AMA President Jesse M. Ehrenfeld, MD, MPH, has experienced the nation’s blood shortage as an anesthesiologist with a patient who needs blood when the blood bank says that they have none to send.
He also has the perspective of being a father with a newborn who needed a blood transfusion, yet knowing that Food and Drug Administration (FDA) rules that didn’t match the science were stopping him and his husband from being able to donate blood at a moment when their son was born prematurely and had spent 50 days in the neonatal intensive care unit.
“As a new dad who is gay and who couldn’t give blood at the time, I am so grateful that he had blood when he needed it the most and I’m so appreciative of the FDA decision to follow the science and to work to safely expand the donor pool,” Dr. Ehrenfeld said during an interview on MSNBC after the FDA finalized blood-donation guidelines to move away from existing deferrals required for men who have sex with men.
The new policy requires that everyone—regardless of their gender or sexual orientation—answer the same risk-evaluation questions to determine their eligibility to donate blood. The questions focus on the potential donor’s recent, high-risk sexual activity.
“This is just a really important step towards equity. It gets rid of a hurtful, discriminatory practice that excludes people like my husband and I from donating blood,” said Dr. Ehrenfeld, who earlier this month was inaugurated as the AMA’s first openly gay president.
As the nation celebrates Pride Month, discover how the AMA is working diligently at the state and federal levels to expand access to medical services, reduce stigma in treating patients with unique needs and break down discriminatory barriers to necessary care for the LGBTQ+ community.
Following the science
Science supports the recent blood-donation changes, as they are in line with what other countries are doing, such as Canada and the United Kingdom. Some estimate the change may prompt as much as a 4% increase in the nation’s blood supply. Donations have been down since the pandemic began.
“I’m an anesthesiologist,” Dr. Ehrenfeld said. “I have personally transfused hundreds of patients in my career, several thousand units of blood. There is nothing more terrifying than getting a call from the blood bank when I’ve got a patient bleeding during surgery and being told ‘Doc, we’re out of blood.’ I’ve gotten that call. These blood shortages are real.”
The AMA has long advocated for the changes to FDA rules that first banned and then created deferrals for men who have sex with men. In March, the AMA submitted comments (PDF) to support the FDA’s then-proposed policy changes. The letter noted, among other things, that every unit of blood is rigorously tested for traces of HIV, syphilis, hepatitis and other bloodborne diseases and that HIV can be detected as early as seven days after infection.
The new guidance “removes outdated categorical restrictions on blood donations,” AMA Immediate Past President Jack Resneck Jr., MD, said in a statement. With the change, the FDA is “applying the latest scientific evidence to ensure that blood-donation criteria are applied more equitably across all segments of our population, including the LGBTQ+ community.”
Beyond blood: Tissue donation
The AMA continues to champion changing the FDA’s rules surrounding donation of tissue, including corneas, human cells and other cellular and tissue-based products.
The March comments urged the FDA to change policies surrounding these areas too. Guidelines require men who have sex with men to defer donation until five years have passed since their last sexual contact. In his letter, AMA Executive Vice President and CEO James L. Madara, MD, noted that “is not consistent with guidelines for other groups of comparable or higher risk” and that this area would “benefit from an individual, evidence-based risk assessment similar to that of blood donation.”
In his statement, Dr. Resneck said “the AMA will continue to relentlessly advocate for eliminating public policies that do not align with scientific evidence and best ethical practices.”
Learn about the AMA Advisory Committee on LGBTQ Issues, which highlights LGBTQ+ news and topics related to patients and physicians.
