The even-handed rule that you cannot donate if you’ve had sex with man who’s had sex with a man would still keep out most gay men
If a man is gay and sexually active, he’s almost certainly had sex with a man who’s had sex with a man, even if the men he has had sex with has only had sex with him. I don’t see how this phrasing of the rule would be an improvement.
My phrasing was unclear; make it “if you’ve had sex with man who’s previously had sex with a man (other than you)”. There wouldn’t be any point in forbidding me from donating (if I’m male) because the man that I’ve had sex with has had sex with me!
This change would include more people; it includes monogamous gay male couples who began their relationship as virgins (as well as some other people). Not many more, but it makes it clear that the blood collector is only willing to trust you and your partners, no further.
Frankly, the first even-handed rule (no sex with a man, period) makes more sense to me. Why should the blood collector trust that I know (if I’m a woman) whether all of the men that I’ve had sex with have had sex only with women? (No doubt many women are donating contrary to guidelines because they don’t know this about their partners.) But because this would cut the potential donor pool in half, the blood collector is basically forced to trust me about my partners too.
In fact, the blood collectors trust women to know the sexual history of their partners, but not men. They are not asking everybody the same questions.
Another possible solution, not even-handed, but more honest: Just don’t ask women anything about the subject.
The idea that a person can be trusted to know about their partners’ partners is preposterous; no other question (in the U.S.) asks the donor about other people’s behaviour, and for good reason. Instead of half-assedly trying to be even-handed about it, just admit what they’re doing: ruling out men who’ve had sex with men, because many of their partners will have had sex with other men, and so on back (in many cases) a long way; but accepting women who’ve had sex with men, because most of their partners won’t have had sex with men, stopping the transmission-from-men sequence.
I’m confident that they already accept blood from most women who’ve had sex with men who’ve had sex with men (because the women don’t know this about their partners), and they are surely aware of this (if I am correct) fact. So why are they asking questions of people who don’t actually know the answers?
Gay people will still be upset that they can’t donate, but I at least would be more willing to trust that the blood collectors are actually making an honest decision.
Mostly, my faith in the quality of the blood supply derives from what testing they’re doing to the blood, not from what unenforceable policies they’re suggesting to the donors.
I’d actually be surprised if the latter significantly affected the quality of the blood.
Mostly, I think the problem they are a solution for is maintaining public confidence in the blood supply. Which I acknowledge is an important problem. And it may well be that being perceived as excluding gay men and their partners is a better solution to that problem than anything else they might do; I don’t know.
That said, if I’m wrong and these policies really do solve a problem related to the blood supply, yet another possible solution is: don’t allow people who have had unprotected sex to donate.
Or, if that’s too big a chunk of your potential donor base, make it people who have had unprotected sex outside of a monogamous relationship.
The original rule bars ‘a man who has had sex with a man’ - X—and then any women who’ve had sex with X. It’s a logical phrasing but unfortunately X maps exactly onto “gay man”, so it feels like gay men are being specifically targeted. The rephrasing mollifies that sense of targeting without, as far as I can tell, changing the included or excluded people.
The original phrase is even-handed, however. If you overspecified an even-handed rule and said “1) You cannot donate if you’re a man who has had sex with a man who has had sex with a man, and 2) you cannot donate if you’re a woman who has had sex with a man who has had sex with a man”—ie, prevent “man who has had sex with a man” from coming into sexual contact with any donor—you could reduce 1) down to “man who has had sex with a man” (it logically implies three, four, and so on iterations). This, therefore, reduces down to the actual rule they have in place.
If a man is gay and sexually active, he’s almost certainly had sex with a man who’s had sex with a man, even if the men he has had sex with has only had sex with him. I don’t see how this phrasing of the rule would be an improvement.
My phrasing was unclear; make it “if you’ve had sex with man who’s previously had sex with a man (other than you)”. There wouldn’t be any point in forbidding me from donating (if I’m male) because the man that I’ve had sex with has had sex with me!
This change would include more people; it includes monogamous gay male couples who began their relationship as virgins (as well as some other people). Not many more, but it makes it clear that the blood collector is only willing to trust you and your partners, no further.
Frankly, the first even-handed rule (no sex with a man, period) makes more sense to me. Why should the blood collector trust that I know (if I’m a woman) whether all of the men that I’ve had sex with have had sex only with women? (No doubt many women are donating contrary to guidelines because they don’t know this about their partners.) But because this would cut the potential donor pool in half, the blood collector is basically forced to trust me about my partners too.
In fact, the blood collectors trust women to know the sexual history of their partners, but not men. They are not asking everybody the same questions.
Another possible solution, not even-handed, but more honest: Just don’t ask women anything about the subject.
The idea that a person can be trusted to know about their partners’ partners is preposterous; no other question (in the U.S.) asks the donor about other people’s behaviour, and for good reason. Instead of half-assedly trying to be even-handed about it, just admit what they’re doing: ruling out men who’ve had sex with men, because many of their partners will have had sex with other men, and so on back (in many cases) a long way; but accepting women who’ve had sex with men, because most of their partners won’t have had sex with men, stopping the transmission-from-men sequence.
I’m confident that they already accept blood from most women who’ve had sex with men who’ve had sex with men (because the women don’t know this about their partners), and they are surely aware of this (if I am correct) fact. So why are they asking questions of people who don’t actually know the answers?
Gay people will still be upset that they can’t donate, but I at least would be more willing to trust that the blood collectors are actually making an honest decision.
Mostly, my faith in the quality of the blood supply derives from what testing they’re doing to the blood, not from what unenforceable policies they’re suggesting to the donors.
I’d actually be surprised if the latter significantly affected the quality of the blood.
Mostly, I think the problem they are a solution for is maintaining public confidence in the blood supply. Which I acknowledge is an important problem. And it may well be that being perceived as excluding gay men and their partners is a better solution to that problem than anything else they might do; I don’t know.
That said, if I’m wrong and these policies really do solve a problem related to the blood supply, yet another possible solution is: don’t allow people who have had unprotected sex to donate.
Or, if that’s too big a chunk of your potential donor base, make it people who have had unprotected sex outside of a monogamous relationship.
The original rule bars ‘a man who has had sex with a man’ - X—and then any women who’ve had sex with X. It’s a logical phrasing but unfortunately X maps exactly onto “gay man”, so it feels like gay men are being specifically targeted. The rephrasing mollifies that sense of targeting without, as far as I can tell, changing the included or excluded people.
The original phrase is even-handed, however. If you overspecified an even-handed rule and said “1) You cannot donate if you’re a man who has had sex with a man who has had sex with a man, and 2) you cannot donate if you’re a woman who has had sex with a man who has had sex with a man”—ie, prevent “man who has had sex with a man” from coming into sexual contact with any donor—you could reduce 1) down to “man who has had sex with a man” (it logically implies three, four, and so on iterations). This, therefore, reduces down to the actual rule they have in place.