Earlier this month, Lukus Estok, 36, was waiting to be seen at the New York Blood Center to donate blood plasma. He was eager and excited because he hadn’t donated blood since he was in high school, before he was 18.
Despite having had multiple phone calls, person-to-person screenings, and blood tests, Estok was turned away simply because he was gay.
Upon hearing of his sexual identity, the person administering the screening allegedly replied, "Well, you will not be donating today."
In 1983, the Food and Drug Administration began to bar gay and bisexual men from donating blood. The policy was birthed during a time in the HIV epidemic when very little was known about HIV and AIDS. There was at the time no effective treatment for the disease, nor any reliable way of screening blood for HIV; now both problems have been solved. Fear of the unknown ultimately created stigmatizing policies — such as bans on donating blood and draconian laws criminalizing those living with HIV.
In 2015, the FDA loosened the lifetime ban to a 12-month deferral period, meaning men who haven’t had sex with a man within a year were acceptable donors. A week before Estok spoke to Mount Sinai, the FDA announced it was reducing the recommended deferral period from 12 months to three months, amid the COVID-19 pandemic, although the FDA policy is not mandatory; blood centers are free to set more restrictive policies.
At the time of the screening, Estok was nearing the end of a turbulent couple of months. He contracted COVID-19 in March and had finally recovered. He started the process of exploring whether he was a potential donor for convalescent plasma.
People who’ve recovered from COVID-19 have antibodies to the disease in their blood, or convalescent plasma, as explained by the Mayo Clinic. Doctors and researchers are currently testing whether plasma can be given to those with the virus to help boost their immune defense, and are taking donations from people who qualify.
Estok had decided to reach out to Mount Sinai’s Convalescent Plasma Program. He answered a few questions over the phone and the staff ultimately invited him to be screened. His blood came back negative for COVID-19 and positive for a high level of antibodies. An employee called him back the next day and asked a few more questions he assumed were “typical donor screening questions.”
Estok qualified under the three-month deferral period, he tells The Advocate, so when they asked him if he had sex with a man in the last three months, he answered truthfully.
“I passed the screening,” he says, “They told me I could expect a call from the New York Blood Center so that they could schedule me for a donation appointment, which they did the next day.”
The New York Blood Center asked him roughly the same screening questions, including the three-month question. He answered no, and things seemed to be moving forward as usual.
“I was relieved. It’s in effect, we're good,” he remembers thinking.
A week later, he found himself waiting to be seen at the New York Blood Center to donate blood plasma. They took his temperature before entering, and things were going smoothly until he was asked to clarify why he hadn’t donated blood since he was a teen.
“At this point, I've passed the screening questions. I've passed the actual screening itself, I know I'm healthy,” he says. “So I kind of dropped my guard and assumed I was in the clear and that we were all on the same page. I responded, ‘I’m a gay man.’ And the moment that happened, I saw the look in the eyes of the person I was speaking with change. Even though their face was covered, I could see their eyes grow cold. And the immediate response back to me was ‘Well, you will not be donating today.’”
Estok says he willingly volunteered to share his sexual identity out of a false sense of security, based on the fact that he was following what he understood to be the federal guidelines.
“I asked for clarification and the response was the same: ‘You won’t be donating today,’” he explains. “And then I pulled out what I felt was the last tool in my belt in that moment, which was to say, ‘You know, if this is because I'm a gay man, I know the FDA has recently relaxed this restriction on gay and bi men donating blood.’ But as I was finishing the last bit of that sentence, I was interrupted."
"The response back to me was, ‘I don't know what you think you know, but you will not be donating here today," he says.
The person then walked away and, according to Estok, started whispering to other staff members at the clinic: “I was angry. I was not sure how to respond, and I was embarrassed."
The person eventually handed Estok’s ID back to him. When he grabbed it somewhat forcibly, Estok says, they responded condescendingly with something to the effect of, “Oh, well, I guess that’s how it’s gonna be.”
“It was a very confrontational exchange,” Estok says. “I remember my response to them being somewhere in the realm of ‘You know, I didn't mean anything personally by the way I grabbed my ID, but I hope you understand that what is happening right now feels very personal to me. And that I've just been told that despite having passed your screenings and having [recovered] from this virus, my donation is not going to be accepted for no real reason right now. Is that true?’”
Staff members ultimately showed Estok to a small office where an employee spoke to him about why he was unable to donate blood.
“They were telling me that the New York Blood Center had advocated on behalf of [gay and bi men to donate blood] for a long time,” he says. “And that they were excited about it, but it wasn't like ‘flipping a switch.’”
After a bit of pushback, Estok asked flat out, “What's keeping you from taking my donation right now? You and I both know that I'm a qualified donor.”
The retort, according to Estok, was that it was an "administrative issue" and that implementing the FDA's new guidelines would require the clinic to “update our computers” and that they’d “need to retrain our staff for the kinds of questions they need to ask.”
When Estok pointed out he had been asked the three-month question multiple times at that point, he claims the person blamed the application process.
“Well, we're going to have to look into that, that shouldn't have happened," the person told him, according to Estok. "Maybe Mount Sinai, who works separately from us, saw the FDA announcement and they got excited and thought, OK, this is great, we can get more donors. But [New York Blood Center] is not there. And this is an administrative issue.”
Estok ended up going home feeling defeated.
When family and friends began to ask about the status of his donation, he decided to share his experience on Facebook in a post that has since gone viral with nearly 24,000 shares.
Upon seeing the post, Memorial Sloan Kettering Cancer Center reached out to Estok and invited him to donate plasma. He donated successfully this week.
Estok is hopeful that by sharing his story, people will be forced to educate themselves about the unjust guidelines around LGBTQ men donating, which is not in tune with science.
This week, Good Morning America profiled Estok and told his story. In the segment, the FDA admitted for the first time it was looking into a pilot program to decide whether it could drop the ban altogether.
“That's a big deal,” Estok says. “But there are medical professionals across the country, hundreds and hundreds, who have sent a letter to the FDA expressing that they don't need a pilot program. The science is there and clear. They can be making this change much more immediately.”
Experts call for the FDA to switch to a policy that would look at individual risk factors rather than exclude whole groups of people.
He adds, “I think that it's much more attainable than we would have hoped. And if I can in any way, shape, or form, put my voice into that conversation right now and put a face for some people that may not have known that in the year 2020 this was a guideline being followed, I think that's something I want to do.”
The Advocate reached out to the New York Blood Center for a comment, but it has not returned our phone calls.