• The Supreme Court sought a response from the government on a plea challenging the guidelines that exclude transgenders, gay and sex workers from donating blood.

• A bench headed by Chief Justice D.Y. Chandrachud issued notices to the Union government, National AIDS Control Organisation and National Blood Transfusion Council.

• The Supreme Court was hearing a plea filed by activist Sharif D. Rangnekar challenging the 2017 guidelines.

• The Court, while issuing notice in the petition, has linked it with a pending matter, Thangjam Santa Singh @ Santa Khurai vs Union of India, which raises similar questions. In that case, the central government, in its affidavit, acknowledged substantial evidence showing that transgender persons, men who have sex with men, and female sex workers are at risk for HIV, Hepatitis B, or C infections. 

• The current petitioners are challenging not the exclusion of individuals at risk for these infections but rather the inclusion of transgender persons, gay men, and female sex workers in the ‘at risk’ category.

What are the guidelines which restrict gay and transgender people from donating blood in India?

• The 2017 guideline excludes transgender persons, men having sex with men (MSM), and female sex workers from being blood donors.

• The 2017 guidelines permanently defer these population groups from being blood donors on account of being at risk of HIV and hepatitis infections or Transfusion Transmissible Infections (TTI).

Global scenario

International guidelines for blood donation by gay and transgender people vary by country and have evolved over time.

1) United States

• Initially, gay and transgender men were completely prohibited from donating blood due to the AIDS crisis in the 1980s. 

• 2023 Proposal: The FDA proposed eliminating time-based deferrals for MSM and instead assessing all donors based on recent sexual activity and multiple sexual partners. 

• The proposal aims to create a more inclusive and risk-based assessment process. 

2) United Kingdom

• The UK’s NHS Blood and Transplant service follows a For the Assessment of Individualised Risk (FAIR) approach. Eligibility to donate blood is based on individual risk rather than sexual orientation. 

• Donors are asked about recent sexual partners and any high-risk sexual activities. 

• Anyone who has had anal sex with a new or multiple partners in the last three months is temporarily deferred. 

3) Canada

• Canada’s blood donation guidelines initially excluded MSM but gradually changed.

• The deferral period was reduced over time from ten years to one year, and then to three months. 

• Health Canada implemented a focus on high-risk sexual behavior among all donors, regardless of gender or sexual orientation. This change aimed to move away from blanket exclusions and towards individual risk assessment.

4) Other Countries

• Netherlands, Israel, Argentina, France, Germany: Many of these countries have moved towards or are planning to move towards policies that do not restrict blood donation based on sexual orientation or gender identity. 

• Australia: Gay and bisexual men face a three-month abstinence requirement before donating blood. 

• Belgium: MSM will be allowed to donate blood after a four-month deferral period starting July 1, 2024. 

• Czech Republic, Switzerland: These countries continue to impose a one-year deferral period for MSM. 

• Denmark, Estonia, Finland: They have a four-month deferral period for MSM and female partners of MSM. 

(The author is a trainer for Civil Services aspirants.)