In 2023, the U.S. Food and Drug Administration updated its blood donor eligibility guidance, removing previous blanket restrictions that disproportionately affected gay and bisexual men and other members of the LGBTQ+ community.
Under the Individual Donor Assessment (IDA) guidelines, eligibility is determined using questions about each donor’s individual behaviors – not their sexual orientation or gender identity.
New York Blood Center has long supported science-based donor eligibility policies that safely expand access to blood donation. We welcomed this meaningful step toward a more inclusive screening process in which all donors are evaluated using the same criteria.
We are committed to providing a welcoming and respectful donation experience for every donor. We also encourage the FDA to build on this progress by continuing to review its guidelines as science evolves, further expanding eligibility while maintaining donor and patient safety.
What This Means for Donors
Sexual orientation and gender identity do not determine a person’s eligibility to donate. All prospective donors complete the same gender-neutral questionnaire and are assessed using the same criteria.
Under the current guidelines:
- All donors are asked whether they have had a new sexual partner or more than one sexual partner within the past three months.
- Donors who answer yes are then asked whether they had anal sex during that period.
- If they answer yes, they will be asked to wait three months from the date they most recently had anal sex before donating.
- Donors who answer no and meet all other eligibility requirements may donate.
These questions are required to help protect the safety of donors and patients who rely on blood transfusions. Eligibility can depend on several factors, and donors are encouraged to contact us if they have questions about their individual circumstances.
Frequently Asked Questions
How do these guidelines maintain the safety of the blood supply?
The FDA determined, based on its review of currently available scientific data, that the Individual Donor Assessment changes would not compromise the safety or adequacy of the United States blood supply. The changes are supported by findings from the ADVANCE Study, the Transfusion – Transmissible Infections Monitoring System (TTIMS) – in which New York Blood Center Enterprises participates – and other data assessed by the FDA.
Isn’t all blood tested anyway? Why are screening questions necessary?
Yes, every donation is tested for an array of infections that could potentially be transmitted by blood transfusion, but no test is perfect. Testing has a limitation called the “window period,” which is the time between when an infection is acquired and when it can reliably be detected. Screening questions protect patients in the rare event a recent infection is not detected by testing. These questions are asked of all donors, are kept confidential, and combined with testing to maintain a safe blood supply.
Why the focus on anal sex?
Anal sex has a higher per-act likelihood of HIV transmission than vaginal or oral sex. Under the Individual Donor Assessment guidelines, donors are only asked about anal sex if they report having a new sexual partner or more than one sexual partner within the past three months.
The guidelines do not account for safe-sex practices such as condom use because condoms can break or slip. These questions are designed to identify any possible recent HIV infection that may still be within the window period for detection by testing.
Why does PrEP / PEP use elicit a deferral?
Pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP) are important, highly effective medications used for HIV prevention. In people taking PrEP or PEP, very early HIV infection may be harder to detect.
Donors who have used oral PrEP or PEP are asked to wait three months, and donors who have used injectable PrEP are asked to wait two years due to how long the medication remains in the body.
NOTE: We do not recommend stopping the use of PrEP or PEP as prescribed by your healthcare provider in order to be eligible to donate blood.
I’ve heard that undetectable means untransmissible (U=U). Why can’t HIV+ people donate if their viral load is undetectable?
“Undetectable equals untransmissible” only applies to sexual transmission of HIV. Unfortunately, this does not apply to the risk for transfusion-transmission. Even blood donated by those who have an undetectable viral load could potentially put a patient at risk for HIV following a blood transfusion.
The risk of transmission is much higher with a unit of blood due to the large volume of a blood transfusion and the much higher total amount of virus present.
Can transgender and non-binary people donate blood?
Yes. Transgender, non-binary and gender-diverse people are welcome to donate. Under the Individual Donor Assessment guidelines, eligibility is not determined by a person’s gender identity or sexual orientation. All donors are asked the same gender-neutral questions.
Why does the registration system only offer male and female options?
At this time, limitations within our registration system require donors to be entered as either male or female. We recognize that these options do not accurately represent everyone’s identity and may feel exclusionary.
We are working to improve the registration experience for transgender, non-binary and gender-diverse donors while continuing to meet applicable clinical and regulatory requirements. This system limitation does not mean that transgender or non-binary people are ineligible to donate.
Schedule a blood donation or contact us with questions about your eligibility.
Other Ways to Support Our Mission
We recognize that some people remain unable to donate under current FDA guidelines, and we are advocating for the FDA’s continued evaluation of its policies as science evolves to safely expand eligibility. In the meantime, there are many other meaningful ways to support patients and help strengthen the blood supply:
- Host a blood drive
- Volunteer with NYBC
- Make a financial gift
- Encourage eligible friends, family members and colleagues to donate
For additional information, review the FDA’s current individual risk-based donor-screening guidance.