In August 2016, I filed a federal lawsuit against Canadian Blood Services and Health Canada to challenge the blood donation deferral policy affecting queer and trans Canadians. Back then, the blood ban barred both men who have sex with men (MSM) and women who have sex with MSM from donating if they had had this kind of sexual contact within the past year. The same policy was also arbitrarily used to bar trans and non-binary people, notably trans women who have not had gender-affirming surgery, from donating. While the policy had been in place for decades, Liberal candidate Justin Trudeau gave me hope during the 2015 federal election when he campaigned on the promise to completely eliminate the blood ban. He was elected prime minister in October 2015, but a year into his term he had made no significant progress. So, I filed a suit in hopes that the ban might finally be eliminated.
I’d experienced the discrimination of the blood ban firsthand. After Trudeau’s election, I tried to donate blood even though I knew I’d likely be turned away. Standing in line to donate, I even removed my rainbow bracelet—perhaps out of fear of the way I may be treated, what might be said to me or the possible stigma I’d face for being a gay man. But even with blood test results in hand, I was told I couldn’t donate. I would later learn that I couldn’t donate unless I was abstinent for five years from the date I was last intimate with my partner—even though, by then, former minister of health Jane Philpott had announced that the MSM blood donation deferral policy was lowered from five years to one.
The blood donation ban came into existence after Canada experienced a healthcare tragedy in the 1980s that claimed the lives of more than 8,000 and infected more than 30,000 people with hepatitis C and 2,000 with HIV. During this time, the blood bank system in Canada was operated by the Canadian Red Cross, without today’s regulatory oversight. In the tragedy’s aftermath, the government held a formal inquiry into the matter. A five-year investigation ensued and, in 1997, the Commission of Inquiry on the Blood System in Canada produced a 1,200 page report. In it, Justice Horace Krever concluded that the calamity was the consequence of the profit motive of Canada’s blood system—a result of brokers importing blood from American prisoners and relabelling it “Canadian.”
Based on Justice Krever’s recommendations, Canada’s blood donation system was separated between the regulator, Health Canada, and Canada’s two not-for-profit blood agencies, Canadian Blood Services and Héma-Québec. But the system has since been shaped by industry: It now consists of the regulator, the two not-for-profit blood agencies and for-profit-agencies like Expharma/Canadian Plasma Resources, Examon Industries and Consulting Services, Biotest Plasma and others.
These for-profit agencies collect plasma from paid blood donors for the purposes of producing plasma-based drugs, and a majority of these drugs are then sold outside of Canada. By collecting plasma for profit, these agencies often deplete Canada’s voluntary blood supply. Should the supply continue to be depleted, Canada’s health system would have to heavily rely on the blood collected from these agencies—the very scenario Justice Krever warned against in his report.
Yet the government has been more than willing to meet with and fulfill the demands of the for-profit plasma industry. In August 2017, Health Canada approved a third for-profit plasma clinic despite warning from Canadian Blood Services. Nearly two years later, in July 2019, Health Canada approved increased plasma donations at Canadian Plasma Resources, which operates in New Brunswick and Saskatchewan. As per their warnings, Canadian Blood Services said there was a drop in voluntary donors in Saskatoon after the clinic opened in 2016.
All the while, several eager voluntary donors—particularly queer men and trans women—remain unable to donate outside of outdated deferral periods.
It seems that the government is only willing to intervene in the blood system when there’s money to be made for industry. For years, LGBTQ2 activists and allies have called on the Canadian government to end the blood ban. But such a call has been deemed by some Canadians as “controversial” and therefore ignored, considered by the government an infringement on the independence of Canadian Blood Services and Héma-Québec. (When re-elected in 2019, Trudeau vowed to end the discriminatory blood ban once again, “in partnership with Canadian Blood Services and Héma-Québec.” Where the government is in that process is unclear.)
Philpott, with whom I spoke about the blood ban last July, maintained that Canadian Blood Services and Héma-Québec must stay politically independent. When I asked if the government was considering public opinion from Canadians who might be opposed and concerned about LGBTQ2 donors, she called the suggestion “inappropriate.” Despite her insistence, Canadian Blood Services and Héma-Québec have not intervened to limit discriminatory policies used against eligible donors who wish to donate blood, organs, tissue, semen, bone marrow and more—despite growing evidence that the deferral practice is outdated. With fewer people eligible to donate, Canada’s health system will likely have to rely on for-profit agencies to fulfill the demand.
Currently, the blood donation deferral period is three months for MSM and trans women who have not had gender-affirming surgery and who have sex with men. Dr. Mindy Goldman, medical director of donor and clinical services at Canadian Blood Services, claims the updated policy aims to recognize the growing number of trans and non-binary people who want to donate, but maintains the policy is in place for MSM. Meanwhile, if you have travelled to Saudi Arabia, Mexico, Central America or South America, you may also not be able to donate. The same is true if you, your mother or your grandmother were born in Mexico, Central America or South America.
Not long ago, Canadian Blood Services and Héma-Québec discriminated against anyone who was born or had lived in Africa since 1977, or who had had sexual contact with anyone from Africa within that period or received blood products from Africa. Most recently, the agencies excluded Cameroon and Togo. These discriminatory policies have since been removed but serve as a reminder of the progress that still needs to be made. Some researchers say policies like the MSM deferral have the effect of targeting these same groups.
And, most gravely, it’s policies like these that will make it more likely to repeat the past.