Ontario’s minister of health would like to donate blood. But as an openly gay man, George Smitherman doesn’t think he’ll be given that opportunity any time soon.
Canadian Blood Services (CBS) won’t lift its ban on gay men donating blood, Smitherman says, despite holding consultations with queer groups last month. The problem, he says, is that Health Canada — the federal department that regulates CBS — is reluctant to deal with the issue.
“If Health Canada’s not one of the groups talking about it, it’s like banging your head against the wall.”
Smitherman says he’s raised the subject a number of times with CBS, with federal health ministers and with other provincial and territorial health ministers. CBS is funded by the provinces and territories — except for Quebec, which has its separate blood donor organization, Hema Quebec — but Health Canada has the final say.
“I have used my privileged role as minister of health in Ontario to ask pointed questions on this topic, in the presence of all of my peers, that is the provincial and territorial ministers of health,” says Smitherman. “To say that there is resistance from a variety of quarters is an understatement.
“A federal, provincial and territorial health ministers conference in Vancouver is the first chance I took to raise the issue in a public forum related to a report they were making about the way they were further securing the blood supply testing regimen. I asked on a very personal basis whether that might lead me as a very sexually active gay man to be able to be a participant not just in the photo ops around blood donations but to be able to make a contribution.
“The answer then and since then under similar forthright questioning from me has been generally strong reluctance on the part of the regulator to see any movement in that area.”
The ban on gay men donating has been in place since 1983. The donor questionnaire states that “All men who have had sex with another man, even once, since 1977 are indefinitely deferred. This is based on current scientific knowledge and statistical information that shows that men who have had sex with other men are at greater risk for HIV/AIDS infection than other people.”
Thousands of Canadians were infected in the late 1970s and early 1980s with HIV and hepatitis C from donated blood that was not properly screened. The scandal eventually led to criminal charges against several doctors, blood products companies and the Canadian Red Cross, which was in charge of the blood supply at the time. In 1998, CBS was created as an entity separate from the Red Cross to run Canada’s blood system.
In 1983, the Red Cross also banned Haitians from donating blood, due to the high rate of infection in Haitian immigrants. That policy sparked charges of racism, and led to heated demonstrations in Montreal, which has a large Haitian population. That ban was lifted around 1990, when the US also lifted a ban on Haitian donors.
Winston Husbands, the co-chair of the African And Caribbean Council On HIV/AIDS In Ontario and the AIDS Committee of Toronto’s director of research and program development, told Xtra Toronto last year that AIDS is now a major problem among immigrants from sub-Saharan Africa.
“The current best estimates are that there are 25,000 people with HIV/AIDS in Ontario. Thirteen percent of those are from Africa and the Caribbean, even though they’re only five percent of Ontario’s population.”
And in fact, CBS does address that in its donor questionnaire:
“People who have lived in certain regions of Africa, who may have been exposed to a new strain of the virus that causes AIDS (HIV-I Group O), are not eligible to donate blood. People who have received a blood transfusion while visiting there or who have had sex with someone that has lived there, are also not permitted to donate blood. This is not based on race or ethnicity but possible exposure to HIV-I Group O. Countries included are: Cameroon, Central African Republic, Chad, Congo, Equatorial Guinea, Gabon, Niger and Nigeria.”
But Smitherman does not believe that Health Canada’s unwillingness to address the ban on gay men stems from the agency’s understanding of risk statistics.
“In the forum where I’m having the discussion has continued to hang this issue on the reluctance of the regulator. What I take that to mean is Health Canada has been clear to the CBS that they have no interest in opening this issue at present.”
And certainly, CBS has held fruitless consultations with queer groups in the past. In 2001, for example, the group met with organizations including Egale Canada and the Canadian AIDS Society — both of whom were involved in another meeting last month — but the ban remained in place.
Statistics confirm what we already know: that AIDS cuts across demographics. According to the AIDS Committee Of Toronto, approximately 58,000 Canadians are currently living with HIV/AIDS, 27 percent of whom may be unaware of their infection.
“Men who have sex with men continue to account for the largest number and proportion of positive HIV test reports. In 2005, they accounted for 43.2 percent of all positive HIV diagnoses in Canada, up from about 36 percent in 2001,” according to ACT.
“Women represent a growing proportion of positive HIV test reports in Canada. They accounted for about 25 percent of all HIV diagnoses in Canada in 2005. From 1985-1992 they accounted for only 8.9 percent of HIV infections.
“Heterosexual men and women accounted for 31.3 percent of all positive HIV test reports in 2005. This exposure category has steadily increased from 7.5 percent of all infections in 1995.
Canada’s policy is looking increasingly isolated on the international stage. The US Food And Drug Administration decided earlier this year not to lift its ban, and similar lifetime bans remain in place in countries such as England, Ireland and Sweden. But a number of countries have lifted their bans. The approach these countries have taken, however, varies greatly.
Spain, Italy and Portugal have all changed their policies to ones banning donors who have engaged in risky sexual behaviour, rather than on sexual orientation. France and Switzerland are moving towards such a policy. Argentina, Brazil and Australia all allow men who have not had sex with men for a year to donate. In South Africa, the period is six months. Japan, Hungary and New Zealand all have similar deferral policies in place, according to the Canadian AIDS Society, although the length of the deferral period is not clear. The Netherlands is currently reviewing its policy. And even Russia — not renowned for its liberal attitudes to gays and lesbians — is reportedly lifting its ban, although exactly what it will be replaced with is not clear.
Smitherman would not say what approach he would like to see Canada adopt but he doesn’t think that serious discussion will happen anytime soon, partially because of a lack of awareness and partially because of strong opposition from groups who suffered from the infected blood.
“Because of awareness about my questioning in this area, some of the affected blood groups, the infected blood groups, have expressed their strenuous viewpoint that were such an initiative as this to gain momentum they would be very, very vocal in opposition to it.”
The Canadian Hemophilia Society leads that opposition. In 2006, David Page, the society’s director of programs and communications told Xtra West that, “By removing a group of men who have had sex with men you are removing a population which has a much higher percentage of HIV and hepatitis C than a population of males who have not had sex with a man. That difference is about 260 times less risk.”
Because of what such groups have gone through, Smitherman does not attribute their support of the ban to homophobia.
“Because I know its roots, I don’t feel comfortable in saying that. Because the events are so searing, I really hesitate to offer that point of view. I do think there is a built-in resistance that relates more to just how searing an event it was than to homophobia.”
In fact, Smitherman attributes much of the lack of progress to a lack of awareness, especially among politicians.
“If it weren’t for the fact that I’m a gay man, I’m not really too sure that this issue would be amongst the plethora of issues that you hear about. This is isn’t one that I would say has a tremendous amount of awareness associated with it to date. I’ve raised these questions and I cannot recall that any of my colleagues came up to me and said that’s an issue we can do some work on together. I don’t even think this is an issue that’s on too many people’s backburner.”
But Smitherman feels that things have changed from the early days of AIDS when the ban was first enacted.
“What I do feel intuitively is that gay people from my experience have a very, very high degree of sophistication and responsibility with their understanding of HIV. I think there is a missed opportunity here that we all continue to work towards.”
As part of that effort, Smitherman appointed long-time queer activist Tom Warner — of the Coalition For Lesbian And Gay Rights In Ontario — to the CBS board as an Ontario representative last year. Warner would not comment for this article.
But even within the queer community, there is no unanimity on the topic. Richard Burnett, a columnist with Montreal paper The Hour, supported the ban last month.
“No one disputes that sex between men is the leading cause of most HIV infections. Because so many men who sleep with men continue to have unsafe sex, and so many more are unaware of their HIV status because they don’t get tested for HIV, would you want a blood transfusion from me?”
In the end, the issue may be settled — as with so many other gay rights issues — by the courts. There are currently two blood donor cases before the courts: one against CBS by Kyle Freeman and one against Héma Québec by Montreal law student Adrian Lomaga.
But a January court decision in a sperm donor case may not bode well for queers. The Ontario Court Of Appeal ruled that it was not a violation of the Charter Of Rights And Freedoms to prevent a gay man from donating to a sperm bank.
“The medical evidence in the record establishes that there is a higher prevalence of HIV and hepatitis among men in the MSM category,” said the decision.
But Smitherman says he hopes the queer community will continue the fight.
“On a personal basis, I’m a gay man who would like the opportunity of giving the gift of life. So I do feel that progress ought to be possible, and we should be working towards those things.”