Transphobia baked into policy at Canadian Blood Services
Trans donors report degrading experiences
Content warning: This story contains descriptions of transphobia that may be upsetting to readers.
For many people, donating blood for the first time is a rite of passage. It’s a way of contributing to the community and supporting the health of others that takes very little time and costs nothing. But for queer people, dealing with Canadian Blood Services can be fraught. A major point of contention is obviously the ban on “men who have sex with men,” a relic of the days when it was falsely believed that only gay men could contract and transmit AIDS. But what’s largely missing from the conversation about Canadian Blood Services are the experiences of trans people, some of whom say their experiences with the organization have been cruel and degrading.
“My experiences with CBS are dysphoria-inducing and hurtful,” said Lee, a transgender man who asked that his real name not be used. “Years of coming out, taking hormones, and going through changes means nothing. Having a name, pronouns, and identity rooted in who I truly am means nothing. All that CBS cares about is what my genitals look like. Until I change that, I won’t be seen or treated for who I really am.” Lee said that the first time he donated blood, earlier this year, when he provided his name and gender identity, he was treated as though he had been “caught” doing something wrong. “I was scolded for not telling them that I’m trans right away.” Lee said he was repeatedly deadnamed, asked about his plans for gender confirmation surgery, and told “you can’t be that gender here.” He added that, “I felt like I was being treated like a bad person for trying to donate blood.”
His experience isn’t unique. Harvey Gibson, a transgender man who has been donating blood for years, said “things started getting weird [with CBS] once I started pursuing my legal and medical transition.” He said that changing his name at CBS, even after it had been legally changed with the government, was an ordeal that took four or five months. “I had to tweet at them to get them to respond to me,” he said. And prior to having his name changed, he had to see his deadname displayed publicly in the waiting area of the clinic. “They had the names up on a big flat screen TV in their main area, which, besides me being transgender, was just a really sketchy thing. You had your first and last name on display.”
Catherine Lewis, a representative from CBS said that they’ve updated their system to make name changes easier. Brit Sippola, a non-binary person who recently donated at the Broad Street Clinic, said it took them 30 minutes for their name change to go through a couple months ago, and at one point, the woman processing the change said, “you know, I’m not even sure if this is possible,” although eventually the change was made successfully. They also find the big screen with full legal names on display to be an uncomfortable experience. “If you’re closeted or before your legal name change it would be a really shitty experience because they have to confirm your identity so many times.” It raises the number of dysphoria-inducing experiences that someone has to pass through before they can donate. Sippola added that they recently donated at the Queen City for All ally donor clinic during Pride Month, where they were repeatedly misgendered. “I felt awkward there.”
While CBS is attempting to make progress on the issue of name changes, Gibson’s story shows how the blood ban reveals the organization’s fixation on genitalia. Even though Gibson is gay, “on paper, technically, according to them, I’m not a man who has sex with men. On paper, to them, I’m still considered a woman.” So, although Gibson has stopped donating for medical reasons, if he wanted, he could walk into CBS tomorrow and donate blood, something that sexually active cis gay men and transgender women who have sex with men are barred from doing. CBS told Gibson that although his gender has been changed legally, they can’t change his gender marker in their system until after he has bottom surgery.
Gibson said that although he thinks donating blood is important, he can see why the experience of dealing with CBS might discourage trans people from doing so. “It was dehumanizing and shitty and it didn’t make me feel like what I was doing was worthwhile even though logically, it is,” he said. “When you talk about the flip side, transgender women are considered men who have sex with men simply because they have penises, that’s a violent misgendering of people who might otherwise want to donate blood. Why would anyone put themselves through emotional turmoil?”
For their part, CBS admits “our eligibility criteria for trans donors is far from ideal.” Lewis said there are two problems that occur for trans, non-binary, and gender nonconforming people who attempt to donate. “The first is the limitations of our eligibility criteria. The second is in terms of staff interactions.” Lewis said that CBS is required to screen for gender assigned at birth in order to prevent an extremely rare but life-threatening complication called transfusion-related acute lung injury (TRALI). It’s more likely to occur when recipients receive plasma from a donor who has had at least one pregnancy, due to the presence of certain antibodies in the blood (it’s unclear why CBS can’t simply screen for donors who have been pregnant). The screening process is also intended to protect the hemoglobin levels of donors, which differ by sex (rapid tests for hemoglobin exist and again, it’s unclear why hemoglobin testing, rather than invasive questioning, cannot be part of the intake process for donors). Lewis added that CBS intends to apply to health Canada to remove the three-month waiting period for men who have sex with men by the end of this year, which CBS hopes will allow more trans and non-binary people to become donors.
Lewis also said that CBS “expect our staff not to misgender donors and for all donors to be treated with respect and sensitivity” although she added that they are aware that “there have been times when this has not happened.” She said that CBS takes donor complaints very seriously and “we often have the donor centre manager reach out to apologize” when this is not the case. However, Gibson said that when he reported his treatment at the clinic on Broad Street in Regina, he reached out to offer them guidance on how to build better trans-inclusive policies into their organization, but they rejected his offer and the experience of making the complaint was so unpleasant that the next time he experienced transphobia at CBS – when the clinician taking his blood misgendered him, and then after he corrected her, “pestered” him with questions about his gender identity and genitalia – he didn’t bother to make a complaint. “It took me a year before I felt okay enough to go back.”
Lee said that while his experiences with CBS have challenged his decision to be a donor, “there are wonderful staff at the facility who recognize the flaws in the system” and he’s grateful for them. He added that “While some staff may benefit from trans-inclusive education, the real issue here is the system and policies they’re working in.” At the end of the day, it’s a problem with the healthcare system as a whole. “In both systems, there are cis people making decisions for trans people without inviting us to the table,” he said. “It’s sad to see that trans people can’t be treated like every other human that walks in these places.”