AIDS crisis of the 1980’s and the depth of its prejudicial history. Early reporting on AIDS was often problematic and actually labeled the disease GRID (gay-related immunodeficiency). In 1982 the New York Times ran the headline “New Homosexual Disorder Worries Health Officials.”

At home, a noteworthy exchange on CBC’s Quirks and Quarks featured a Canadian doctor who proposed a system was needed for public notification when a person living with AIDS was “dangerous and not behaving adequately.” “Picture. Name” suggested the doctor, imagining the format for public notification on Canadian televisions and newspapers. “Like a wanted poster?” asked the CBC host, “more like a not-wanted poster” his guest responded.

People were scared. The disease was deadly, there was no cure, no vaccine, and it was predominantly impacting gay men. Canadians could regularly tune into mainstream media interviews where guests suggested we consider American legislative proposals to ban HIV-positive immigrants or follow religious leaders who believed the “one sure cure for AIDS [was] the traditional family.” In other words, the solution to the AIDS crisis was not education, science, or policy, but an end to same-sex relationships. The continuation of the blood ban tacitly concedes to this pernicious belief. Moreover, maintaining a one year-ban from MSM donors is a holdover of the misguided tradition of implicitly designating all MSM as HIV-positive and all non-MSM as safe.

At the onset of the epidemic, countries around the world introduced permanent bans on MSM blood donations. Successful screening technologies did not exist and by 1985 the Canadian Red Cross acknowledged the blood supply had been contaminated. There were no clear solutions but instead of a sustained investment in evidence-based policy, the case for blood donations from gay men was labeled hopeless.

Discriminatory policies, albeit initiated due to unprecedented crisis, only advanced misconceptions about AIDS and led to entrenched fear. The 1980’s were an era when Canadians were debating whether children with AIDS should be in schools and whether it was safe to shake the hand of a gay person. It is perhaps no surprise that in such a climate the Canadian Red Cross, and its successor Canada Blood Services, would shut its doors to gay men. This is the toxic history the blood ban was born out of. Today’s “one year deferral period” — to put it in such sanitized terms — is the residue of a fearful and often hateful period in our nation’s history.

Queer blood has been the state-sanctioned Big Bad Wolf for far too long. Scientists agree.

The demographics of HIV/AIDS have changed significantly. Annual incidence of HIV resulting from MSM has been more than cut in half, from 3171 new infections in 1983 to 1396 in 2014.

An article published in the Journal of Public Health Policy in 2016 noted that progress in screening methods at Canada Blood Services have test sensitivity nearing 100 percent. Moreover, American quantitative modeling studies support statements made by FDA officials that with modern screening practices ‘‘the probability that errors in routine screening will result in release of a unit [contaminated with HIV] is so remote as to be inconsequential.”

The blood ban is outdated.

Beyond scientific opinion, scholars believe the gift of blood donation is a rite of passage and a means of expressing and performing one’s citizenship. The one-year deferral period for MSM donations effectively deprives an entire group of Canadians from partaking in this civic tradition.

American scholars have pointed to the September 11th attacks in New York as a time when blood donation was a “fundamental ritual of post-catastrophe citizenship as well as the nation’s figurative and literal healing.” This sentiment would have proven true during the Pulse Nightclub massacre when news coverage consistently called on locals to donate blood. Many healthy gay and bisexual Americans would not have been able to support their own communitywith a crucial life-saving gift, just as gay and bisexual Canadians cannot. Dying gay men can only be saved with straight blood.

Though such tragedies are less prevalent in the Canadian context, all Canadians who are healthy enough to contribute to our blood bank should have the ability to do so, and we need all the help we can get. In 2014 Canada Blood Services labeled the country’s blood supply “a critical situation.” Allowing healthy MSM to donate would strengthen Canada’s blood supply and even save lives.

As recently as March of 2018, reporting out of Newfoundland and Labrador spoke to the importance of blood donations to citizenship. A group of Syrian refugees “lined-up” in St. John’s to donate blood. The group brought a handwritten thank-you note to Canada Blood Services addressed to “the generous country which helped us and saved our souls.” Their act is one to celebrate as it both demonstrates the humanitarian impact of accepting refugees and their desire to pay forward the benefit of calling Canada home. For the purpose of this letter, the event also highlights the limits of queer citizenship. The Government of Canada prioritized accepting particularly vulnerable refugee populations including children and LGBTQ2+ persons. Yet the MSM ban at Canada Blood Services means the very people we have prioritized welcoming to our country cannot denote their thanks and express their emerging Canadian identity through the time honoured tradition of blood donation. That has to change.

It is time for Canada to take the lead. Our policies and our science on MSM blood donation is an opportunity for Canada to further advance its position as a global leader when it comes to upholding the dignity of LGBTQ2+ citizens.

Canada ought to fund research projects, create mechanisms for international cooperation, and support the development of innovative technologies to further ensure the safety of the blood supply and concretize the promise to the Canadian public that the removal of the MSM blood ban is a prudent decision. Italy and Spain have eliminated their MSM ban and substituted it with a successful individual risk-based assessment indifferent to sexual orientation. Canada should consider learning from and adapting this process to the Canadian context.

It should come as no surprise that during the 2015 federal election you publicly supported the removal of the MSM ban. A petition on the Liberal Party website decried Canada Blood Services’ then 5-year deferral policy and redirected visitors to donate to the Liberal campaign to support this policy plank among others. The shift to a 1-year deferral period since you took office seems arbitrary.

In your apology to LGBTQ2+ Canadians in November of 2017 you noted that “while we may view Canada as a forward-thinking, progressive nation, we can’t forget our past: The state orchestrated a culture of stigma and fear around LGBTQ2 communities.” The blood ban firmly situates a state orchestrated culture of stigma and fear around LGBTQ2+ communities not in some remote past but in the present-day. As long as LGBTQ2+ communities face state-sanctioned exclusion and violence, portions of your apology will remain a vacant gesture.

With this in mind, newly funded studies through the MSM Research Grant Program launched in 2017, such as those aiming to generate new forecasting data and better reflect the diversity of the MSM community in blood donation questionnaires, are cause for hope that we are moving in the right direction. The mandate letter for Canada’s Minister of Health where you called for “safety and non-discrimination in donation policies,”serves as a reminder of your acknowledgement that change is essential.

Canadians of all ages and backgrounds want you to keep your promise. Six years ago a poll demonstrated 8 in 10 students favour eliminating the MSM ban. Right now, E-Petition 1589is open to signatures until July 2018 and has received thousands of signatures from Canadians who support reforms on blood donation policy for MSM and demand improved intake procedures for trans donors.

On the first World AIDS Day on December 1st 1988, Peter Mansbridge, while anchoring The National, echoed the mantra of many AIDS activists when he announced: “The message for World AIDS Day is more information less discrimination. That’s the only way we can deal with AIDS because we don’t have a vaccination and we don’t have a cure.”

Nearly 30 years later that statement is still true. When it comes to the MSM blood ban I implore you to proceed with a philosophy of more information less discrimination.

It’s time to live-up to your promise to LGBTQ2+ Canadians. For being the first sitting Prime Minister to march in a pride parade, for apologizing to LGBTQ2+ Canadians ejected from their jobs with the Canadian government, and for passing a bill which protects trans people from discrimination, I applaud your government’s work in listening to community activists and urge you to continue to take bold action.

The knowledge base needed to eliminate the ban exists and is growing. The resources can be put in place. We need political will. We need political courage.

Yours sincerely,

Donovan Taplin

–With special thanks to members of the Prime Minister’s Youth Council. My official term on the council concluded about a month ago. My colleagues on the PM’s council entrusted me to undertake the research toward the council taking a position on the MSM ban and ultimately write the recommendation that a strong majority of councilors would go on to co-sign for a formal submission to the PM. For this reason I think it is important to recognize their support and solidarity in putting forth our view on the matter to the PM.