Canadian Blood Services places restrictions on transgender donors

Canadian Blood Services is introducing new criteria that will screen transgender people by their assigned birth sex if they have not undergone gender confirming surgery. The policy also includes rules targeted at trans women

Complex new policy, to begin Aug. 15, is discriminatory, activists say

Health Minister Jane Philpott donates blood at Canadian Blood Services in December 2015. (Justin Tang/Canadian Press)

Canadian Blood Services will introduce a new donation policy for transgender people this summer that does not sit well with some critics.

The policy will be implemented on Aug.15. Up until this point, donation clinics in Canada allowed trans people to give blood on a case-by-case basis. 

Dr. Mindy Goldman, medical director of Canadian Blood Services, told CBC News that at least 30 to 50 of the country's 409,000 registered blood donors currently identify as transgender. 

She says the policy is a way to "recognize that (trans people are) a group of Canadians interested in participating in blood donation.".

"This is the first time that we have standardized and put something in our national criteria manual. Previously, (trans) donors could have gotten a different screening outcome if they had gone to a clinic in Vancouver compared to a clinic in Montreal," said Goldman.

But many activists are upset with the policy because it focuses on whether or not a trans person has undergone gender confirming surgery. 

Goldman says the criteria will create a countrywide, streamlined mandate for all trans blood donors. 

According to Canadian Blood Services, there has been an increase in potential trans donors and this prompted the organization to implement criteria for those individuals.

The policy specifically targets trans women and is similar to Canadian Blood Services' updated guidelines for gay blood donors. On June 20, Health Canada announced that gay men would be allowed to donate blood if they had abstained from sex for at least one year.
Susan Gapka 'would not bother' donating blood and thinks the new policy is discriminatory. (Susan Gapka/Twitter)

Trans women who undergo gender confirming surgery will have to wait one year before they can donate blood. After the wait period, Canadian Blood services will also identify them by their reconfirmed gender. "If a trans woman has not had [gender confirming surgery], that person would be considered as a male having sex with a male," Goldman said.

Canadian Blood Services says there are regulations specific to trans women because that demographic is at high risk for HIV. 

According to the Interagency Coalition on AIDS and Development, an estimated 27.7 per cent of trans women in Canada are living with HIV. 

"There is a very high HIV prevalence rate in trans women," Goldman said. "So we are obliged to treat (them) as a high risk group." 

Criteria come with complexities 

The guidelines differ depending on the trans donor's sexual history. For instance, if a trans woman or man is intimate with a female, that person will not have to wait before they donate blood, but they will still be screened by the sex they were assigned at birth.

Goldman acknowledges that the policy is complex and may overlook some individual cases.

"If a situation is not covered in the criteria manual, (our staff) needs to do a medical inquiry and get in contact with one of our physicians. We would get more information and work things out on a case-by-case basis," she said. 

Canadian Blood Services will identify transgender blood donors by their assigned birth sex if they have not received gender confirming surgery. (Ryan Remiorz/Canadian Press)

Dr. Adrian Edgar, a specialist in trans, queer and reproductive health at Clinic 544 in Fredericton, N.B., believes the trans blood donation policy should not emphasize gender confirming surgery as a focal point in its criteria.

Edgar says there is also no medical proof that the surgery will directly affect the safety of a trans person's blood.

"I have never seen data that suggests that the sexual anatomy of a person who is trans would have an impact on their HIV, syphilis or their hepatitis status," he told CBC News.

Edgar also believes screening trans people by their sex assigned at birth will discourage them from donating blood.

"No one is going to go to a facility that refuses to respect and acknowledge their gender identity," he said.

Activist 'would not bother' donating

Susan Gapka, a trans woman and the founding chair of the Trans Lobby Group, says she "would not bother" going through the process of donating blood given the new rules, which she thinks are discriminatory.

"It says that they don't want my blood. It says that I'm not worthy. It says that I don't belong, that I am not good enough. It just really builds on that erasure," Gapka told CBC News.

Canadian Blood Services will implement a nationwide policy for trans blood donors for the first time in August. (Ryan Remiorz/Canadian Press)

The policy's focus on gender confirming surgery is also problematic for Gapka.

"It reduces people to a surgical procedure, which is not accessible to everyone and not everyone wants it. It is really outdated," she said.

Trans people have limited access to gender confirming surgery in Canada. The Centre Métropolitain de Chirurgie, located in Montreal, is the only clinic in the country that performs the procedure.

The medical coverage for the surgery varies between provinces but there is no coverage provided in P.E.I.

Montreal-based trans activist Sophia Banks expressed her outrage on social media.

"How does me castrating myself all of a sudden mean my blood is clean and I can't have HIV? What sense does that make?" she said.

"Everything about this is extremely transphobic."

New rules are 'not perfect' 

Canadian Blood Services says that it included various stakeholders, donors and members of the trans community who currently donate blood in crafting the new policy, which was approved by Health Canada in June. 

Health Canada told CBC News that "the change in (Canadian Blood Services') policy will allow some transgender people to donate blood who may have been excluded before."

But Goldman acknowledges that the new procedure is not perfect.

"I think moving forward we will have to see if there is something we can craft that will meet our regulatory framework, ensures safety for recipients and is more acceptable to members of the trans community. But it is complex and we will have to beg people's patience," she said.