Why LGBTQIA+ community is battling India’s blanket ban on blood donation

Despite strides in transgender and gay rights, India has latched on to a rather archaic and discriminatory policy, stemming from a fearful mindset, when it comes to the rights of homosexuals and transgender individuals in donating blood.

Activists, medical experts, and members of the LGBTQIA+ community, who echo these sentiments, have slammed the Centre's recent decision refusing to alter a long-standing ban on blood donation by transgender women and gay men. They say the ban is discriminatory, unscientific, and ignores advances in blood screening technology that make transfusions over 99 per cent safe.

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The government’s order has come even though the Supreme Court, in May this year, while hearing a petition on the matter, asked whether an entire identity group needs to be stigmatised when medical science has advanced to screen blood for infection.

“Why should an entire community be deemed unsafe when modern medical science can effectively screen blood for infection? This discourages willing donors and denies life-saving blood. Such prejudice is appalling,” Ujan, a transwoman from West Bengal, told The Federal.

What does the law say?

Clauses 12 and 51 under the Guidelines on Blood Donor Selection and Referral tag transgender individuals, homosexual and bisexual men, and female sex workers as “high-risk” groups and bar them from donating blood irrespective of their lifestyle, health conditions, or sexual practices.

The guidelines were drafted in 2017 by the National Blood Transfusion Council (NBTC) and the National AIDS Control Organisation as a precaution during a time of declining HIV/AIDS incidence. It, however, continues to exclude entire communities without scientific justification, say activists.

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Santa Khurai, a transgender activist from Manipur, founder of the community organisation AMANA, and a petitioner in a 2021 case challenging this policy, noted, “The Supreme Court of India questioned the government’s stigmatising response to our petition in May 2025.” It was Khurai’s petition that the Supreme Court had referred to while posing the question to the Centre in May this year.

Status in other countries

Activists say the continuation of the ban in India is unfortunate, even though many countries, including the US, the UK, Canada, Brazil, and Australia, have replaced such blanket bans with behaviour-based risk assessments.

“The US Public Health Service initially implemented a lifetime ban on men who have sex with men (MSM) donating blood in 1983, in response to the emerging HIV/AIDS epidemic. However, in 2023, the US Food and Drug Administration revised these guidelines to adopt a gender-inclusive, behaviour-based screening process,” Naveenraj, a queer activist and trainer based in Tamil Nadu, told The Federal.

He emphasised that this modern approach prioritises individual risk factors over blanket bans based on sexual orientation or gender identity.

Organ donation criteria are more flexible – especially for biologically related donors. Yet queer and trans individuals may still face rejection based on personal bias: Dr Gargi Dhananjayan, healthcare provider in Tamil Nadu

Many countries, including Brazil, the UK, Canada, Australia, France, Spain, Italy, Argentina, and Chile, have already scrapped such discriminatory policies. Brazil’s Supreme Federal Court, for instance, ruled the ban unconstitutional and highlighted the efficiency of modern blood screening technologies.

“India’s Supreme Court should similarly lift the ban, in keeping with its commitment to equality, dignity, and inclusion,” Naveenraj added.

‘Flawed science guides policy’

Medical professionals are also calling out the “flawed science” underpinning the policy. Umang, an undergraduate medical student in Pune, remarked, “Heterosexual and homosexual individuals can both transmit HIV. It's practically impossible to determine someone’s sexual orientation during blood donation. With current methods, HIV detection in India is over 99.5 per cent accurate, so targeting MSMs is not about safety—it’s about exclusion.”

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This sense of injustice resonates deeply within the queer community. “Whether or not it’s a fundamental right, denying a minority group the chance to donate blood is dehumanising. India must take progressive steps, like the EU, Canada, and Australia, where donor eligibility is assessed based on behaviour, not identity,” Srini, a volunteer with Good As You, a Bengaluru-based queer support group, told The Federal.

This is not about protection; it’s about discrimination. Rather than investing in quality testing, the system excludes LGBTQIA+ people from saving lives: Rudrani Rajkumari, transgender activist

Echoing this sentiment, Jayant Iyer, founder of Queer Nilayam in Bengaluru, called the government’s continued enforcement of the ban “disappointing, outdated, discriminatory, and unscientific.” He shared personal frustration: “I’ve been denied the chance to donate blood multiple times despite being healthy and willing. Even during shortages, prejudice trumps science and compassion.”

‘Structural transphobia’

For many, the policy reflects broader systemic bias. “Can the Indian government ban cisgender heterosexual people based on their gender or sexuality?” asked Rudrani Rajkumari, a transgender activist and founder of Xomonnoy in Guwahati. “This is not about protection; it’s about discrimination. Rather than investing in quality testing, the system excludes LGBTQIA+ people from saving lives.”

From a global perspective, the issue strikes a chord with transgender communities elsewhere. “The Indian government’s stance wrongly associates LGBTQI+ identities with risk,” said Mandy Jovial, a South Africa-based transgender activist.

“This is more than a blood ban—it’s structural transphobia. Fortunately, in South Africa, policies aren’t based on sexual orientation or gender identity, even though stigma persists.”

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What India needs

Even within India, trans individuals raise questions about the logic of such exclusion. Vaidehi, a trans woman from Mysuru, asked, “How would anyone know someone’s SOGIESC [sexual orientation, gender identity and expression, and sex characteristics] unless disclosed? Assuming trans or homosexual persons have HIV is discriminatory. Anyone can have HIV. Besides, trans persons on hormone replacement therapy should consult a doctor before donating, but that’s a medical concern—not a reason to ban an entire community.”

Considering the severe blood shortage, we must include all willing and healthy donors. Blanket bans only reinforce harmful stereotypes and damage mental health, especially when trans persons themselves may need blood: Dr Pallavi Preetinanda, a psychiatrist in Bhubaneswar

Medical experts agree that the government’s approach is flawed and misleading. “One data point doesn’t scientifically justify a ban,” said Dr Swathi SB, a public health practitioner and HIV physician in Karnataka. “Equating identity with sexual behaviour is dangerously reductionist. We need sensitised pre-donation counselling and inclusive, behaviour-based screening.”

She pointed to countries like the UK and Canada that have successfully implemented such reforms while maintaining blood supply safety.

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Dr Pallavi Preetinanda, a psychiatrist in Bhubaneswar, underscored the broader implications: “Considering the severe blood shortage, we must include all willing and healthy donors. Pre-donation testing through ELISA and NAT is fast and reliable. Blanket bans only reinforce harmful stereotypes and damage mental health, especially when trans persons themselves may need blood.”

Same bias not in organ donation

Beyond blood donation, these biases often extend to other areas of healthcare. Dr Gargi Dhananjayan, a queer-affirming healthcare provider in Tamil Nadu, told The Federal: “Organ donation criteria are more flexible – especially for biologically related donors. Yet queer and trans individuals may still face rejection based on personal bias.”

The battle is now before India’s highest court. While the Ministry of Health and Family Welfare reaffirmed the current policy in an August 2025 affidavit, the Supreme Court is seeking expert input to determine how to remove discriminatory elements without compromising blood safety.

As Santa and Srini jointly observed, “Can we expect an unbiased, life-saving outcome, even as we acknowledge that science, too, can be shaped by social prejudice?”