One factor that rarely seems consdered in the blood donation ban is the very real toll in human lives that the social stigma of homophobia creates. As a result, I’ve attempted to drive home that point with regard to the ban in my letter to Dr. Holmberg. Dear Dr. Holmberg:

I am delighted to learn that the FDA has begun a reevaluation of the wisdom on a lifetime ban on blood donations from men who have sex with men. I believe that there is, and has been for some time, ample evidence that this risk can be reduced with no measurable harm to public safety, and just as importantly, accomplish signficant public good.

With regard to public safety, the numbers are clear and overdue, I’m certain that other writers will reiterate the broad scientific consensus that the number of infected blood units that would enter the system from a modest change in MSM deferral policies would be unmesasurably small, perhaps 1-2 pints per year–the last number I saw was 1.7.

Were direct safety of every blood unit the only concern, even one life would be overriding, but it’s not. Shortages of blood do, I would guess, create a measurable harm on the people who need that blood to survive.
urely simply the increased availability of blood would save that potential 1-2 new infections per year?

For the moment, though, let me put aside that very real issue and examine another–the possiblity that there might just be other lives at stake.

The lifetime risk also includes a social stigma in the United States, and the risk to the physical health of gay and bisexual Americans from that stigma is underappreciated, but starting to be directly taken on by research. The social stigma of something so slight as a state marriage ban appears to cause signficantly increased HIV rates (Tolerance and HIV, Journal of Health Economics 29(2), March 2010, 250-267, Mialon/Francis) at rates which can be numbered in the thousands of new US HIV infections per year. One in three LGBT teens attempts suicide as an effect of this stigma (we could quibble, that’s my analysis based on the types of error reported in the seven studies described here: http://www.jeramyt.org/gay/gaysuic.htm ). Many succeed, probably thousands per year (based on an assumption that LGBT teens are not uniquely inept at committing suicide.)

People are dying in large numbers from anti-LGBT social stigma, of this there is evidence, not mere speculation.

The opponents of changing the lifetime ban argue, and I quote Cifff Kincaid here, “Do you or your loved ones want to die in order to advance the gay rights agenda?” I’d ask instead, “Do you want my loved ones to die in order to advance a religious and/or political agenda?” You have in your hands an awful balance. You can keep a lifetime ban which might arguably save a 1-2 lives per year due to the increased rate at which testing errors allow HIV-infected blood into the system. Or you can change a ban, and that the minor but real reduction in social stigma from this move will save a tiny fraction of the tens of thousands of lives I’ve described as harmed directly each year. So long as we accept that the stigma effect of the lifetime donation ban is within four orders of magnitude of the stigma effect of a state marriage ban, and so long as we claim to hold the notion that the value of all human life is equally precious, the right decision, I believe, is transparent.

Thank you for your attention,

Best regards,

–Joe Decker

Joe Decker

Joe Decker