Advocates and members of the LGBTQ2 community in Canada and the United States are frustrated with the policies that limit queer people’s ability to donate tissue following their deaths.
According to Nova Scotia Health, Canada’s regional tissue banks use the American Association of Tissue Banks (AATB) screening processes when determining if donors are eligible to donate.
However, the AATB’s screening guidelines follow a 15-year-old U.S. Food and Drug Administration regulation stating men who have sex with men (MSM) must be deferred from donating for five years after the relationship ends.
“With tissue donation, the vast majority of donors are deceased at the time of procurement and screening, so people just aren’t aware of it,” said Cole Williams, founder of the American organization Pride and Plasma. “There’s not a need to turn away an entire demographic of donors when we are facing a shortage, and it’s just discriminatory.”
Pride and Plasma is an activist group that aims to reform America’s deferment policies that discriminate against MSM donors.
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The group was originally formed to change the FDA’s blood regulation, but is now looking at the MSM tissue deferment as the next policy in need of reform. But Williams said any change to the FDA policy wouldn’t mean an end to the issue.
“If we were to see a reduction from the five-year deferment policy for tissue,” he said, “that doesn’t mean that there would be anything put in place, and it would still have to go from the FDA to AATB.”
According to Nova Scotia Health, changes made to AATB’s guidelines are then adopted by Canada’s regional tissue banks, which determine donor eligibility.
But Williams said this process excludes many viable donors based on the dated MSM deferment policy, and that trans women and those assigned male at birth are also frequently denied eligibility.
“The effectiveness of screening blood and tissue is wonderful … there’s no reason to turn away donors when these screening processes work,” Williams said, adding that when similar policies, like those involving blood donation, were adopted, there wasn’t a way to screen or test for HIV.
“That’s not the case anymore,” Williams said. “The risk of HIV transmission after nucleic acid testing, which is the gold standard, is one in 1.5 million, and it can be detected in a lot less than three months, certainly a lot less than five years.”
This eligibility process has upset many, including Cindy Gates-Dee, the mother of Liam Dee, who passed away last November.
Gates-Dee said Liam had always wanted to donate his tissue, but his body was denied by the regional tissue bank due to the fact that he was in a gay marriage.
Neither Liam nor his husband, Jacob MacDonald, were told his tissue would be considered ‘high-risk’ due to his sexual orientation until it was too late.
“It felt to me like, because my son was gay, they automatically assumed that he had engaged in risky behaviours and that he was carrying HIV or hepatitis,” Gates-Dee said. “Had they investigated further, had they spoken to Jacob who they should’ve spoken to, then they would have gleaned that they had been together for four years in a monogamous relationship. They were not engaging in risky behaviours, they were a happily married, loving, gay couple.”
If anything, both Williams and Gates-Dee would like to see the questionnaires used focus on individual risk assessment, rather than singling out donors as ‘high-risk’ based on their sexual orientation.
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