Blood Donation

[Guest My_Genesis]

I went to donate blood today.... well I didn't actually get to donate because they told me that while I'm not anemic, my hematocrit was not high enough (that made me a bit dysphoric because guys are supposed to have higher levels than girls... but whatever, that isn't the topic of this thread.) Gotta eat more red meat and chocolate, haha. But when you fill out the form, they ask a lot of gender-related questions which got me to thinking - what happens/how do you answer all those questions during and after physical transition?

The easiest question is, what is your sex. For now I put female (again, more dysphoria but that's not what I'm getting at.) They also ask other questions such as have you ever been pregnant, and if you are male you just check off "I am male" instead of answering the question. There are a few others like that - they ask quite a bit about sexual history and I think they ask something about penetrative sex that has that same thing, where if you are male it doesn't apply and you check off "I am male." I ended up just checking no to all these things (most of them ask about things like STD's or HIV or whatever, or anything else that would only apply to females - like, specific example: If you are female, have you ever been with a male as a sexual partner who has had another male as a sexual partner?) And I just said no because I can't check off "I am male." Then there's one asking if you are male, have you ever had sex with another male? that disqualifies you from donating. but anyway, in that question you would check off "I am female" because it doesn't apply. So that's what I did.

So I am wondering... even after I physically transition and become legally male and all that, will I still not be able to consider myself male when I donate blood, since I am not biologically male? If anyone has any experience with this, I would appreciate your input

[Guest Pól]

Have a read through this -- it's really interesting: www.cbbsweb.org/enf/2003/donor_sexchange.pdf

Consensus seems to be 'not sure' though the most recent addendum seems to suggest that if you've legally changed your gender to male then you should be considered male when you donate blood.

[Guest Evan_J]

Once you physically and legally transition, pretty much you check the boxes of any male. It's correct because you're legally that. The legality is big thing because in this country it determines many things. But you'll find this out as you progress.

[Guest My_Genesis]

Have a read through this -- it's really interesting: www.cbbsweb.org/enf/2003/donor_sexchange.pdf

Consensus seems to be 'not sure' though the most recent addendum seems to suggest that if you've legally changed your gender to male then you should be considered male when you donate blood.

that is really interesting.

according to his gender at the time the individual has come in to donate

Okay, that's what I was wondering. There was a similar topic about donating blood about a year ago, where one of our members said

FTMs who take testosterone CAN donate blood, even though testosterone is obviously not a medication pregnant women should be taking.

Not sure if this is true or not, but I'm hoping it is. I'm just concerned because I thought maybe transitioning would disqualify me from donating altogether, or at least it would make my answers to the questions hard to answer unambiguously and then they might tell me I wasn't being honest and go home. Unless it's best to just tell them your situation from the start?

On a side note,

So, a transsexual woman is not a "man who wants to be a woman." A transsexualwoman is a woman in a neurologically phenotypic sense, and vice versa.

Good to know they understand this concept.

[Guest My_Genesis]

Once you physically and legally transition, pretty much you check the boxes of any male. It's correct because you're legally that. The legality is big thing because in this country it determines many things. But you'll find this out as you progress.

Ah. See I'm thinking more along the lines of is there a medical issue with not being a bio-male (or with an MTF not being a biofemale) but if legality is the bigger issue here that totally makes sense.

[Guest Evan_J]

Ah. See I'm thinking more along the lines of is there a medical issue with not being a bio-male (or with an MTF not being a biofemale) but if legality is the bigger issue here that totally makes sense.

Legality would be the bigger issue since post transitionally ,with regard to blood , your blood basically is "the same" as any natal mans. The notion that it would be 'unacceptable medically" would disqualify all natal males donating blood . Using the pregnant woman scenario, it would have to then be "dangerous" for her to receive any mans blood since the testosterone level, hemoglobin, red blood cells etc would be more or less equal.

[Guest My_Genesis]

Legality would be the bigger issue since post transitionally ,with regard to blood , your blood basically is "the same" as any natal mans. The notion that it would be 'unacceptable medically" would disqualify all natal males donating blood . Using the pregnant woman scenario, it would have to then be "dangerous" for her to receive any mans blood since the testosterone level, hemoglobin, red blood cells etc would be more or less equal.

Oh okay, see that makes sense. As long as there aren't differences in the blood. But with regard to some of the questions like "if you are female, have you ever been pregnant?" what if you are a FTM who hasn't had a hysto yet - would you still mark off that you are male or would you have to answer that no? Just little technicalities like that got me confused. But I guess if you are legally male you can just mark it "I am male", right?

[Guest Pól]

On a side note,

So, a transsexual woman is not a "man who wants to be a woman." A transsexualwoman is a woman in a neurologically phenotypic sense, and vice versa.

Good to know they understand this concept.

Note that that was a non-physician transgender woman who was responding, not the people running the blood banks though. She made a lot of really good points, I thought. Her response to this physician was really good

A transfusion medicine physician in Maryland reports that a question involving a very similarcase was posed to him recently. He answered that he would defer the donor, but admits that his answer may be based mostly on an instinct that he would not want his family member to receive this donor's blood. He also attempted to provide a 'scientific' reason to give to the donor when refusing him. He would tell the donor he was deferred based on his history of hormone therapy as part of the sex conversion.The Maryland physician does not believe that the medications being used to induce the sex change have been licensed for that indication or even adequately studied in this setting. He performed a Medline search using the Mesh headings 'sex reversal' and 'estrogens' and found that there are very few references on the effect of female hormones onhuman male physiology, but many animal studies that show a change in the expression of many enzymes. Because of this, the Maryland physician would be concerned that this donor's blood is not 'normal' and may not have the expected levels of various factors involved in the clotting cascade.Although this has not been studied, there is evidence that the levels of other plasma constituents are abnormal in males taking female hormones (Morbidity in transsexual patients with cross-gender hormone self-treatment: Med Clin (Barc). 1999 Oct 23; 113(13):484-7). Also, he would be concerned about the effect of the donor's plasma, which would be expected to contain supra-physiologic levels of estrogen, on the embryos of pregnant females. (No threshold dose for estradiol-induced sex reversal of turtle embryos: how little is too much?: Environ Health Perspect. 1999 Feb;107(2):155-9)5.

She said:

Regarding the effects of exogenous estrogens on blood, it is very well established that these conjugated estrogens are of healthy benefit to transsexual women. Taken in large doses pre-opover time periods exceeding 3 years, there is risk to the liver of such patients, but this is due tometabolism of oral estrogens over long periods of time. Post-operatively, transsexual women take hormone replacement therapy (HRT) in line with that of post-ovariectomy women. These estrogens are metabolized in practically similar ways to endogenous estrogens. Such hormone therapy can hardly be called "experimental", having been prescribed by thousands of doctors for 50 years. As the Red Cross itself does not restrict women on HRT from donation, this "risk" seems to be quite invalid, and probably fascetious.

Here's some more highlights:

Respondent number 4 would do well to use proper clinical nomenclature in his search parameters -it is "sex reassignment surgery", not "sex reversal". Try looking for "transsexuality" or "Gender Dysphoria" or "Gender Identity Disorder" and one might have more winnings.

Any reasonable analysis would find the effect of a very few transsexual women donating to be on the balance a good, adding to the total blood supply, which your organizations continually trumpet to be in crisis. An analysis based on subjective impressions of risk is unprofessional, unethical, and counterproductive to the needful work of finding able volunteers for blood donation. Any cursory examination of mainstream literature on transsexuality provides a contrast to such undeserved bigotries. As such donation is widely pushed as an act of civic virtue,such biases maintain illiberal constraints upon a phenotypically (and quite probably) genetically predisposed sexual minority. (As an aside, just how does one define "male" and "female" biology? Intersexual conditions are fairly common, both phenotypically and genotypically. Transsexuality is sometimes viewed by sympathetic, educated professionals as a highly dichotomous variant of intersex. Are you willing to write off entire sectors of the populace because they aren't "textbook"?Even though their blood may save lives?) I hope your members revisit and reappraise this discussion, hopefully with more consideration and educated opinions.

That is, your constant referral to transsexual women as "he" and"him" shows no science, only moralistic bias, and reveals you as completely disrespectful. It would behoove you to change such uses to be in line with a volunteer's presentation, at the very least from a self-interested perspective of good public relations. As your "colleagues" show little understanding of transsexuality as a condition, this may be a futile request, but a needful one.Some of the anonymous addenda in your article relate unethical and arbitrarily discriminatory behavior which could open up such blood banks to litigation. Transsexuals do, believe it or not, at times hold positions of power. Some are even doctors and healthcare professionals. Some even ready our own journals. It's obvious to this transsexual woman that some reform is necessary in the blood banking world."

I wonder how much difference this actually made (her addendum is from 2004). There's also basically no mention of transmen in the whole collection of addenda, but I'd guess that the same people who are discriminating against transwomen would likewise discriminate against transmen.

If you really want to donate, I suppose you could call a blood bank anonymously and ask. If you do, let us know what the answer is.

[Guest My_Genesis]

Note that that was a non-physician transgender woman who was responding, not the people running the blood banks though. She made a lot of really good points, I thought. Her response to this physician was really good

She said:

Here's some more highlights:

I wonder how much difference this actually made (her addendum is from 2004). There's also basically no mention of transmen in the whole collection of addenda, but I'd guess that the same people who are discriminating against transwomen would likewise discriminate against transmen.

If you really want to donate, I suppose you could call a blood bank anonymously and ask. If you do, let us know what the answer is.

Ha, I will do that In fact, in a week or two when the people come back to campus, I could just ask them there. I wouldn't even have to make it about me; I could say I'm asking for a friend. New York, at least I think, is pretty non-discriminatory with these kinds of things so I wouldn't anticipate a response like that of the dr. in the link you provided.

And you're right, that woman's response was really good and I really hope she did make her mark when it comes to trans people donating blood.