VANCOUVER, BRITISH COLUMBIA – A new report published by the Community-Based Research Centre (CBRC) calls for an end to discriminatory practices in organ and tissue donation and transplantation (OTDT) that target 2S/LGBTQ+ populations.
While changes to reduce discrimination have recently been implemented in Canada’s blood donation policies, these same rules don’t apply for organ and tissue donors. Discriminatory practices in OTDT are diverse and often informed by an outdated understanding of HIV transmission. Some current policies are not based on scientific evidence at all.
For instance, men who have had sex with men in the past 12 months are considered “increased infectious risk” donors, regardless of their relationship status or HIV prevention methods, like condoms, pre and post-exposure prophylaxis (PrEP and PEP), or the type of sexual behaviours associated (or not associated) with transmitting HIV.
"People of diverse sexual orientations and gender identities face structural discrimination and inequities in many areas of our health system,” says Dr. Murdoch Leeies, who authored the report. “When it comes to organ and tissue donation, there are a number of discriminatory policies and processes that are not supported by science and could be readily reformed to support a donation and transplantation system that is safe, inclusive and supports optimal outcomes for all.”
Other discriminatory practices in the OTDT system include invasive rectal exams to identify “evidence” of anal sex. This is meant to identify potential HIV exposure, yet these exams are not backed by science and offer no clinically relevant indication of HIV status.
“Current policies in organ and tissue donation—including invasive rectal exams—harm 2S/LGBTQ+ people and people living with HIV by reinforcing stigma” says Michael Kwag, CBRC’s Knowledge Exchange and Policy Development Director. “Treating 2S/LGBTQ+ people differently in organ and tissue donation also disregards current evidence on HIV transmission and limits the number of available organs and tissues for all Canadians who need them.”
The federal Standing Committee on Health, a group of elected MPs from all political parties, previously called for an end to OTDT policies that discriminate against 2S/LGBTQ+ people as part of a 2019 report. CBRC supports the Standing Committee’s decision and has listed out 6 key recommendations to update the policies, including removing the invasive rectal examinations, and removing the 12-month abstinence criteria for men who have sex with men.
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