Blood Donation For Trans Persons in Canada

Canadian Blood Services recently announced that, aside from its new policy on men who have sexual relations with men, a new policy revolving around trans people would come into force on August 15th 2016. Héma-Québec, plausibly, will follow in their footsteps.

The legality of this new policy is unclear, as both federal and provincial laws prohibit discrimination against trans persons.

Under this policy, trans people will be categorised as men or women based on their genitalia. Thus, trans women who have not undergone genital surgery will be considered men, whereas trans men who have not undergone genital surgery will be considered women. Non-binary individuals will be similarly categorised. This policy is not supported by the available statistics on seroprevalence amongst trans people, and contributes to the marginalisation of an already very vulnerable population.

I will begin by mentioning that trans people are amongst the at-risk groups with regards to HIV. Seroprevalence amongst trans people is higher than the average. Yet, the new policy of Canadian Blood Services does not appear to be interested in seroprevalence: trans women who have undergone vaginoplasty are classified as low-risk, although they were considered high risk immediately prior to surgery. Furthermore, if gay and bisexual trans men are also at higher risk, this policy classifies them as low-risk by re-imagining them as women, inscribing itself in a long tradition of trans men erasure in policies and studies on HIV, to their detriment.

Furthermore, heterosexual men may find it difficult to donate blood if they are sexually active with trans women. The message expounded by the policy seems to be that a large portion of trans women are not really women. This message is not only false, but it is extremely dangerous given the prevalence of the “trans panic” justification in justifying violence against trans women, even today. This “trans panic” has the very same underlying logic as that of the policy set out by Canadian Blood Services.

The new policy regarding men who have sexual relations with men was strongly criticised, and I join others in requesting the abolition of the one year delay which is at the centre of the policy. Nevertheless, if we were to admit that it may be commendable to establish policies based on HIV prevalence within a population, it would be sensible to have a policy on blood donation from trans people. However, this policy should be based on detailed statistics, and be written in light of trans realities.

Trans women are women, and not men. Trans men are men, not women. Non-binary persons are neither. It is deplorable that we still have to repeat ourselves. Gender has an influence on sexual behaviour of trans people and their partners, and on the seroprevalence of trans people. A judicious policy would take those factors into account, as well as the plethora of other relevant factors, such as access to sterile needles for hormone injection. The relevance of genitalia on HIV rates will have to be re-evaluated.

Without suggesting an exhaustive list of relevant factors, it remains essential to establish a policy which sufficiently takes reality into account. The policy must be established on the basis of the experiences of trans people, and with the help of the best scientific data available. It must be concerned with the factual situation of trans people, without reducing us to simplistic and inadequate categories which reveal stereotype more than reason. The creation of specific categories for trans women, trans men, and non-binary persons would be a good start.

Canadian Blood Services is a flagship institution in Canada, and its example has an undeniable influence on other institutions, such as Héma-Québec. It is crucial for its policies to be respectful of trans people, and to avoid perpetuating notions which underlie anti-trans discrimination. We are not defined by our genitalia. It is time for our institutions to begin recognising that.

A truncated version of the original French article was published on August 17th 2016 in the newspaper Métro of Montreal.