Oct. 2—Because he is gay, Grant Ogren has not been allowed to donate blood in 30 years.
Stepping into Spokane's Vitalant Blood Donation center Monday morning, Ogren was excited to do something for his community.
"It's very important to me to give back. I'm O positive, which is always needed, and I always felt a bit guilty I couldn't donate," Ogren said. "I'm so glad the FDA has been able to open their eyes and realize being gay shouldn't keep you from donating blood."
A remnant of a 1980s policy amid the AIDS epidemic, gay men have been largely banned from donating blood since 1983 amid fear HIV, the underlying condition that causes AIDS, would find its way into banks' blood supply. It was not until May this year that the FDA fully lifted the 40-year ban.
Even as evidence showed those engaging in gay sex were not at higher risk than straight people engaging in comparable sex acts, the policy remained for decades.
For much of its history, that meant if a man admitted to ever having sex with another man during a pre-donation questionnaire, they would be forever forbidden from giving blood.
"It was a black mark on your record — tied to your ID," Ogren recalled. "No matter where you tried to donate, they would see you had sex with another man. And that would be it."
Ogren is now executive director of the Spokane AIDS Network and said he has seen how the stigmatization has affected those with AIDS and their loved ones. While those living with AIDS still cannot give blood, the FDA's ban on gay men as a whole has "exacerbated the stereotype and connection of gay men and AIDS," he said.
Ogren first began donating blood while serving in the military as a young man.
"I always saw it as part of my civic duty and very core as to who I am," he said. But by coming out in the 1990s, Ogren thought he would never donate blood again.
Even as he currently lived as a married man in a monogamous relationship, the hope of donating blood "always seemed pretty far out of reach."
Ogren knows of many gay men who lied on the paperwork to give blood because they were in long-term monogamous relationships and sure to be HIV-negative. Ogren never wanted to lie.
Under pressure as the gay rights movement gained mainstream acceptance, the FDA has slowly chipped away at the ban for the past decade. Beginning in 2015, gay men were allowed to donate blood if they were celibate for at least a year. The requirement was lowered to three months in 2020.
While glad to be rid of the permanent ban, Ogren said these previous policies still prevented most gay men from donating blood.
"It was like they were placating the gay community even though it was not really feasible for pretty much anybody to give blood in the gay community. You had to be celibate for three months — even if you were married. And that's an issue in any community — let alone the gay community."
Ogren said he was surprised when the FDA completely axed the ban on gay men donating — even if some requirements remain.
"This is going to open up the world for so many people in the LGBTQ community who won't have to worry about horrible, stigmatizing questions and just get to participate in this important act of service," he said.
What are the new requirements?
Instead of pre-emptively banning any man who has had sex with another man, the new process uses a series of individual risk-based questions to reduce HIV transmission in the blood supply.
According to the FDA recommendation, these questions will be the same "for every donor, regardless of sexual orientation, sex or gender."
Under the questionnaire, individuals will be deferred from donating blood if they have engaged in anal sex in the past three months with a new sexual partner or with multiple sexual partners who may be new or not.
These requirements "reduce the likelihood of donations" by those who have had a recent HIV infection that is too new to be flagged by testing, according to the FDA. Because the standards apply to everyone, they do not specifically target gay men or others.
The questionnaire also defers anyone who has taken medication to treat or prevent HIV infection within the last three months, such as PrEP. These drugs are often prescribed to sexually active gay men and other adults to reduce risk of contracting HIV or AIDS.
These drugs are "safe, effective, and an important public health tool," according to the FDA. But they may "delay detection of HIV" by currently available tests. Individuals should not stop taking PrEP to donate blood, the FDA added.
Ogren also hopes the FDA will relax this requirement as more study is done on PrEP medications.
Despite these concerns, he had been "surprised" at how dramatically the FDA's new rules will change the ability for gay men to give blood.
"It was really quick," Ogren said after giving blood Monday. "There were 47 questions in a link they sent me this morning and about 10 more questions on -site. And it didn't ask anything about your sexual preference. The questions weren't stigmatizing. They were more general, which is good."
Vitalant Northwest Regional Director Jennifer Hawkins said blood banks have been "screaming" for the FDA to implement these scientific-based questions for a long time.
"We have been very behind the rest of the world, but we're getting there," she said of the new policy.
Vitalant and Red Cross implement new policy
After the new policy was approved by the FDA in May, both Vitalant and the Red Cross, the major blood banks in Spokane, implemented it that month.
In a statement, the Red Cross said they are committed to making the FDA policy even more inclusive.
"We recognize the hurt the previous FDA policy that restricted gay and bisexual men from blood donation has caused and that these are just the first steps in repairing relationships with the broader LGBTQ+ community. The Red Cross welcomes everyone who wishes to be part of our humanitarian mission," reads the Red Cross statement.
Though it is the largest blood bank in the nation, the Red Cross does not have a permanent site in Spokane. Instead, the organization holds drives at varying times and locations within the Inland northwest.
With its permanent donation sites both in Spokane and Spokane Valley, Vitalant is the most prominent blood bank in the region. Hawkins said it had been difficult to turn those in the LGBTQ community away when Vitalant is in such need for donors.
"It was hard. And folks didn't understand that this wasn't a blood bank decision. These were FDA guidelines that we were required to adhere to," she said.
Hawkins had many conversations with her son, who is gay but unable to donate blood for unrelated reasons.
"What really hit home in what my son told me was that giving blood is something that can draw communities together in a time of crisis. It can be so valuable to give back. And this was just another area where the LGBTQ community was excluded from society and the greater community," she said. "And that didn't feel good."
Why now?
In its recommendation, the FDA cited new data collected through the Assessing Donor Variability And New Concepts in Eligibility (ADVANCE) study, which examined rates of HIV risk factors among men who have sex with other men.
The study was funded by the FDA and conducted by Vitalant, the Red Cross and ONEBlood. Concluding a year ago last month, the study found using a general scientific-based questionnaire was sufficient to rule out those who have HIV or could be at a higher risk of contracting HIV.
"We specifically targeted those who may have been deferred in the past and then they went through the normal process," Hawkins said. "That gave us a large enough pool to really look at how they answered questions, what the outcomes were. And we showed and demonstrated that scientific-based questions is the future and where we needed to go."
Hawkins said Vitalant was "very proud to have participated in research that contributed to the end of the 40-year ban."
Hawkins also speculated the FDA may have been spurred to action by the dropping numbers of donors over the past decade or more — unable to afford turning away possible lifelong donors in the midst of a blood-shortage crisis.
According to Hawkins, Vitalant in the Pacific Northwest has lost 80,000 donors since 2010 even as hospitals have needed 10% more blood since that time. As of 2023, there are only 20,000 donors left in Vitalant's regional system.
Much of this drop is caused because younger generations are donating blood at much lower rates. Blood banks are dependent on baby boomers to provide the bulk of their supply. Many in that generation are now prescribed medications in their old age, which can prevent blood donations, and others have died.
"We're not bringing in Gen X, millennials and Gen Zs into the fold to become lifelong donors," she said, noting it is important to ingrain the practice of giving blood at a young age to create lifelong donors.
This pattern has been exacerbated by the pandemic. While their region had 30,000 donors at the beginning of 2020, that has fallen to 20,000 donors as of today, Hawkins said. As schools and businesses became remote, many of the opportunities where blood banks were able to advertise disappeared.
"We actually had high school students graduate never having attended a blood drive,' she said. "This has never happened before, at least in this region."
As schools struggle to improve academic performance, they often now see blood drives as a "distraction," she added.
Where can you donate blood?
Those who would like to donate blood at the Spokane Vitalant center can make an appointment at vitalant.org/donate. The organization does accept walk-ins but prefers appointments to ensure adequate staffing levels.
Even though it does not have a permanent donation center in the region, the Red Cross is holding two Spokane blood drives in late October.
* Oct. 24: Centennial Hotel at 303 W North River Drive, noon-5 p.m.
* Oct. 25: Saint George's school at 2929 W Waikiki Road, 9 a.m. -2 p.m.
In addition to becoming a regular donor again, Ogren said he would work within the Spokane nonprofit LGBTQ community to hold blood drives raising awareness of the new donation policy.
Hawkins likewise promised Vitalant would raise awareness in the LGBTQ+ community by attending Pride and other community events.
