LGBTQ Breaking News Service

IN 1983 BRITAIN’S National Blood Transfusion Service released a pamphlet entitled “AIDS and how it concerns blood donors”. It described how the disease attacks the immune system and listed the groups most at risk, including gay men who had several sexual partners and intravenous drug users. Much was still unclear, though: the authors suspected that AIDS was caused by a virus but it was “not known for certain”; they reckoned it could “almost certainly” be passed on through blood and blood products. There was no screening that the service could provide to detect infections, so “until there is and more is known…donors are asked not to give blood if they think they may either have the disease or be at risk from it”. Restrictions have lingered for decades on blood donations from men who have sex with men. But on June 14th Britain switched to an individual risk-assessment system for all donors.

Even as scientists have learned more about HIV/AIDS—it is transmitted via bodily fluids and can afflict people of any sexuality—many countries have remained cautious about blood donation by gay and bisexual men. In the 1980s and 1990s, after thousands of people were infected with HIV via products made from donated blood, health services introduced formal policies that excluded donors who engaged in “high-risk behaviour”. These ranged from outright bans to “deferral periods” (ie, a man must refrain from having sex with another man for months, if not years, before donating.) In effect, these deferral periods amount to bans by proxy. LGBT activists argue that such measures are homophobic.

Today the risk of transmitting HIV through the blood supply is negligible, because knowledge of HIV prevention, testing and management has deepened. People who have HIV but are on antiretroviral drugs cannot pass on the disease. Every blood donation is swiftly and accurately tested for the virus: the leading tests have a median “window period”—the time following the initial infection during which the virus may be undetectable—of only 18 days.

Many countries are relaxing their rules as a result. Brazil, Italy, Poland, Russia and South Africa, among others, have already done away with sexuality-based deferrals (see map). Covid-19 has also increased the demand for blood products and encouraged countries to reassess their policies, or at least to shorten deferral periods. In America, where community blood-donation drives were cancelled during the first wave of the pandemic, the deferral period was dropped from 12 to three months in April 2020. New Zealand did the same in December and Australia followed suit in January.

Reducing or ending deferral periods may help combat the stigma still associated with HIV and AIDS. Crucially, it will also increase the amount of blood available for patients in need. A study conducted in 2014 by the Williams Institute, a think-tank which studies sexual orientation and public policy, found that lifting bans and restrictions on men who have sex with men would increase the annual blood supply in America by between 2% and 4%. A report in Britain by FAIR (For the Assessment of Individualised Risk), a steering group set up by the Department of Health and Social Care, found that LGBT people were more likely to encourage others to donate under the new policy.

Several physicians expressed support for a new draft policy report from the American Medical Association (AMA) Board of Trustees recommending that the sex designation be removed from the publicly available portion of birth certificates at a Special Meeting of the AMA House of Delegates.

Currently 48 states and DC allow people to change the sex designation on their birth certificate to align with their gender identity, but only 10 states allow a gender neutral option. Two states, Ohio and Tennessee, prohibit changing the sex marker on a birth certificate entirely, according to the report.

“We unfortunately still live in a world where it is unsafe in many cases for one’s gender to vary from the sex assigned at birth,” said Jeremy Toler, MD, a delegate representing GLMA: Health Professionals Advancing LGBTQ Equality (previously known as the Gay & Lesbian Medical Association), who spoke in support of the report’s recommendations.

Given that laws around birth certificate criteria vary by state, eliminating sex on the public part of the birth certificate would “serve as an equalizer among individuals who were injured due to their state of birth,” he stated.

Sophia Spadafore, MD, a delegate for the Resident and Fellow Section, authored the original resolution that led to the report. She spoke on her own behalf, and shared the story of Preston Allen, her friend and a transgender man. Allen transitioned 4 year ago, and most government documents have been revised to reflect the transition. But in order to amend the birth certificate, Allen had to rely on “‘people who may work against me because of their personal issues with my identity,'” Spadafore quoted Allen as saying.

Continuing to quote Allen, Spadafore stated, “‘This is an example of a myriad of situations, in which mine and other trans people’s lives, jobs, and safeties could be threatened by having to reveal documents that locked us into a box at birth, and force us to exist through that lens forever.'”

Allowing the sex designation on a birth certificate to remain private would be “life-changing” for a lot of people, Spadafore said, and it would “set a new much needed standard that a body part, and a word on a piece of paper, does not and should not define who any of us are.”

One delegate at the virtual committee meeting questioned the recommendation. Robert Jackson, MD, an alternate delegate for the American Academy of Cosmetic Surgery, spoke on his own behalf, saying that he knows he’s “old-fashioned” but that he was taught throughout medical school, residency, and his specialty training to track “all of the physical findings” of the patients in his care.

“So I think when a child is born, they do have physical characteristics of either male or female, and I think that probably should be on the public record. And that’s just my personal opinion,” Jackson said.

The committee also discussed a second report from the Council on Science and Public Health (CSAPH) focused on preventing youth suicides.

Given the significant increase in youth suicide in recent years, CSAPH member Mary LaPlante, MD, stressed the importance of physicians accessing tools to help them identify youth at “imminent risk” of suicide, and to be able to respond appropriately.

The CSAPH report called for the AMA to encourage the development and dissemination of resources, such as screening tools, safety plans, and appropriate follow-up care including treatment. The council also encouraged more research into suicide risk and prevention efforts among high-risk subpopulations, such as Blacks, LGBTQ, and Indigenous/Native Alaskan youth.

Joanna Bisgrove, MD, a delegate for the Women’s Section Governing Council, requested that the report specifically include young people with intellectual disabilities among those high-risk subpopulations. Teens with disabilities are between three and nine times more likely to attempt or complete suicide, she said. She also noted that people with autism spectrum disorder and attention deficient-hyperactivity disorder (ADHD) are more likely to attempt suicide.

Samantha Rosman, MD, MPH, a delegate for the American Academy of Pediatrics, requested that the report include an acknowledgement of the current pandemic-related “pediatric mental health crisis.” She cited CDC data from January to October 2020 showing age-dependent mental health-related emergency department (ED) visits jumping from 24% to 31%.

Rosman said her own ED has about 60 beds, and roughly half are being used by “boarders” waiting for “mental health beds.”

“So while screening is very important — and we certainly don’t say to wait until [something bad] happens — we need to acknowledge the crisis,” she said.

This and other policy recommendations will be decided in the coming days and potentially voted on by the House of Delegates.

After the Florida Department of Transportation rejected a request from Sarasota to light the John Ringling Causeway Bridge with rainbow colors in solidarity with Pride Month, Sarasota’s LGBTQ+ community decided to light it themselves.

A group of more than 50 LGBTQ supporters marched the bridge Saturday evening with rainbow colors to show support for the community. The rally coincided with the 5th anniversary of the Pulse nightclub massacre that left 49 people dead. 

Members of the march said the rally was so much more than just lighting the bridge. It’s about human rights.

Pulse anniversary:Five years later, grief remains for friends of Pulse shooting victim from Sarasota

Bridge lighting:Florida’s own bridgegate highlights gay rights struggle, angers Sarasota LGBTQ community

“I feel like it’s kind of a slap in the face to the LGBTQ community,” said Steven Philips, who heard about the rally from an email blast on SarasotaOut.com, a website that promotes LGBTQ events and businesses. “It’s saying, ‘You’re not important enough for us to recognize.’ The rainbow colors is just a symbol, but it’s a powerful symbol for the gay community around the world.” 

The state’s decision to reject a plan by Sarasota to light the bridge in rainbow came the same week Gov. Ron DeSantis signed a bill banning transgender girls from playing girls sports. On June 2, DeSantis’ veto list included getting rid of funding that would go towards counseling for survivors of the Pulse massacre.

“This is the most hateful, anti-LGBTQ bill,” said Shannon Fortner executive director and founder of the Harvey Milk Festival. “We’ve had funds taken away from Pulse survivors, access for LGBTQ organizations that were providing mental health and housing took away; a lot of really important funding that was being used for the community that was really important, and he (DeSantis) took that away.” 

“It’s obvious it was done strategically as an insult to our community.”

The march went from Marina Plaza to the opposite end of the bridge just before St. Armands Circle. The group waved their flags, held signs and shouted towards drivers passing by. Some drivers honked their horns in solidarity with the group, and an occasional passenger stuck their head out of the window to chant with the protestors. 

Background:State denies Sarasota plan to light Ringling Causeway in rainbow for Pride Month

Pride:City of Sarasota issues proclamation recognizing June as Pride Month for the first time in history

The protest turned emotional as they reached the end of the bridge, when lead organizer, Traci Lipton, stopped to read the 49 names of those who lost their lives that day five years ago at Pulse. After she read each name, the group shouted the words “never again.”

Lipton said she created the event to show the community love and support because the State of Florida hasn’t. 

“I wanted people to be in a community with people where they could feel the love and feel the support,” said Lipton. “To be able to be around people that they know care about them, that was my entire goal.”

Other organizers of the event included the Party for Socialism and Liberation – Florida, the Leaders Rights Organization and Vegang.