A self-enforced ban is a staple weapon in any political activist's arsenal, whether it's a boycott, picket line, or hunger strike. But in an age of social-media induced apathy, it's rare to see real activism in action. Why bother marching for gay rights when you can just overlay your profile picture with a rainbow flag in a half-assed gesture of support?
Twenty-one-year-old Jay Franzone is no half-assed activist. The college student is refraining from sex for over a year in order to protest existing US laws around blood donation. Currently on month eight of his yearlong sex ban, Franzone will be eligible to donate blood in January 2017 if everything goes according to plan.
If you're a gay or bisexual man who's had sex with another man (MSM) in the last twelve months, you're prevented from donating blood in America—even if you used a condom. According to federal guidelines, the regulations are in place to reduce the risk of HIV transmission, and are consistent with the laws in place in other countries such as Australia and the UK (both of which have twelve-month bans in place). Also banned from donating blood are sex workers, those with a history of intravenous drug use, or people who've had tattoos from non-licensed parlors in the last year.
Critics argue that the restrictions on gay and bisexual sexually active men donating blood amount to institutionalized homophobia and should be revoked. "We continue to push for a fair blood donation system that screens donors based on risky sexual behavior and does not discriminate based on sexual orientation," says a spokesperson for Stonewall, an LGBT charity. They note that straight people who engage in risky sexual behavior are able to donate blood, while gay and bisexual men who practice safe sex are still precluded.
"A system that asks everyone the same questions to accurately assess risk of infection would increase blood stocks and create a safer supply," the spokesperson adds.
"I think some people were a little shocked when I first announced I was giving up sex for a year," Franzone explains. "But I've had friends who've needed blood transfusions, and for me it's symbolically important." Although Franzone is part of the National Gay Blood Drive, an advocacy group which lobbies the FDA to relax the restrictions on gay and bisexual men donating blood, he stresses that he's undertaking his sex-free year in a personal capacity.
When asked why it's so important to him to donate blood, he responds, "At high school they'd always have blood drives, and I'd never be able to give blood. The question is, what sort of message does that send? As a student, I'm being given this reinforcement that my blood isn't worth anything, and it's really disheartening to hear that."
Franzone further argues the policy reinforces misperceptions around HIV. "We know HIV isn't a gay disease, but the policy perpetuates the stigma."
Both the USA and the UK have relaxed their rules in recent years: In both countries, men who have sex with men had been previously banned from donating blood for life. The UK changed its policy in 2011, and the US followed suit in 2015. Following the FDA's announcement last year, the Human Rights Campaign said the updated US policy was a "step in the right direction" but cautioned that it "still falls short of a fully acceptable solution because it continues to stigmatize gay and bisexual men."
The World Health Organization blood donor selection guidelines from 2012 list men having sex with men as a "high-risk sexual behavior," though they acknowledge the criticism that this view is discriminatory.
In the UK, authorities defend adopting the WHO guidelines. "Statistically, men who have sex with men have a higher risk of acquiring blood-borne diseases, infections and viruses," says the official blood donation website. "This isn't meant to be discriminatory. It's not based on anyone's sexual history or sexuality. It reflects statistical risks for the sexual behavior that increases the risk of virus transmission." On the FDA's FAQ page for blood donors, they don't directly engage with the criticism of their current policy—but they do link to a CDC fact sheet titled "HIV Among Gay and Bisexual Men."
According to HIV charities, however, the existing policies are based on outdated scientific evidence. "The safety of the blood supply must come first," says Ian Green of the Terrence Higgins Trust. "The 2011 review that the one-year ban here in the UK was based on is now out of date, and the rules need updating to reflect current evidence of the reality of conditions like hepatitis C and HIV."
Last year, the American Public Health Association sent a letter to the FDA in which they lambasted the 12-month exclusion period for MSM as "arbitrary." "Instead of protecting and enhancing the nation's blood supply, a 12-month deferral represents a missed opportunity to save the lives of people in need of blood," the letter stated. "According to the Williams Institute, it is estimated that full elimination of a ban would result in 4.2 million newly eligible donors and an estimated 615,300 additional pints of blood donated each year."
Franzone similarly emphasizes the importance of increasing the prospective pool of blood donors. "We live in a world of mass shootings," he argues. He points to the horrors of the Orlando nightclub massacre, where 49 LGBT people and LGBT allies lost their lives—and many in their community were unable to donate blood in the aftermath, despite wanting desperately to help. "We don't know how many people may be affected by that [gun violence] and how much blood we're going to need. We want to be able to do the right thing and help save lives."