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Blood Donations
Produced by the
HRC Foundation
In January 2023, the Biden administration and the U.S. Food and Drug Administration (FDA) took a significant step toward dismantling antiquated and discriminatory policy preventing gay and bisexual men from donating blood.
The policy moves away from discriminatory policy based on identity and toward a science-based, individualized risk assessment approach.
Click here to learn more about the progress made in Blood Donation policies and follow HRC’s efforts to drive change.
Top Ten Questions on Updated FDA Blood Donation Guidance
The Food and Drug Administration (FDA) guidelines were updated in 2023 to expand blood donor eligibility, no longer ruling out donors based solely on sexual orientation.
The screening questions are the same for all prospective blood donors regardless of sexual orientation or gender identity.
Blood donation is now more inclusive for the LGBTQ+ community, and the American Red Cross is committed to welcoming LGBTQ+ blood donors into their program.
The American Red Cross follows the FDA regulations for blood donation, including the screening guidelines about recent sexual activity, and they recognize that some people may be in sexual relationships with more than one steady partner.
+ Prospective donors will not be asked if they are monogamous, or in a monogamous relationship.
+ Under the new guidance, all prospective donors will be asked the same set of questions about new or multiple sexual partners.
+ Under the FDA’s individual donor assessment guidance, people with multiple sexual partners who have engaged in anal sex with one or more partners in the last three months will be required to wait three months to donate to allow time for the HIV screening test to detect any antibodies.
According to the American Red Cross, as of August 7th 2023, all of its blood centers are accepting newly eligible donors. The America’s Blood Centers are also in the process of accepting newly eligible donors.
+ All prospective donors will be asked the same questions and complete the same Donor History Questionnaire.
+ With the new guidance, individuals will not be deferred simply because they had male-to-male sexual contact.
At this time, The American Red Cross can only put one name in their system, which is the name on the government-issued ID.
They are working hard to add a field for “chosen or preferred” name, and in the meantime, if someone has changed their name, there is an established process that donors can use to update their name in the system. You will just need to provide a photo ID or two forms of non-photo ID with your updated name.
When you come in, you can share the gender you identify with. You do not need to tell staff if you are transgender—that is private information unless you want to share it.
Most importantly, the gender you state will not by itself decide if you can donate. What matters is whether your height, weight, and iron levels are in a safe range for donation.
+ Transgender women have been eligible to donate blood since December 2015.
+ Transgender men and other prospective donors will be evaluated based on the same eligibility criteria
+ According to America’s Blood Centers, approximately 3% of the U.S. population donates blood each year.
+ Modernizing the eligibility guidelines will expand the pool of eligible donors and has the potential to increase the blood supply and, in turn, help respond to blood shortages.
+ Persons taking oral PrEP or PEP will be deferred for 3 months, while those taking injectables will be deferred for 2 years.
+ While undetectable still equals non transmissible for sexual transmission, the same does not apply to transfusion transmission of HIV.
+ The basis for this deferral is grounded in current science. If a prospective donor using PrEP acquires HIV, it is possible that the medication could cause a false-negative test result because the virus has dropped to an undetectable level. That means a person taking PrEP/PEP could unknowingly transmit the virus to our nation’s blood supply.
The Red Cross and the FDA are involved in ongoing research, data collection, and assessment related to transfusion safety, including the use of HIV-preventative medications, and will continue to seek opportunities that could potentially lead to additional changes.The Red Cross does not recommend that individuals stop taking these medications to donate blood.
+ We have called on HHS and FDA to advance implementation of pathogen reduction technology that can inactivate pathogens like HIV, Zika, and many, many more.
+ Blood centers across the country have currently have this technology in place for use on plasma and platelets.
+ Similar technology for red blood cells is currently in Phase III clinical trials.
+ Individuals may be deferred from donating for a variety of reasons: recently traveling in a country where malaria is prevalent, taking a range of medications that could result in an adverse reaction if the blood were passed through transfusion.
+ We ask that all individuals who show up to donate be honest in response to the questions as they are the first line of defense in keeping the blood supply safe.
The FDA, HHS, blood centers, and patient advocates share the same goal -- ensuring the safety of the blood supply. These changes could not have been made without rigorous scientific review, and confidence that the blood supply would continue to be safe for all recipients.
Still have questions?
If you are nervous about the screening questions and the possibility of being turned away as a blood donor, you can prescreen yourself privately with the American Red Cross app and then decide whether to show up in person.
Advocating for Change
HRC has been at the forefront in the decades-long effort to update the policy, alongside other advocates.
Nearly 15 years ago in 2010, HRC renewed its call to change the policy to be more fully inclusive of LGBTQ Americans.
In 2015, following a new change to the policy that required gay and bisexual to be abstinent for a year, HRC again affirmed that this approach was unacceptable. HRC believes further investment in technologies and research – such as technology to reduce pathogens in red blood cells currently in Phase III Clinical Trials – is needed to enable even more individuals to donate whole blood.
In 2020, HRC sent a letter to the FDA urging the agency to make swift changes to the policy in the face of the COVID-19 pandemic, which led to thousands of blood drives being canceled across the country. HRC has repeatedly asked for changes to the federal policy on blood donations, since the FDA adopted its initial, discriminatory policy in 1983.
In August 2023, the American Red Cross implemented the FDA’s updated final guidance regarding an individual donor assessment for all blood donors regardless of gender or sexual orientation. This change eliminated previous FDA eligibility criteria based on sexual orientation.
They encourage individuals who believe they may now be eligible to give under the new guidelines to visit RedCrossBlood.org to learn more about donor eligibility requirements that help ensure the safety of both blood donors and blood recipients.
The FDA’s Center for Biologics Evaluation and Research regulates and establishes standards for the collection of blood and blood products. The center receives advice on this issue from the Blood Products Advisory Council, which meets regularly to consider issues such as altering the pool of potential blood donors.
In a 2023 HRC survey, nearly 90 percent of respondents believe the federal government needs to “prioritize investing in more technologies and research to allow more people to donate blood.” The technology exists today to prevent transmission of certain pathogens such as HIV in plasma and platelets.
Last Updated: 11/20/2023
The Human Rights Campaign reports on news, events and resources of the
Human Rights Campaign Foundation
that are of interest to the general public and further our common mission
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