In a landmark change to existing policy, the United Kingdom will allow sexually active gay and bisexual men to donate blood, with the new criteria focusing on individual behaviors and lifting the outright ban on blood from men who have sex with men.
“This is such a fundamental change and victory,” Ethan Spibey, a blood donation advocate, said. “It’s a groundbreaking, pioneering new policy for gay and bi men in the U.K.”
Under the new guidelines, donors who have had only one sexual partner for more than three months will be eligible to give blood. A health check questionnaire completed prior to donating will be used to assess eligibility and safety. The criteria will apply to all people interested in giving blood, regardless of their gender, their partner’s gender or the sexual activity in which they engage.
The new criteria was born out of a report by the “For Assessment of Individualised Risk” (FAIR) steering committee, a collaboration of British blood services and LGBTQ nonprofits. After two years of research, the group proposed a move to identify a wider range of risk behaviors that apply to all donors, according to the U.K.’s Department of Health and Social Care.
Sexually active gay and bisexual men who fall under the new guidelines will be able to donate blood in England by summer 2021. The rollout plans for Scotland, Wales and Northern Ireland are not yet known.
“Patients rely on the generosity of donors for their lifesaving blood and so we welcome the decision to accept the FAIR recommendations in full,” Su Brailsford, associate medical director at the U.K.’s National Health Service Blood and Transplant (NHSBT), the governmental body that will implement the new guidance, said in a statement.
The existing British policy requires men who have sex with men to abstain from oral and anal sex with another man for three months prior to donating. This is similar to the current policy in the United States, which earlier this year had changed the donation deferral period from 12 months of abstinence to three and had once been a lifetime ban on any man who ever had sex with another man since 1977. The policies date back to the 1980s during the early days of the HIV/AIDS crisis. However, the blood shortage caused by the coronavirus pandemic has reignited calls for a change to these policies. The ban prevented sexually active gay and bisexual men from donating plasma to a coronavirus research trial in the U.K. over the summer.
“The U.K. is seen as leading in this policy area,” Spibey said. “We genuinely believe this will impact thousands here and millions around the world.”
Spibey is the founder of FreedomToDonate, a coalition of nonprofits working to change policy so men who have sex with men are more easily able to donate blood. His team sits on the FAIR working group to push forward this policy. He said his organization regularly speaks with teams in the U.S. working to adjust blood donation policies there to an individualized risk assessment format.
The new guidelines will still ban individuals who have a known exposure to a sexually transmitted infection and those who use pre-exposure prophylaxis (PrEP), the HIV prevention medication. Spibey said his organization got the U.K. government to agree to reconsider the guidelines regarding PrEP as soon as more U.K.-based research on the medication is published.
“Gay and bi men have that recognition to make that small but lifesaving gesture,” Spibey said of the new donation rules. “That recognition and that inclusion is hugely significant.”
Six in 10 gay and lesbian Europeans avoid holding hands with same-sex partners in public, and over half of LGBTQ people in Europe are almost never open about their sexual orientations or gender identities, according to a new survey.
“The overarching finding was that not much has changed and there’s a long way to go,” Miltos Pavlou, the survey’s project manager, told NBC News. “Hate and inequality remain a major challenge in our society.”
“Changing laws are incredibly important first steps, but really building meaningful acceptance takes years.”
EVELYNE PARADIS, ILGA-EUROPE
The report, “A long way to go for LGBTI equality,” published by the European Union Agency for Fundamental Rights, found that there has been “little, if any, progress during the past seven years in the way LGBT people in the EU experience their human and fundamental rights in daily life” since the first edition of the report was issued in 2012. The findings are based on a survey of 140,000 lesbian, gay, bisexual, transgender and intersex people in the E.U., the U.K., Serbia and North Macedonia.
Based on the survey’s criteria — which included questions about discrimination, awareness of rights, life satisfaction and experiences at work and in education — transgender and intersex respondents reported higher rates of discrimination and threat. For example, 1 in 5 trans and intersex people said they were physically or sexually attacked in the five years before the survey, double the proportion of other groups across the LGBTQ spectrum.
While LGBTQ people are legally protected in many nations across Europe, Pavlou said the survey found a hesitation to rely on law enforcement and other government officials. The report found that while one-third of respondents felt their national governments effectively combat prejudice and intolerance, only a fourth of trans respondents said they agreed, and 14 percent of LGBTQ survivors of physical or sexual assault do not report the crimes to the police.
“People are more aware of their rights, but at the same time they don’t report discrimination,” Pavlou said.
Evelyne Paradis, the executive director of the International Lesbian, Gay, Bisexual, Trans and Intersex Association of Europe, said the findings were “not entirely surprising.”
“It’s concerning that our sense of stagnation is confirmed,” said Paradis, whose organization was not involved with the report. “We would’ve hoped there would’ve been more progress.”
Echoing the survey’s findings, she said, “It’s very clear that in a broad rainbow umbrella, the trans and intersex communities are even more marginalized and vulnerable than lesbian, gay and bisexual people.”
When compared to the Agency for Fundamental Rights’ 2012 survey, the 2019 report shows little, if any, progress in how LGBTQ people in the E.U. are treated. While all LGBTQ people reported that they felt discriminated against in all aspects of life in the 12 months before the survey, transgender people reported a significant rise in overall discrimination — 60 percent today, up from 43 percent in 2012. Over 20 percent of all LGBTQ people reported feeling discriminated against at work in 2019, relatively unchanged from 19 percent in 2012.
The comparison between the two surveys did find that LGBTQ people have become increasingly open about their sexual orientations and gender identities: In 2019, 52 percent of respondents over 18 said they were often or always open about their identities, compared with 36 percent in 2012.
“The main reason those who said the situation in their country was better was because of their openness, visibility and participation in society,” Pavlou said.
The report found that in some countries, such as Ireland, Malta and Finland, over 70 percent of respondents think society is more tolerant but that in others, such as Poland and France, more than half find it less accepting.
“It’s not just about policy and law. It’s about implementing them,” Pavlou said. “Belgium has been a progressive country, and they have one of the highest results in terms of hate and violence.”
Paradis said countries with legislation affirming LGBTQ rights become complacent. As people are more aware of the diversity of LGBTQ identity and experience, she said, governments need to continue to protect the LGBTQ population and endorse educational efforts to ensure that equality remains.
“The mistake that many governments still make is thinking that once you adopt the laws, then everything will work out,” Paradis said. “Changing laws are incredibly important first steps, but really building meaningful acceptance takes years.”
Finding a secure place to live has not been easy for Nez Marquez, 23, who has experienced homelessness for the past five years. Born in Mexico and raised in New York, he left home at 18 because his family did not accept his gender identity and sexual orientation, he said.
Marquez is staying at Sylvia’s Place, an emergency shelter for LGBTQ young adults on the bottom floor of a Manhattan church. He said shelters that specifically cater to lesbian, gay, bisexual, transgender and queer people are safer for him because he has been subjected to homophobic attacks at general-population shelters. But now, in addition to anti-gay violence and the inherent dangers of life on the streets, Marquez has another fear: the coronavirus and its ripple effects.
“I’ve been worried about not having housing,” Marquez said in an interview. “If where I’m staying shuts down, I’ll be out of options.”
Not only does he worry about being “forced to live in a homophobic environment,” but he also has a congenital lung issue, putting him at higher risk for adverse outcomes if he were to get COVID-19, the illness caused by the coronavirus.
LGBTQ youth and young adults, like Marquez, make up a disproportionate number of homeless young people, and this vulnerable demographic is facing unique hardships amid the global health crisis. With countrywide shutdowns of schools and youth programs, diminished office hours at LGBTQ community centers and, for many of them, unsupportive family members, these young Americans and the organizations that serve them are forced to find new ways to get and provide support.
Increase in needs, decrease in services
LGBTQ adults make up an estimated 4.5 percent of the U.S. population, but recent studies have found that 20 percent to 45 percent of homeless youth identify as LGBTQ, and among young adults ages 18 to 25, LGBTQ people have a 2.2 times greater risk of homelessness than their non-LGBTQ peers, according to a new research brief by the Williams Institute at UCLA Law.
Many homeless LGBTQ young adults rely on the approximately 260 LGBTQ community centers across the U.S. for their vital needs and general well-being. During the pandemic, however, many of the centers are reducing their hours and services or closing their doors completely to protect staff and visitors.
“Our clients rely on nonprofits to provide health care, and a lot of those places have closed or shut down hours.”
KATE BARNHART, NEW ALTERNATIVES EXECUTIVE DIRECTOR
New York City’s LGBT Community Center, at the center of the pandemic in the U.S., closed its Manhattan location and suspended its in-person operations indefinitely on March 13. It is providing some services remotely, such as individual counseling sessions, 12-step support groups and youth social programs. Similarly, the Los Angeles LGBT Center has canceled all nonessential meetings and limited its youth programs to lunch services and critical needs while keeping its housing center open.
Detroit’s Ruth Ellis Center, which includes drop-in services, a health clinic and an overnight shelter, has also reduced some of its services. Before the coronavirus crisis, the drop-in center offered hot meals and showers daily and professional skills training three days a week. Now, the center is open only to distribute groceries from its front doors on Mondays and Wednesdays from 3 p.m. to 5 p.m. Staff members are still doing videoconference appointments for behavioral health and primary care.
“The need for services is increasing, and the availability of services is decreasing,” said Kate Barnhart, executive director of New Alternatives, a New York City-based nonprofit for LGBTQ homeless youth.
Barnhart said the pandemic has further complicated her clients’ already inconsistent access to care, particularly when it comes to their health needs.
“Our clients rely on nonprofits to provide health care, and a lot of those places have closed or shut down hours,” she said, saying a client of hers recently ran out of psychiatric medication when all her go-to medical providers were closed because of the crisis.
Barnhart said a third of her clients are living with HIV, and she fears what will happen if they are unable to get their daily medication.
For LGBTQ youth and young adults who are able to find beds at one of the few overnight shelters across the country that cater to them, there is a different set of challenges and risks.
Brad Schlaikowsky, co-founder of Courage MKE, a Milwaukee organization that operates a group home for LGBTQ youth, said soap, hand sanitizer and other hygiene products — many of which are crucial to help prevent contraction of the coronavirus — have been hard to come by for people who are housing insecure. Due to the contagious nature of the virus, his organization is not accepting food and clothing donations.
“This is a huge expense on the budget, and it’s hitting everyone hard right now,” Schlaikowsky said. “The best way people can help any organization is through financial support.”
The Centers for Disease Control and Prevention recommends that everyone physically distance themselves from others by about 6 feet to reduce the chance of contracting the virus. The CDC has issued interim guidelines for the country’s thousands of homeless shelters if someone does get sick, including confining symptomatic clients to individual rooms or moving them to alternative facilities if possible. However, at many shelters, the guidance is impractical.
“We don’t have a private room,” said Wendy Kaplan, director of Trinity Place Shelter, an LGBTQ youth shelter in New York City. “It’s unrealistic, out of touch and makes us feel like the government isn’t able or prepared to protect some of our most vulnerable members of society.”
‘Serious implications’ for mental health
In addition to the physical well-being of LGBTQ homeless youth and young adults, there are also concerns about the unique mental health challenges they may face.
The Trevor Project, a national nonprofit that focuses on LGBTQ youth in crisis, released a white paper Friday outlining the “serious implications” the COVID-19 crisis could have on the mental health of lesbian, gay, bisexual, transgender and queer young people. The organization cited the physical distancing, economic strain and increased anxiety related to the pandemic as being among the most worrisome problems.
“For a lot of LGBTQ young people, the main sources of support that they get are at their schools, at clubs, at community centers, at physical spaces that they no longer have access to.”
AMIT PALEY, TREVOR PROJECT CEO
“LGBTQ young people … are already at risk of discrimination and isolation, which can impact their mental health,” Amit Paley, the organization’s CEO, said Tuesday in an interview with MSNBC. “For a lot of LGBTQ young people, the main sources of support that they get are at their schools, at clubs, at community centers, at physical spaces that they no longer have access to. … Not being able to connect with some of those really important, positive influences in your life can be extremely challenging for LGBTQ youth right now.”
Paley said the Trevor Project, which operates a 24/7 crisis hotline, has had a steep increase in the number of LGBTQ youth who have been reaching out.
“We saw nearly twice the level of young people reaching out, and we know that this pandemic is having an impact, that young people are not sure where they can turn to for support,” he said.
‘It’s most important they know they’re not alone’
Local and national organizations that serve LGBTQ homeless youth are working to acclimate to the new normal, developing innovative pathways to accommodate the changing and expanding needs of this vulnerable population.
Lilianna Angel Reyes, director of the Ruth Ellis Center’s drop-in service, said staff members at the Detroit facility “aren’t waiting for people to create a solution.”
“They’re creating them, and we’re helping [our clients] be the healthiest they can,” she said.
With schools closed, staff members at the center’s group home, Ruth’s House, have developed an educational curriculum for their residents, who are ages 12 to 17. And at the drop-in center, which typically caters to teens and young adults ages 13 to 30, staffers have turned the large open space into a makeshift classroom for their group home residents.
Reyes said the Ruth Ellis Center is a safe space that “can be built anywhere” — including online, where the center has ramped up its presence. Staffers are now offering some services through digital video platforms, like its tobacco cessation program for transgender women, and clients can connect with staffers on social media, including Facebook Messenger and Snapchat.
Reyes said that overcoming obstacles and a lack of resources “isn’t new” for the youth and young adults whom the Ruth Ellis Center serves and that this may ultimately help them get through the pandemic and its ripple effects.
“Most of our youth have had long histories of trauma, and they’re extremely resilient,” she said.
Trinity Place Shelter, which caters to LGBTQ New Yorkers ages 18 to 24, is typically open only in the evening and overnight, but during the pandemic, it is operating 24 hours a day. The extended hours give the center’s 10 residents a place to socially distance, three meals a day and somewhere to wash their hands.
“The less time they’re on the subway and out interacting with the public, the safer they are,” the Rev. Heidi Neumark, the shelter’s executive director, said in an interview.
Neumark, who is a pastor at Trinity Lutheran Church, which houses Trinity Place Shelter, said that now it is “particularly important that we offer a lot of extra reassurance.”
“Most of the young people are here because they have been rejected by their families and do not have the support system and comfort that some people can count on,” she said.
While Milwaukee schools and most of the city’s youth programs are closed, Courage MKE has tripled the number of onsite staff members working at its group home, Courage House, the only LGBTQ youth shelter in Wisconsin. The increase is intended to help ensure that the organization’s clients get the extra support they need during the pandemic while also keeping burnout low and morale high among the staff.
“We’re 24/7 for the next 30 days, and it’s not always sunshine and daisies, so we want to protect them, too,” Schlaikowsky said of his staff.
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Schlaikowsky said Courage MKE’s staffers are also trying to keep a brave face on for the youth and young adults they serve.
“If we show fear, it will rub off on the kids and make their anxiety even higher,” he said.
In addition to getting help, Courage MKE’s clients are helping others by preparing sandwiches for people in the community in need of food. Schlaikowsky said that making 300 peanut butter and jelly sandwiches has been an effective distraction for the organization’s clients and that feeding others has been an affecting way to thank the broader community for all the support it has given the nonprofit since it launched in 2015.
In his interview on MSNBC, Paley of the Trevor Project spoke directly to LGBTQ young people, telling them they “are deserving of love and respect” and are not alone. He also stressed that “social distancing is not the same as social isolation.”
“There are places you can reach out to for support,” he said. “There are always organizations like the Trevor Project that are here 24/7.”
The Trevor Project provides multiple round-the-clock services for LGBTQ youth in need, including TrevorSpace, a social networking site specifically for LGBTQ youth, and a network of trained crisis service counselors who can be reached through TrevorChat, TrevorText and TrevorLifeline (1-866-488-7386).
In its new report, the Trevor Project also encourages LGBTQ young people who are in distress because of the negative social impacts of physical distancing to participate in shared activities online, like gaming, watch parties and physical activity classes.
As for Nez Marquez, he has been staying indoors most of the day at his shelter, which is offering extended hours. He said that while his circumstances were not ideal before the coronavirus emerged, he longs to return to his pre-pandemic life.
“I was applying for housing, I was applying for jobs and had interviews, and I can’t do that anymore,” Marquez said. “I just can’t wait for this to be over and I can go back to my life to do what I need to do.”