Blood Politics

How Placating the LGBTQ+ Movement Impacts the Blood Industry

Blood is a remarkable transport fluid. Composed of red and white blood cells, plasma, platelets and countless other beneficial proteins, blood truly is the gift of life from donor to recipient. Despite its critical functions in the transport of gases, nutrients, immune-system components, and hormones – for the blood recipient – blood can also act as the vector¹ of dangerous antigens and viral agents. While the American Red Cross and the Food and Drug Administration have historically issued guidelines and practices to maximize the safety of blood transfusions, policies placating the LGBTQ+ movement in recent years have certainly only increased the cost of blood products and have undermined the safety of recipients, placing them at greater risk for certain syndromes and diseases. How so? Let me explain.

Nearly everyone is familiar with the ABO blood group antigens. Prior to their discovery over 100 years ago, all blood was assumed to be the same resulting in the often tragic consequences of blood transfusions – deaths whose etiologies were not understood at the time.² Most of us are aware of scenarios in which an incompatible type of ABO was transfused–due to a clerical error, or even a maleficent nurse. Although ABO antigens are the most provocative of all blood group antigens to the immune system response, there are still others that can wreak havoc on the recipient: for example, anti-HLA and anti-granulocyte antibodies.

Anti-HLA and anti-granulocyte antibodies are produced by women who have had more than one pregnancy. Generated by an immune system response, the antibodies are developed because of the mother’s exposure to fetal blood. Historically, blood donors potentially carrying these antigens were typically identified in the donor screening process. By this process, the donor is provided a questionnaire with inquiries informed by their sex as to past medical history, lifestyle and life events. Not surprisingly, female donors are asked to report on any past pregnancies, and sexual activity. What is most disconcerting is that due to pressure from LGBTQ+ activists, blood centers are not requiring that potential donors indicate in pre-screening, their biological sex as they state, “In the context of the donor history questionnaire, FDA recommends that male or female gender be taken to be self-identified and self-reported.”

Seeking clarification on exactly what the FDA recommendation means, in a telephone conversation with a Red Cross eligibility specialist,³ I learned that a biological female self-identifying as a male, will receive a donor history questionnaire that will ask nothing about past pregnancies, since men do not typically get pregnant. Hypothetically then, a mother of two can self-report that she is a male, and donate blood as a “male:” blood teeming with anti-HLA and anti-granulocyte antibodies. Taking note of the risks associated with such “male” blood, I asked a case manager at the Red Cross⁴ whether all blood products are tested for these female-specific antibodies, since mere donor self-reporting as to gender status yields unreliable information not based in biological reality. I was unable to get a confirmed answer either way with respect to such testing.

In yet another conversation last year, a Southwestern Ohio blood center representative⁵ expressed his own concern when the center entertained bowing to the pressure of the LGBTQ+ community, by allowing donors to report the gender of their identity, as opposed to their biological sex. He explained that senior management – having witnessed the bullying tactics of the community against other blood centers in Southern California – expressed grave concern that they would be targeted next if they did not change their screening protocols. They reasoned that they could not afford the negative publicity associated with a viral social media campaign. When the employee remarked to his supervisors that in placating LGBTQ+ activists they would run the risk of offending religious donors – they were dismissive of such concerns, noting that religious donors are not nearly as combative.

It would seem that in placating the very vocal LGBTQ+ community (in granting much-desired “legitimacy” to their sociological construct of gender fluidity) that many people are put at risk. Consider the safety of that unfortunate biological male (with confirmed y-chromosomes) receiving a blood transfusion from a mother-of-two self-reporting as male. Transfusion-related acute lung injury (TRALI, “a very serious pulmonary syndrome that can lead to death if not recognized and treated appropriately”⁶) is a severe immune-system response on the part of blood recipients, triggered by the female-specific anti-HLA and anti-granulocyte antibodies. So serious is this syndrome that the FDA reported in 2012 that TRALI was the third leading cause of transfusion-related deaths in the United States. The incidence of TRALI could obviously be reduced if donors filled out donor history questionnaires based off their biological sex.

One can hope whenever the FDA, the American Red Cross, and blood center directors enact screening protocols for donors, that policy decisions are informed more by donor and recipient safety – as opposed to the “social justice” issue occupying the news cycle at the moment. In catering to pressure brought to bear by LGBTQ+ activists, at best, blood has gotten more expensive as centers are forced to develop new methods for testing all blood donations for HIV and anti-HLA/ anti-granulocyte antibodies. At worst, recipient safety is compromised as blood may not always enjoy that lofty status of being the gift of life, but rather the vector of disease. 

Notes:

1. Retrieved from: https://www.medicinenet.com/script/main/art.asp?articlekey=5968.

2. Dean, L., & Dean, L. (2005). Blood groups and red cell antigens (Vol. 2). Bethesda, Md, USA: NCBI.

3. Telephone conversation with Red Cross eligibility specialist at 1-866-236-3276, on February 28, 2020.

4. Telephone conversation with Red Cross case manager at 1-800-733-2767, on March 3, 2020.

5. Personal interview with Southwestern Ohio blood center upper-management employee on January 11, 2019.

6. Retrieved from: https://www.fda.gov/vaccines-blood-biologics/safety-availability-biologics/transfusion-related-acute-lung-injury-trali.