LGBTQ Donors

Under the FDA’s individual donor assessment guidance, there are no eligibility criteria related to men who have sex with men. Any individual, regardless of gender or sexual orientation, who has had new or multiple sexual partners in the last three months, and also had anal sex in that timeframe, will be asked to wait three months to donate blood from last anal sex contact. Individuals who have had anal sex in the last three months may be eligible to donate as long as they did not have sex with someone new or with multiple partners during that timeframe.

We understand how blood donation deferral related to anal sex may feel like it unfairly targets gay and bisexual men. Please know, the Red Cross is committed to achieving further progress and will continue to provide data to the FDA in support of making blood donation even more inclusive.

Under FDA’s individual donor assessment, the MSM policy has been eliminated. Individuals who have been deferred under the previous MSM policy in the past may be eligible to donate once the three-month wait period from their last MSM deferral has passed, providing they meet all other eligibility criteria.

A new sexual partner includes someone you have sex with for the first time, or someone you had sex with in the past and then stopped but had sex with that person again in the last three months.

Statistically, anal sex has a significantly higher chance of HIV transmission per sex act than vaginal or oral sex due to the potential for the exchange of blood. This does not account for individuals’ own safe sex practices but is based on an evidence-based approach to overall risk. Additionally, condoms have a significantly higher failure rate in anal sex compared to other forms of sex.

According to the FDA, condom use, while a good sexual health practice, isn’t an evidence-based method of screening donors because condoms are not always effective and can break or slip. We also know from research that questions about condom use are less reliably answered because people don't always recall accurately.   

There are gender-specific donation eligibility criteria, such as height to weight ratio for certain donation types and iron levels. Donors can report the gender with which they identify at the time of donation. Individuals do not need to tell staff if they are transgender.

There are no donor eligibility criteria related to being transgender. Donors can report the gender with which they identify at the time of donation.

Red Cross staff members are required to verbally confirm demographic information, including gender, with all presenting donors. This step helps ensure donor safety and accuracy of records. If Red Cross records have the incorrect gender, prospective donors may ask staff members to make the change upon registration. Individuals do not need to tell staff that they are transgender. Individuals with specific questions about eligibility can contact the Red Cross Donor and Client Support Center at 1-866-236-3276.  

There are no donor eligibility criteria related to being intersex. Donors can report the gender with which they identify at the time of donation. The FDA requires the Red Cross to have donors select either male or female. Individuals do not need to tell staff that they are intersex.

There are no donor eligibility criteria related to being non-binary or gender non-confirming. The Red Cross values all potential blood donors and understands that selecting either male or female may not align with how some individuals identify. The Red Cross also knows that there is a difference between biological sex and gender. Under the FDA’s individual donor assessment guidance, the donor history questionnaire is gender-neutral and all donors will answer the same questions regardless of gender. However, there are still some gender-specific eligibility criteria – such as height to weight ratio for certain donation types and iron levels – which require individuals to select either male or female on the donor history questionnaire. We understand this is not ideal for individuals who do not identify as male or female, and are committed to working with the FDA to continue to make blood donation more inclusive. Individuals with specific questions about eligibility can contact the Red Cross Donor and Client Support Center at 1-866-236-3276.  

We recognize that some people may be in sexual relationships with multiple people where their partners are not new partners. Under the FDA’s individual donor assessment guidance, people with multiple sexual partners who have engaged in anal sex with one or more partners in the last three months will be required to wait three months from last anal sex contact to donate.

Undetectable equals untransmissible only applies to sexual transmission of HIV. Unfortunately, even those who have an undetectable viral load may transmit the virus through blood transfusion due to the volume of a blood transfusion and therefore the amount of virus potentially present.

If you have taken a drug to prevent an HIV infection, known as pre-exposure prophylaxis and post-exposure prophylaxis (PrEP or PEP), you are asked to wait three months from last oral dose and two years from last injection to donate blood. The waiting period is required due to these drugs interfering with viral replication and thus possibly altering the detectability of diagnostic and screening tests for HIV, including extending the window period prior to detectable infection or a delay in producing antibodies.

If you have ever taken a drug to treat an HIV infection, known as antiretroviral therapy or ART, you are deferred from blood donation permanently since antiretroviral drugs do not fully eliminate the virus from the body, and donated blood can potentially still transmit HIV infection to a transfusion recipient.

The Red Cross and the FDA support individuals making responsible choices for their health and the broader health of our communities. The Red Cross and FDA are involved in ongoing research, data collection and assessment related to transfusion safety, including the use of HIV preventative medications, and will continue to seek opportunities that could potentially help lead to additional changes. The Red Cross does not encourage individuals to stop taking these medications in order to donate blood.

The Red Cross tests each unit of donated blood for a number of infectious diseases. While testing has greatly improved, it is not 100 percent effective at detecting infectious diseases in donors with very early infection. The FDA selected the 3-month deferral to provide adequate time for the detection of infected individuals. Learn more about blood donation screening tests.

Although testing has improved, it is not 100% effective at detecting infectious agents at the time of donation from individuals with very early infection, or those who may be on preventative treatment for HIV. The three-month deferral was selected to provide adequate time for the development of other infectious disease markers in individuals with early infection—not just HIV. Each infectious disease agent (including hepatitis B and C) has a different length of time following infection where tests may not detect the virus, referred to as the window period. While the average time for HIV may be 9-10 days, this isn’t true of all infected persons, especially if they are on preventative treatment for HIV. Additionally, the window period for hepatitis B on average may be weeks to longer than a month.

The Red Cross worked for many years to change the deferral policy concerning men who have sex with men. This work included decades of data collection and assessment on the impact to transfusion safety, ongoing advocacy to eliminate donor questions based on sexual orientation, and our recent role as a leading contributor in the FDA-funded ADVANCE Study.

Through the ADVANCE Study, the Red Cross worked closely with LGBTQ+ centers and with our own internal LGBTQ+ Pride Group to promote the study and recruit eligible study participants. The LGBTQ+ community has long been an important part of our humanitarian mission, serving as employees, volunteers and leaders in responding to disasters, training individuals in first aid and CPR, and more to support communities across the country in times of need. There is more work to be done to make blood donation even more inclusive and we will continue to provide data to the FDA in support of further progress.

All are welcome in the mission of the Red Cross and there are many ways to help the Red Cross support the community. Individuals can encourage someone donate in their place, become a blood volunteer, host a blood drive, start a SleevesUp campaign and much more. Learn more about volunteer opportunities.