Health

Gay Men in Canada Still Face Discrimination When It Comes to Organ Donation

Men who have sex with men face extra scrutiny due to Health Canada policies.

by Lisa Power
Dec 22 2016, 7:00pm

Main photo via Flickr user Magnus D

Kody Carlson is the perfect candidate to donate part of his liver to his ailing grandfather: he's young, healthy, and a male relative. But since he's gay, there's a chance he may not be able to.

Carlson, who lives in New Brunswick and is the representative for the federal NDP LGBT Commission, recently discovered that he may be unable to donate to his grandfather because of a Health Canada policy that prohibits men who have had sex with another man within the last five years from donating organs without the approval of a physician.

"I think that the policy is completely homophobic and it's an ancient policy started by the AIDS epidemic but I don't think that Health Canada or Canadian Blood Services has caught up to the times," Carlson told VICE.

"There are a lot of other groups that have statistically higher rates of HIV because of their lack of access to health care, like racialized people," he continued. "[But] Health Canada would never make policies against any other group because it would be too politically dangerous."

The policy, in accordance with Safety of Human Cells, Tissues, and Organs for Transplantation Regulations, notes that evidence of anal intercourse is something that "may be associated with the presence of a transmissible disease" and should be examined in the interest of determining if the potential donor is considered high risk.

"Donors are assessed for a variety of risk factors (including MSM activity within the past 5 years) connected with the incidence of infectious disease transmission," Health Canada wrote in a statement to VICE. "If a potential donor has a risk factor, the regulations allow for their organs to be used based on the judgement of the transplanting physician and with the informed consent of the recipient."

The question surrounding the hard science behind the decision to exclude MSM without exception remains vague. Typically the rationale revolves around ensuring that Canada's blood supply system is protected from any potential contamination.

Health Canada did not provide access to the medical literature for which the policy is based on, and the Canadian Hematology Society was reluctant to discuss any medical findings that might shed light on the issue.

In the past, VICE Canada has attempted to investigate the matter further and was met with similar responses.

"I think the policies are archaic and they're rooted in bad science," said Carlson.

Blood Services Canada says that it abides by the policy set forth by Health Canada when considering potential organ donors.

"In Canada, living organ donation is under the operation of local transplant programs," a CBS representative said in an email to VICE. "Men who have had sex with men, or 'MSM' donor candidates, are not excluded from living organ donation as there is a process in place to make an 'exceptional distribution' for any organ at the discretion of the attending physician and with the consent of the patient. This requires specific testing to exclude certain infectious diseases prior to donation."

The "exceptional distribution" rule means that while hypothetically anyone can donate an organ, if the donor questionnaire issued by Health Canada gives any indication that the person's behavior or lifestyle may qualify as high risk, the physician and potential recipient will be notified.

"It's a little bit out of the guideline," explained Jessica Bonnelly, Nurse Manager for the New Brunswick Organ Donation Program. "So do you still accept the organ or not? The patient and the doctor are still gonna make the final decision."

When asked why gay men are considered high risk, Bonnelly admitted she didn't have an answer, only that there are a lot of inconsistencies with what is considered high risk and why. At the end of the day, donation programs across Canada are obligated to follow the policy.

The reality, Carlson says, is that there's always a risk that the physician is homophobic.

In 2014 the NDP proposed Motion M-516 which called "for an end to discriminatory policies on blood and organ donation from gay men," while the ban on blood was softened earlier in 2016 when the deferral period was reduced to one year.

But more often than not, men who've have had sex with another man within the past five years are still made to jump through (seemingly arbitrary) extra hoops. The 2013 case of Rocky Campana—a gay organ donor—showed that some men considered high risk may have their potentially life-saving organs rejected.

"As we've seen with Justin Trudeau, I know he made a commitment to end the blood ban but a lot of people don't know about the organ ban as well and I don't think it's in the Liberal Party's policy—or any of the parties' policies—to end the organ ban," said Carlson.

Fredericton Liberal MP Matt DeCourcey told VICE that the reduction in the deferral period for blood donors is the first step towards "updating Canada's donor eligibility criteria for MSM." He said that there are several research initiatives and investments that the Government of Canada has put forth to "build an evidence base to support sound decision making on this issue."

A review of the current policies is set for January 2017.

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