Towards an Evidence Based Approach

Excerpt from 2006 Canadian Blood Services Record of Donation discussing HIV/AIDS status, including questions of donor's relationship to Africa

Following the policies pushed in the U.S.A., the CRC included Haitian people in their “voluntary self-exclusion” donation policy, which effectively banned them from donating blood (CBS, 2016). Individuals were singled out through their “language and skin colour,” which made them “the easiest group to identify publicly.” (CBS, 2016). Testimonies were presented before the Krever Commission in 1994, which argued that the exclusion of the Haitian community from blood donation lacked “irrefutable scientific evidence,” using a statement of principle signed in 1988 by doctors of Haitian origin to request the adoption of “at-risk behaviours” rather than group-based rulings (CBS, 2016).

These anti-immigration and anti-Black racist rhetoric which permeated CBS eligibility protocols regarding their policies on donation from those of Haitian origin did not end with the removal of this restriction. However, the focus shifted away from Haiti and toward the African continent at the same time. In 1996, a new question came into place, with donors being asked about their relationship to Africa. If they answered yes to either being born in or having sexual contact with anyone from Central African Republic, Cameroon, Chad, Congo, Equatorial Guinea, Gabon, Niger, and Nigeria, they would receive a lifetime blood donation ban (Dryden, 12; Canadian Red Cross).

Article on Holly Betram's fight against Canadian Blood Services to allow for trans blood donation.

The 1990s saw a second case against the blood ban, this time regarding the exclusion of trans people from donating blood and blood products. Holly Bertram, a transsexual woman from Winnipeg who had donated blood numerous times in the past, was rejected from CBS when she informed them that she was a transsexual woman. The CBS did not have a formal policy in place to account for trans donors, therefore, without knowing what to do, they turned her away. As a result, Bertram went public with her case and fought against the temporary ban in place against trans people to account for a lack of policy. Bertram argued that this was unfounded, and resulted in CBS stating that “it was made very clear to us that transgendered sexual behaviour is no different than average heterosexual individuals” (University of Saskatchewan Libraries). From this, trans people were then permitted to donate blood, given the donor does not engage in “high-risk” behaviours that all screened donors were screened for. 

Through these confrontations with the ban, it is possible to see the underpinnings of a sexual behavior based screening for blood and plasma donation, with CBS moving away from the identity of the donor. Despite this model not becoming policy for many years, the fallibility of an identity based screening model was very clear.

Letter from Bill Siksay and Megan Leslie to The Honourable Leona Aglukkaq, P.C., M.P. Minister of Health

Even with fights for an evidence based approach to blood donation that ignores identity, as seen through both fights against bans for Haitian communities and trans people, when this turned toward the MSM community, the emphasis was placed on allowing ‘good donors’ to participate instead of ruling out the entire population. In 2010, NDP Critic on LGBTT Issues, Bill Siksay, and NDP Critic for Health, Megan Leslie, penned letters to the House of Commons and Ministry of Health arguing that “it makes sense to allow healthy, gay men to donate [blood],” further stating that “the outdated ban sends an incorrect message about sexual orientation and health” (F0189-02-015). Further, AIDS expert Dr. Mark Wainberg stated in an interview with Xtra! that only monogamous gay men should be able to give blood as “gay men are statistically more likely to have more partners than heterosexual men” (McKinnon). Both of these statements were made in 2010, decades after the origins of the ban, accessible HIV testing, and the other fights against the ban. However, due to moralistic beliefs surrounding promiscuity, fights against the MSM ban could only account for those who aligned most with a heteronormative relationship or partnership structure, allowing for these fears of promiscuity to persist long past necessary.

This focus of who is a “good donor,” was amplified even further when looking at the ban’s impact on sex workers. As stated in her speech at the 5th International AIDS Conference in 1989, Valerie Scott from the Canadian Organization for the Rights of Prostitutes stated “Whores are safe sex pros…” and that despite being cited at the reason for the spread of AIDS, “if that were true, half the government would be dead already.” (Sorfleet, 3). This outcome of the ban on blood donation hinged on the concept that the behavior of sex workers was unsafe, promiscuous, and a risk to public good, a belief that sex workers fought against for decades but were met with constant stigmatization in return.