Open Letter to Utah's Congressional Delegation

Dear Representatives and Senators:

We are writing to request that you use your position in Congress to urge the Food and Drug Administration (FDA) to rescind entirely its recommendation that blood donation centers turn away members of the LGBTQ community, especially gay men and transgender people. We all celebrate the FDA’s recent decision to reduce the period that men who have sex with men (MSM) must wait to donate blood to three months. While this change represents progress, there remains a significant disparity between the treatment of LGBTQ people during blood donation screening.

The coronavirus crisis is leaving a lasting and damaging impact on the nation’s blood supply. Blood drives throughout the country have been canceled, resulting in a decrease of roughly 130,000 donations.[i] Utahns are known for our generosity and volunteerism [ii]and yet, as recently as January of this year, the Red Cross of Utah was facing a “critical blood shortage.”[iii] A multitude of federal, state, and local officials - including Surgeon General Dr. Jerome Adams and Dr. Brett Giroir, Assistant Secretary for Health at the Department of Health and Human Services - have publicly encouraged people to donate blood.[iv] 

The FDA’s antiquated policy is not based on current science, stigmatizes the LGBTQ community, and undermines crucial efforts to increase the nation’s blood supply as the United States grapples with COVID-19.

Detached from Scientific Knowledge

Despite progress, the revised guidance still does not withstand scrutiny based on current blood safety testing capabilities. Every donation of blood undergoes comprehensive testing for a full battery of blood-borne infectious diseases, including syphilis, hepatitis, human T-lymphotropic virus, and HIV. A person who was recently infected with HIV may initially test negative but testing methods can detect the virus 8 to 12 days after transmission, rendering the three-month deferral unfounded.

The recently revised FDA policy still unnecessarily restricts blood donations. According to one estimate, FDA’s policy could prevent up to 4.5 million people from being eligible to donate blood. Revising the current restriction could result in as many as an estimated 615,000 additional pints of blood being donated each year without increasing the risk to the blood supply. [v]The American Public Health Association’s assessment has concluded that the FDA’s policy “continues to prevent low-risk individuals from contributing to our blood supply” and “is not based in science but appears to be modeled after other countries’ choices and fears.” [vi]

The United States has a chance to lead the rest of the world by embracing a fair policy that bases deferral decisions on individual risk assessment and not community identity. Such a transition would be in line with the public policy goals of the American Medical Association (AMA), “the AMA also encourages the FDA to promote additional research into behavioral factors associated with transfusion transmissible infections (TTIs), with the ultimate goal of assessing the effectiveness of individual risk assessment as a preferred strategy.” [vii]By transitioning to a process based on individual risk assessment, the United States will come into line with the values of the Red Cross, the largest provider of blood donation services in our country.

Incompatible with Timeline of Need

Given the stress that the coronavirus crisis is putting on the nation’s blood supply, a three-month deferral will do little to meet rising needs. If the LGBTQ community is excluded from participation in the blood supply, a key component of civic duty is lost during this time when all citizens must engage in civic life. By transitioning to individualized risk assessment, the deferral period for all donors - including those from the LGBTQ community with low risk - could be significantly shortened. For example, under the FDA’s newly revised guidance, a heterosexual man who has sex with multiple partners within one week of donating blood would likely be allowed to donate while a gay man who is in a monogamous sexual relationship with their spouse, would be denied the opportunity to donate unless they abstained from sexual contact for three months.

Transgender Utahns face an additional barrier to blood donation in the form of inconsistent guidance from the FDA on the definition of gender. Any revision of FDA policy should include firm guidelines for blood donation providers that include a definition of gender that is based on each individual donor’s reported identity.

Coronavirus is a Clarion Call

The short and long-term impacts that the coronavirus crisis will have on the nation’s blood supply, we implore you to use your positions as Utah’s congressional delegation to urge the FDA to further revise its policy so that every Utahn who can safely donate blood has the opportunity to do so.   

The coronavirus crisis has revealed unique vulnerabilities and disparities in our community. Times like this call each of us to embrace the civic values that make our country strong.

Utahns across the state, including many members of the LGBTQ community, stand ready to rise to the challenges of the coronavirus crisis. It will take leadership from Congress, in partnership with the President, to allow them to do their civic duty to save lives through blood donation.

Respectfully,

Turner C. Bitton
President                                                          
Utah Center for Civic Improvement

Maria Garciez
CEO
NeighborWorks Salt Lake

Mindy Vincent MSW, LCSW, MPA
Executive Director
Utah Harm Reduction Coalition

Brian Rogers, PhD
Executive Director
One Voice Recovery Inc.

Troy Williams
Executive Director
Equality Utah

Candice Metzler
Executive Director
Transgender Education Advocates of Utah

Ahmer Afroz, MPH, CHES
Executive Director
Utah AIDS Foundation

Richard Holman
Chairman
Westside Coalition - Salt Lake City

Athena Schwartz, Theadora Soter, and Whitney Geertsen
Signing Members
Youth of Utah Advocacy Coalition

Tara Grace Owen
Founder
Transgender Inclusion Project

Nicole Maestas and Kyli Rodriguez-Cayro
Founders
Sex Worker Outreach Project - Salt Lake City Chapter

MaryAnne Russel and Rose List
Organizing Members
Moab Pride

 

[i] Letter from Debra BenAvram, Chief Executive Officer, AABB, Kate Fry, Chief Executive Officer, America’s Blood Centers, and J. Chris Hrouda, President, Biomedical Services, American Red Cross to The Honorable Stephen M. Hahn, MD, Commissioner, Food and Drug Administration (Mar. 20, 2020) (online at www.aabb.org/advocacy/correspondence/Documents/Joint-Letter-to-FDA-on-Blood-Supply-Chain.pdf). 

[ii] Still #1 in Volunteering! (n.d.). Retrieved April 3, 2020, from https://userve.utah.gov/still-1-in-volunteering/

[iii] Forgie, A. (2020, January 20). Red Cross: 'Critical blood shortage,' donors of all blood types urged to donate. KUTV2. Retrieved from https://kutv.com/news/local/red-cross-critical-blood-shortage-donors-of-all-blood-types-urged-to-donateStill #1 in Volunteering! (n.d.). Retrieved April 3, 2020, from https://userve.utah.gov/still-1-in-volunteering/

[iv] Sternlicht, A. (2020, March 19). White House Calls On Millennials, Gen Z To Donate Blood Amid ‘Severe’ National Shortage. White House Calls On Millennials, Gen Z To Donate Blood Amid ‘Severe’ National Shortage. Retrieved from https://www.forbes.com/sites/alexandrasternlicht/2020/03/19/white-house-calls-on-millennials-gen-z-to-donate-blood-amid-severe-national-shortage/#2301c6ab5e55

[v] UPDATE:  Effects of Lifting Blood Donation Bans on Men Who Have Sex with Men, Williams Institute (Sept. 2014) (online at https://williamsinstitute.law.ucla.edu/wp-content/uploads/Blood-Donation-Ban-MSM-Sep-2014.pdf). 

[vi] Letter from Georges C. Benjamin, M.D., Executive Director, American Public Health Association, to Food and Drug Administration (June 12, 2015) (online at www.regulations.gov/document?D=FDA-2015-D-1211-0053). 

[vii] Letter from James L. Madara, M.D., Chief Executive Officer and Executive Vice President, American Medical Association, to Leslie Kux, J.D., Associate Commissioner for Policy, Food and Drug Administration (July 13, 2015) (online at www.regulations.gov/document?D=FDA-2015-D-1211-0063).


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