Until recently, St. Paul’s Hospital was a source of nothing but immensely sad memories for Tim McAree. The Vancouver resident saw many of his dearest friends die there during the AIDS crisis. Now 50, he went back to St. Paul’s last year for the first time since those terrible days to carry out an act of altruism.
A good friend’s brother was on the waiting list for a kidney. The man was told he’d be waiting close to eight years for a suitable one to become available for transplant through the B.C. organ-donor program, a length of time he likely wouldn’t survive. So McAree gave him one of his own.
The fact that McAree was willing to be a living donor is an exceptional story in its own right; it takes a certain kind of person to go through with the ultimate act of generosity. Although living-kidney donations hit an all-time high in B.C. in 2013, there were still only 127 transplants from living donors that year, according to B.C. Transplant.
What makes McAree’s situation unique is that he is gay. Men who have sex with men (MSM) are not precluded from being organ donors; generally, they are eligible if it has been more than five years since their last sexual contact with another man. Because of the scarcity of organs available for transplant, though, doctors may make exceptions, as in McAree’s case: if a prospective donor has had sex with another man within the past five years, the organ donation requires the informed consent of the recipient.
Yet while McAree was allowed to donate a kidney, he is still legally prohibited from donating blood because of his sexual orientation. MSM are ineligible to donate blood for five years following their last sexual contact with another man, no exception.
McAree says that although he considers giving life to someone in need both an honour and a duty, his greatest wish is that Canada’s laws pertaining to blood and organ donation by MSM will be changed.
“All this seems humiliating and [like I’m a] second-class citizen,” McAree says. “If you won’t let a guy give blood even though he’s HIV-negative and donating a kidney… It’s just so ridiculous. There’s a law that makes me different from other people. This law makes discrimination legal.”
McAree, who has no regrets about his organ donation, says the process felt insulting at times. During the lead-up to his surgery, for example, he was given surprise blood tests, and had to sit through a safe-sex seminar—at age 49—and provide full disclosure of his sexual acts.
“I don’t need lectures on AIDS; I remember it,” McAree says. “We lost our friends. I remember going into St. Paul’s and seeing all these people that I knew. Every time you walked into that hospital it was like, there’s Death standing there and you’ve got to get by him.
“They’ve closed the AIDS ward,” he adds. “These laws are the last thing that makes me think of that whole shitty time. They’re the last thing that makes us separate. If these laws changed, gay guys could donate blood just like regular people. If we could change these laws…there wouldn’t be laws that separate us.”
Canadian Blood Services, which handles blood donations, submitted a proposal to Health Canada to reduce the blood-donation-ineligibility period for MSM from five years to one.
“Health Canada needs time to thoroughly review the submission,” its website states. “These incremental changes are important steps towards being as minimally restrictive as possible while also maintaining the safety of the blood supply.
“In 2010, the Ontario Superior Court ruled that the deferral policy for MSM is not discriminatory because it is based on health and safety considerations,” the site also says. “However, we do understand this policy may cause strong feelings and want to emphasize it is not intended as a negative reflection on any one individual.”
Last year, the Canadian Centre for Diversity and Inclusion (CCDI) launched a campaign called “There’s No Such Thing as Gay Blood: #EndTheBan”. The Trudeau government, meanwhile, has said it will lift the deferral. (A request for an interview with a Liberal party representative went unanswered.) CCDI executive director Michael Bach says Health Canada’s move to change the deferral from five years to one is a positive first step. However, he says the organization faces an obstacle because there is not enough research to support an all-out removal of the restriction.
The CCDI, Bach adds, is in discussions about leading or participating in a research project to resolve just that: provide the evidence that the current behaviour-based system does not offer any more protection than a risk-based system, and possibly less.
“Our current system eliminates MSMs entirely based on their sexual partner or partners,” Bach said. “So a man who is in a long-term monogamous relationship with another man is effectively banned from donating unless he and his partner refrain from sex for five years—soon to be one year, we expect. Yet a woman could have multiple sexual partners today and donate blood tomorrow without any restriction. A risk-based system would be driven by the number of partners a donor had had within a certain period, and the riskiness of the sex, among other factors.
“We believe that research project will be green-lit in the very near future, at which point we’ll get the research we need to remove the deferral completely,” he says.
For McAree, a full deferral can’t come soon enough.
“I really do care about people, and I would help people [by donating blood regularly] if I could,” he says.
“I saw the point of these laws at the time,” he adds, referring to the peak of the AIDS crisis. “It’s wrong now. It’s prejudice now. I couldn’t do anything to help my friends, but I would do anything to fix this. I would love, love, love to see these laws changed.”