Men must answer the question, “Are you pregnant?” before donating blood with the American Red Cross, which provides almost 40 percent of U.S. blood components. Gender-neutral blood donor eligibility is designed to create an “inclusive” blood donation process, the RedCross says on its website.
Before donating blood, patients are asked to fill out “RapidPass,” an online survey that asks donors for initial information, including name, age, and gender. Donors must provide answers to all questions.
Upon selecting “male” as one’s gender, individuals are asked, “Are you pregnant now?” and, “Have you ever been pregnant?” The questions include the disclaimer, that “persons” who are pregnant are not eligible to donate blood.
On its website, the Red Cross notes that there are “no donor eligibility criteria related to being transgender . . . intersex . . . non-binary or gender non-confirming.” The organization says it “knows that there is a difference between biological sex and gender,” which is why the donor questionnaire is “gender-neutral.”
“All donors will answer the same questions regardless of gender. However, there are still some gender-specific eligibility criteria — such as height to weight ratio for certain donation types and iron levels — which require individuals to select either male or female on the donor history questionnaire,” the Red Cross says on its website. “We understand this is not ideal for individuals who do not identify as male or female, and are committed to working with the FDA to continue to make blood donation more inclusive.”
Unlike height to weight ratio, pregnancy is not one of the questionnaire’s gender-specific criteria.
On August 7, the Red Cross introduced a new screening process to accept gay blood donors, without restriction, for the first time since the HIV/AIDS epidemic in 1982. Until August 2023, men who had sex with other men had to wait three months before giving blood. Blood donors are now screened on based on “individual risk factors,” not sexual orientation, the Red Cross said in a statement, which “expands blood donor eligibility” and achieves an “inclusive blood donation process that treats all potential donors with equality and respect while maintaining the safety of the blood supply.”
Although the Belgian Red Cross asks transgender donors to wait three months after receiving hormone therapy to give blood, the American Red Cross lists no such provision.
“Hormone therapy can affect blood counts such as haemoglobin. After three months we can be sure that these blood counts, particularly the haemoglobin concentrations, have settled at the levels typical for the new gender,” the Belgian Red Cross says on its website. “Haemoglobin counts are an important means of ensuring that donors are not anaemic.”
Belgium’s Red Cross also says that doctors must know the donor’s sex at birth and their change thereafter. The Belgian medical checklist asks: “Is your current sex the same as your certified sex at birth”? America’s Red Cross does not require patients to disclose their biological gender in order to donate blood. According to its LGBTQ+ guidance, “donors can report the gender with which they identify at the time of donation.”
Update: In a statement to National Review, the American Red Cross confirmed that, “Under the FDA’s new individual donor assessment eligibility criteria, which the Red Cross implemented on August 7, the donor history questionnaire was updated to be gender-neutral—meaning all donors will answer the same questions regardless of gender. Questions regarding a donor’s health history, including those about pregnancy, are important in ensuring not only donor eligibility but also ensuring the health and safety of the patient receiving the blood product.”