AABB22: Information About Real-World Donation Needed to Improve Donation Experience of Gender Diverse Donors

In September 2022 Canadian Blood Systems (CBS) moved to a gender-neutral, risk-based screening approach. Yet more work is needed to understand and promote inclusivity for Two Spirit*, lesbian, gay, bisexual, transgender, queer, questioning, intersex and asexual (2SLGBTQQIA+) individuals.

Transfusion medicine nurse specialist supervisor Terrie Butler-Foster of Canadian Blood Services and Western University discussed ongoing research to understand the experiences of gender diverse donors during Monday’s session “DEIA in Focus: Advancing Equity and Inclusivity for Sexual and Gender-Diverse Donors.”

“Being gendered in the donation system leads to gender questions, gendered assumptions and staff confusion,” she said.

The researchers conducted a study to better understand the donation experiences, barriers and enablers to safer donation experiences, and views about the donor questionnaire and gender registration options. The study involved semi-structured one-on-one interviews with thematic analysis. Data analysis is ongoing.

More than half of participants were transman/transmasculine gendered 59% (N=13), 36% were transwoman/transfemine gendered, and one individual self-identified as nonbinary/queer. Nearly three-

The researchers found:

• Using donors' correct names is ESSENTIAL to ensure physical and psychological safety.
• Gendered registration and screening processes are difficult to understand and navigate for donors and staff.
• Screening takes a longer time for gender-diverse donors that for other donors.
• Participants expressed mixed views on a two-step question.
• Donors wanted to know why gender/sex is requested and what will be done with the information.
• Authentic and acknowledging staff and interactions with other donors were enablers for a safer, inclusive donation experience.

Several recommendations have come out of the study: (1) enhanced, ongoing staff training is needed; (2) staff should stop asking donors to verbally confirm their gender/sex, and (3) privacy and confidentiality for donors during screening is key.

In practical terms, this means embracing the concepts of gender neutrality, asking, carefully considering, ensuring transparency, and communication with donors.

Moving to gender-neutral screening practices includes asking ALL donors about current/prior pregnancy. Gender diverse donors want to be asked direct questions — gender is not a direct question. Blood systems should carefully consider whether knowing a donor’s gender and sex assigned at birth are necessary. Diverse gender donors (and non-diverse gender donors) need to know why information about gender and sex is important for transfusion recipients —  how will this information be used. Communicating the “why” and “what” of gender/sex questions should be asked by staff with authenticity and transparency.

Butler-Foster concluded by noting that “the views and experiences of 2SLGBTQIA+ people must be foregrounded to guide the advancement of more inclusive donation policies and practices.” This means that while policy change is essential, it’s not the only component of inclusive donation experiences. Changes are also needed so that the process and procedures can be informed by diverse gendered-people with their experience through research, engagement, and practical engagement. Lastly, affirming and safer practices that are research- and community-informed are necessary to ensure inclusive and welcoming donation.