Queer-rights violation in India’s discriminatory blood donation policy

By defending a policy that bars the queer community from donating blood, the government and medical system violate queer health rights 

Athira Elssa Johnson, Nikhila V 

The Central government recently defended the decision to bar people from the gay and transgender community and female sex workers from donating blood in India dismissing them as a "high-risk" group for HIV/AIDS (Acquired immunodeficiency syndrome) and sexually transmitted illnesses.

This was in response to the petition filed by Thangjam Santa Singh (Santa Khurai), a transgender activist from Manipur, challenging clauses 12 and 51 in the Guidelines for Blood Donor Selection & Blood Donor Referral. 

The guidelines were issued by the National Blood Transfusion Council (NBTC) and the National AIDS Control Organisation, in October 2017. In the petition, Singh points out that clauses 12 and 51 are unconstitutional and “violative of Articles 14, 15, and 21…”

In response to the Centre, the Supreme Court said that “the determination of the population group that is to be precluded from being blood donors is prescribed by the National Blood Transfusion Council (NBTC)” and is based on scientific evidence. 

The public interest litigation challenges the exclusion of transgender persons, men who have sex with men, and female sex workers from donating blood. Khurai said, “This blood ban should go, it’s wrong on many levels.” The petitioner further noted that the exclusion of people entirely based on gender identity and sexual orientation is unscientific.

Prejudice against the queer community is rampant in the medical field. When asked about the blood donation eligibility of the transgender and gay community, the department of Transfusion Medicine at Dr. M.G.R Medical University answered, “We don’t let those people donate blood, it’s risky.” 

The doctors were also confident in admitting that there is no scientific parameter behind it. They were not hesitant to explain the blood donation programmes — monthly awareness campaigns and advancements of their blood donation schemes. But when asked about the medical biases towards the queer community, especially with regard to barring them from donating blood, the answer was “We do not encourage such people to donate blood”. 

In a tweet Kurai explains this discriminatory pattern. “Blood donation; a breeding ground for trauma, shame and fear for the trans community” Khurai mentioned in the post about Milan Thangjam, a transgender girl from Manipur who underwent a spinal cord surgery and required blood, but her trans friends were helpless to support her due to the blood ban. 

Out of the 64 blood donation banks in Chennai, one responded to the issue. The public relations officer of the Chennai blood banks, Kalaiselvan said, “We run tests and are cautious with transgender as they are prone to illnesses.” He also said that any person is prone to any illnesses, thereby contradicting the misinformation that the queer community is a high-risk community and his own previous statement. 

The lack of social understanding of issues in the medical community push the queer community to the margins. This is evident from an interview with four future doctors pursuing Master’s at the department of Transfusion Medicine at Dr. M.G.R Medical University, who talked about the various reasons behind the ban on blood donation by the trans and queer community. 

Dr. Archana explained, “There is no scientific explanation, but they have a lot of sexual relations and may have some sexually transmitted diseases and they will be in some window period (incubation period). So we won’t take their blood. We have a history also regarding that.” 

As per the information sheets every donor has to fill out, there is a permanent deferral on the trans community, the gay community, and female sex workers. Even though Dr. Archana agreed that there is no scientific reason behind this ban, she was also of the opinion that “it is not safe to take [blood from] such people. They are high-risk.”

They are aware of the petition and the case going on but stuck to their viewpoints. They reiterated that the people from the community are very high-risk and run the risk of infecting others. 

While talking about the process of blood donation, the doctors detailed that they check for every disease, adding that “even if they [the queer community] have a common cold we won’t take it because they will transmit the infection.” 

It is standard procedure to screen blood for diseases such as HIV or Hepatitis B. So to set those from the community apart is not scientific in any sense. The founder of  The Queer Foundation of India, Meghna Mehra, responded to the issue. “They are trying to use HIV and other diseases against the  community to justify the ban as if cishets don’t get HIV or the blood doesn’t get tested before transfusions,” she said.

Dr. Chandrashekar at the transfusion department talked about the need for tests even on regular donors. “Even if he is a regular donor who has donated more than 60 times, we will screen everything. We will consider it as new only.” So the assumption that trans people are more prone to STDs doesn’t really hold water in the case of blood donations.  

Even when the medical community has scientific understanding and is aware that the public learned of HIV and AIDS through a stigmatised lens suggesting the virus was inherent in and inseparable from gay men, they still tend to enable the stigma. 

Dr. Babi, director of the Tamil Nadu State AIDS Control Society (TANSACS), spoke about the functioning of the AIDS Control Society. “We work according to the guidelines by the National Aids Control Organisation (NACO), from procuring medicines for people living with HIV to tracking illnesses.”

The petitioner challenges this foundation of the medical system that does not question unjust and unscientific guidelines. There is an urgent need to challenge and repeal the blood ban to continue to progress as an equitable society. Dismantling the ban would help decrease the existing stigma because when there is less of a stigma, more people are likely to get tested for sexually transmitted illnesses. 

The elimination of the policy may actually lead to a healthier populace because of the increase in donated blood as well as an increase in people knowing their HIV status and being able to take proactive and preventive measures to reduce its transmission and seek treatment. 

The blood ban in donation policy is rooted in queer hate and has negatively impacted the morale and feelings of inclusion of individuals in the community. The community is only banned based on their sexual orientation, there is no authentic explanation. The relationship between preventing the spread of AIDS and disclosing sexual orientation becomes increasingly tenuous under scrutiny.

 Khurai questions hospital authorities handling the blood bank who have harassed transgender persons. There have been  instances of derogatory remarks and queer-shaming. “This is the highest form of discrimination. If one is not treated as a human, what is the purpose of laws and welfare schemes?” Khurai demanded. 

Activist Fred Rogers talked about how the guideline clearly states that if a person’s haemoglobin level is above 12.5, and they have passed the physical tests and other criteria,  they are eligible for donation. This should be the same for everyone irrespective of gender or sexuality. He added, “All we need is some kind of sensitivity and sensitisation that would help the community and will help the bureaucrats to come up with a solution.” 

Rogers recalled an incident when a trans person from Assam was not allowed to donate blood based on his identity. The authorities simply asked them to leave knowing that the person was from the trans community. He explained that the medical system has a long way to go to understand the issues of the queer community. Rogers has recently filed a petition for gender-neutral toilets and works for inclusion and accessibility for the community.