Bad Blood: Why does Canada still reject queer and immigrant blood?

Illustrations by LeeAndra Cianci

By Jamie Woo

The 75-year history of Canadian blood donation contains rarely discussed divisions based on gender, race, and sexual orientation. Public blood donation began during World War II, and for the first two years women couldn’t donate for fear that they couldn’t physically endure it. Furthermore, blood was sorted by donor race so that white soldiers only received white blood. Today, some populations, such as people from certain African countries or men who have sex with men (MSM), remain banned from donating.

For most of a decade, Dr. OmiSoore H. Dryden has researched blood donation and examined the 30-question Canadian Blood Services (CBS) donor questionnaire that determines who is eligible to donate. I spoke with Dryden about how blood donation is conflated with good citizenship, how blood creates identities, the concept of “good” blood vs. “bad” blood, and why the donation process isn’t as scientific as you’d imagine (or hope). We began by discussing blood’s symbolic significance and the virtue of giving.

Whether it’s “my friend and I became blood siblings when we were 8,” or “I got beat up in school and blood was running from my nose,” people have blood stories. So when I talk about Canadian blood donation, people all say, “Yeah, I’d totally give blood.” I ask, “Why do you do that?” To help people! You help people.

One of the very early videos on the Canadian Blood Services YouTube channel — it’s no longer there—had a Q+A with a CBS guy. He said: “New Canadians ask me what I do to be a good Canadian, and I say donate blood.” There is this thing about being able to perform one’s citizenship in giving blood.

Blood donation began in this framing. The first blood donor clinic happened in January 1940, in Toronto, and the advertising said, “Make a date with a soldier," or “Give blood, help a soldier.” The blood collected at that time was 100% used for the army in World War II. I don’t think that patriotic, militaristic, nationalising call has changed all that much.

“It’s in you to give,” says the CBS motto — but for many populations, this is not the case. What happens when, to be “good,” one must abstain from giving?

It really is about observing unbelonging. The only way you know your belonging is “wrong” is that others consider you to not belong. That’s it. You must continue to occupy that site of not-belonging. That’s troubling and disturbing.

Given how every blood donation gets screened and how blood-screening techniques have continued to improve, I can’t wrap my head around why bans on certain groups is still considered fair policy.

Blood is currently tested, but much of what we see in the donor questionnaire is a snapshot of the ’80s and ’90s HIV/AIDS crisis. Until 2009, there was no test for a particular strain called HIV-1 Group O. CBS argued that HIV-O was endemic to eight African countries and that we therefore needed a permanent ban for anyone who was born in or had lived in Africa since 1977, or had sexual contact with anyone from Africa since 1977, or had received blood products from Africa.

At that point, HIV-O was also present in other countries around the world, but those countries weren’t banned. HIV-O testing came out in 2009, yet the change to the donor questionnaire did not occur until 2015. So why, in those six years, did CBS feel the need to still ban anyone who was born in or had lived in Africa since 1977, or had sexual contact with anyone from Africa since 1977? We see this pathologising of blackness.

Today, the donor questionnaire asks about Cameroon, which is one of the original eight banned countries, but it also asks about Togo. And when CBS is asked why it targets Togo and Cameroon, their argument is: “We want to make sure that if there are any possible new strains of HIV that we don’t have tests for, we have a deferral that will prevent them from getting into the blood system.” There’s the sense that any new strains would only come from Africa. 

But aren’t the decisions about who can and can’t donate based on science?

Science is as culturally framed as anything else. There’s no such thing as objective science. There is data demonstrating that some questions on the questionnaire aren’t useful. When you push CBS about this, they pass the hat to Health Canada, saying: “Health Canada dictates that we ask these questions.”

Your work also looks at how restricted populations overlap, and how some groups privilege themselves over others. You describe your shock at hearing a queer student group argue that it was unfair to lump gay people in with drug users because it erroneously stigmatizes gay people.

I thought: “Wow, what are you doing? What classes are you taking? What books are you reading?” This is not the argument. The argument is not to say “we’re not like those dirty drug dealers over there” because there are many queer, trans people who are drug-involved.

In my work, let’s make this about all queer and trans people. That means genderqueer people, queer trans people who are involved with sex work, queer trans people who are street-involved, who use drugs. Let’s think through what a questionnaire would look like if we started with that. If we assume that this population is diseased and everybody else is not diseased, that is a false understanding of how illness works.

Illness is culturally formed, culturally thought through, culturally defined. This idea that we begin as disease-free people is what perpetuates the stigma with, say, herpes or HIV. The purpose is to diminish the stigma around STIs and think about what disease and infection look like. To do that, we have to step away from the sexual exceptionalism that says: “we’re good gays and those are bad dirty queers.” We need to get away from that.

How would you change the questionnaire?

What is the purpose of the questionnaire? What does it do that testing does not do? I’d ask why is there even a need for one.

This interview has been condensed and edited.