The head of the organization overseeing organ donations in Ontario says gay men should not let new regulations stop them from contributing their organs.
“The message we want to send to the gay community is that we want them to be donors,” says Frank Markel, president of the Trillium Gift of Life Network (TGLN). “The first message is we’ve heard your concerns and we’re responding. The second is we’d like you to be donors.”
In December Health Canada — which sets nationwide rules for organ donations — quietly enacted regulations prohibiting a man who has had sex with another man even once in the past five years from donating organs.
Technically gay men are still allowed to donate organs but in order for those organs to be used, doctors and recipients have to go through a special “exceptional distribution” process certifying that they are aware of the risk involved in using organs from a gay man.
Markel says the new regulations are based on existing guidelines and do not change the procedures commonly followed in Canada for organ donations. But he says the new regulations make it much harder to deal sensitively with gay men.
“Before if we didn’t want to do it that way we had the freedom to change,” he says. “Now we have no choice. Ultimately Health Canada could close us.”
Markel says he agrees with complaints that the policy unfairly singles out gay men from other groups with high rates of infection like aboriginals, people from sub-Saharan Africa and young heterosexual women.
“Why pick one group and not another?” he says. “This is inconsiderate and offensive. We’ll be urging Health Canada to conduct a speedy review in hopes that they’ll make changes. The specific risk of infection arises from behaviour. Let’s make that clear.
“What we’re looking at and hoping to change it to is high-risk behaviour. We’re going to talk to the community about substance and tone.”
Markel says he thinks Health Canada’s policy is based on out-of-date science.
“The wording goes back to 1994,” he says. “It was actually developed by the Centres for Disease Control in the States. That wording was developed from the understanding of AIDS in the early ’90s. Some 15 years later our understanding has changed.”
Markel says the regulations also allow no latitude when it comes to low-risk sex practices.
“If a man is having oral sex with another man the present wording in the regulations would put him at high risk,” he says.
George Smitherman, the Ontario minister of health and an openly gay man, says he’s been battling with Health Canada since he took office over their ban on gay men donating blood. Men who have had sex with a man even once since 1977 are banned from donating blood.
“Twice in the last four years at meetings of Canadian Blood Services I really did raise the issue of blood donation with their regulator, which is Health Canada, wondering aloud when might I be able to give blood,” he says.
“Health Canada has replaced the doctor with a lawyer in the decision-making process.”
But Smitherman urges gay men to continue to donate organs.
“My primary motivation is I know people who need the organs,” he says. “You meet people who are languishing on the waiting list needing organs and these regulations work against it. We have to keep working to see if we can get a little more common sense in the process. They took away a little of that common sense latitude.”
But not all provincial bodies seem concerned by Health Canada’s approach. BC Transplant — that province’s equivalent of TGLN — has no problem with the new regulations.
Allison Brown — the communications coordinator for the agency, which administered a record 262 transplants last year — says the regulations are necessary.
“There just have to be some blanket standards across the board,” she says. “The regulations exist to identify who should be considered high risk.”
Brown says she doesn’t think the regulations actually discriminate against gay men.
“It doesn’t actually identify gay men,” she says. “It says men who have sex with men. That could be someone living down the street who has a wife and kids.”
Brown says BC Transplant does still welcome organ donations from gay men.
“My message is you’re still a potential donor,” she says. “Our position is that every person should be a donor and every organ that can be transplanted should be.”
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