Transfusion law: why gay blood donors have been discriminated against so far

Watson answers

What almost sounds like a bad joke in 2023 is unfortunately not one: Until now, sexually active homosexual and bisexual men could be excluded from donating blood across the board. This procedure according to the transfusion law was practice in Germany for decades. Blood donations are indispensable for medicine, both for research and to save other people’s lives. In addition, canned goods of certain blood groups are scarce in many hospitals.

Discrimination is still part of everyday life for many homosexual people.Bild: iStockphoto / Getty images / Vittorio Gravino

Now the Bundestag has put an end to discrimination against homosexual men. The new regulation was not passed as a separate law, but adopted as an addition to the new law for independent party advice (UPD). Anyone willing to donate blood is allowed to donate if they meet the criteria. Regardless of their sexual orientation and gender identity.

But why was there this form of discrimination in blood donations at all? And what exactly does the decision of the Bundestag change? Watson provides the key questions and answers.

What used to be the case for homosexual men?

Blood donations are strictly regulated by the Transfusion Act. This stipulates how often and at what intervals blood donation is permitted. Or what criteria blood donors have to meet. The aim is to ensure safety when donating blood and to ensure that the population is supplied with blood products.

Discrimination against gay and bisexual men

For a long time, men who had sex with men were not allowed to donate at all. Over time there were always changes. As of 2017, gay men were only allowed to donate blood if they hadn’t had sex with a man for a year.

The sexual orientation of the donor has so far played a role in blood donations.Image: E+ / Getty Images / Nikola Stojadinovic

From 2021, they were allowed to donate blood if they were in a permanent monogamous relationship. From then on, sexual contacts between men outside of such relationships led to an exclusion for four months instead of one year as before.

Specifically, homosexual and bisexual men were only considered donors if they had not had sex with “one new or more than one sexual partner” in the past four months. This continued to discriminate against them. Because: For all other people, this ban only applied to “frequently changing partners”.

Why were gays discriminated against at all?

Blood donations are subject to strict guidelines. This also means that the donated blood is tested for HIV and other infections before it is used. Depending on the test method, some pathogens or the antibodies against them can only be detected after a certain period of time. Therefore infections can be overlooked. This includes the HI virus.

Blood donations are screened before use.Image: dpa / Friso Gentsch

The restrictions on gay and bisexual men donating blood date back to the time of the great AIDS crisis. The crisis years of the 80s and 90s concerned medicine as much as the population. At the time, the decision was based on concern that homosexual men were more at risk of passing on the HI virus through blood donations.

Because of the time it takes for pathogens to be detected, potential donors are also asked about their behavior relevant to infection. This is to minimize the risk of an undetected infection.

What is the increased risk?

The German Aidshilfe writes about the increased risk of gay and bisexual men on their website:

Criticism of the blanket exclusion of gay men from blood donations

Despite this statement, the Aidshilfe criticizes the guidelines that have been in place to date in relation to homosexual and bisexual men. The previous approach excludes men who have sex with men far too generally.

Federal Health Minister Karl Lauterbach (SPD) also recently described the regulations as discrimination. “Whether someone can become a blood donor is a question of risky behavior, not sexual orientation,” he said.

What will change with the new regulation?

A change has been called for for years from various quarters. Now the demands are bearing fruit: With its vote on Thursday, the Bundestag obliges the German Medical Association to change the discriminatory directive. The government factions are thus implementing an agreement from their coalition agreement. The traffic light parties there had decided to end this practice. “There is no scientific reason for this discrimination,” said SPD MP Heike Engelhardt. “It’s a shame that people in 2023 are still struggling with such disadvantages and prejudices.”

From now on, the “donation suitability” will be assessed individually

Instead of generalization, other criteria should now come to the fore, such as the “individual sexual behavior of the person willing to donate”. According to the law, the new regulation should “avoid discrimination in the selection of donors”. It also states “that the sexual orientation and gender identity of persons willing to donate as such may not be criteria for exclusion or deferral”. This applies not only to “men who have sex with men (MSM)”, but also to “trans people”.

In the future, more and more doctors will evaluate people who are willing to donate according to their “suitability to donate”.Bild: Getty Images/iStockphoto / shironosov

But not only them: With the change, other maximum age limits also apply to blood donors. So far, first-time donors – depending on the region – were only allowed to be around 65 years old. For repeat donors, the upper limit was usually between 70 and 75 years. In the future, the doctors should now assess the individual “suitability for donation”.

What almost sounds like a bad joke in 2023 is unfortunately not one: Until now, sexually active homosexual and bisexual men could be excluded from donating blood across the board. This procedure according to the transfusion law was practice in Germany for decades. Blood donations are indispensable for medicine, both for research and to save other people’s lives. In addition, canned blood of certain blood groups is scarce in many hospitals.