Equality for gay men in blood donation achieved in Finland

Marko Leimio
Senior Adviser at the Non-Discrimination Ombudsman in Finland

Maria Swanljung
Communications Manager at the Non-Discrimination Ombudsman in Finland

Starting from 1 October 2023, the criteria for donating blood in Finland have become more equal by removing a disproportionate ban for sexually active gay men. The Finnish Non-Discrimination Ombudsman and many actors in the civil society have worked for several years for the change that has now entered into force. This is an important step forward in equal access to services for the LGBTQI+ community. In what follows, we will highlight the key role played by the Non-Discrimination Ombudsman, together with Finnish civil society, for this win for LGBTQI+ equality in Finland.

A disproportionate ban on blood donation

Before 2023, the blood donation regulations by the Finnish Medicines Agency imposed a 12-month ban on donating blood for sexually active gay men regardless of whether they had a new partner or not. A 12-month ban on donating blood was also imposed on women whose male partner had had sex with a man. Other blood donors did not have similar restrictions as they were only subjected to a 4-month ban on donating blood if their sexual partner had changed. The blood donation ban imposed on sexually active gay men clearly treated gay men less favourably than other donors based on their sexual orientation.

Early in 2018, the Non-Discrimination Ombudsman started to work on changing the discriminatory situation by sending a request for information to the Finnish Medicines Agency, which is responsible for preparing the blood donation regulations in Finland. In the request for information, the Ombudsman asked for an answer to why the length of the waiting period set for donating blood and the basis for the waiting period were different based on the gender of a person and the person’s sexual partner. The request for information also asked for specification of the grounds for the 12-month ban on donating blood, whether there were justified reasons for it in light of the current information, and if it would be possible to give up the different length of the waiting period. The Ombudsman also asked for clarification on why the 12-month ban on donating blood for also applied to gay men whose partner had not changed.

At the time, the Finnish Medicines Agency justified the practice in force with the need to ensure the quality and safety of blood products. The agency said that since it has not always been possible to make a completely accurate risk assessment regarding an individual blood donor, risks have been defined on a population level. As a result, donation restrictions have been imposed on several different groups with the aim of minimising the safety risks to both the blood donors themselves as well as the patients receiving blood products. The higher-than-average prevalence and incidence of HIV infections in sex between men, for instance, was considered a ground for a longer donation ban. Moreover, the Finnish Medicines Agency found that the change in blood donation regulations in 2014, based on which sex between men no longer led to a permanent blood donation ban, was sufficient. The Finnish Medicines Agency also justified its instructions with the fact that at the time, there was a permanent donation ban in force in 16 out of 29 countries in Europe with a similar blood donation ban of 12 months in five countries, and the blood donation ban was evaluated on a case-by-case basis in the rest of the countries. In its decision, the Parliamentary Ombudsman (national authority overseeing legality) had also found that there were acceptable grounds as referred to in the Constitution of Finland for a blood donation ban due to sex between men. However, the Finnish Medicines Agency stated that the blood donation ban and its grounds would be evaluated in the annually held meetings of the expert group discussing the safety of donated blood.

The Non-Discrimination Ombudsman working towards LGBTQI+ equality

The Non-Discrimination Ombudsman monitors discrimination based on sexual orientation in all areas of life. Discrimination related to gender, gender identity and gender expression belongs to the domain of the Ombudsman for Equality. Situations involving multi-based discrimination, e.g. sexual orientation and gender, are monitored by the Non-Discrimination Ombudsman.

In its response to the justifications provided by the Finnish Medicines Agency and the Finnish Red Cross Blood Service following the request for information, the Non-Discrimination Ombudsman explained that for the realisation of equality, it is of central importance that the donation ban of a year and its necessity as well as the possibility of shortening the deadline must be reviewed carefully and regularly with different expert parties. According to the Finnish Non-Discrimination Act, authorities, such as the Finnish Medicines Agency, have an obligation to advance equality in their activities and take necessary measures to promote the realisation of equality in practice. These measures must be effective, expedient and proportionate, taking into account the authority’s operating environment, resources and other circumstances.  Even after responding to the parties in question, the Ombudsman has advocated for the removal of the 12-month blood donation ban on sexually active gay men, and for making the criteria for donating blood more equal in different contexts, e.g. awareness raising in social media (for reference, see this Instagram post or this Instagram post in Finnish).

More inclusive access to blood donation

After 5 years of the Non-Discrimination Ombudsman’s work to ensure equality in blood donation, in 2021 the temporary ban for sexually active gay men was shortened from 12 months to four months. In 2022, the Finnish Medicines Agency reported that their expert group discussed changing the blood donation suitability criteria, in particular, the temporary donation ban of four months related to sex between men. After the meeting of the expert group, the Finnish Medicines Agency initiated the update of the regulation on blood services. A draft regulation in which the blood donation ban after sex between men was removed was circulated for comments early in 2023. The updated regulation of the Finnish Medicines Agency on blood services entered into force on 1 October 2023. Now, everyone in Finland can donate blood with the same blood donation suitability criteria, regardless of their sexual orientation.

This important change required many years of investigation and dialogue between the Non-Discrimination Ombudsman and the Finnish Medicines Agency and counted on the active engagement of civil society. Blood donation regulations were not changed in a parliamentary legislation process; instead, the Ombudsman and civil society’s advocacy for equal access to blood donation contributed to the amendment of regulations by the Finnish Medicines Agency.

The Non-Discrimination Ombudsman underlines that it is important to review the blood donation suitability criteria as well as the practices of the Finnish Red Cross Blood Service in a broader context from the perspective of equality regularly in the future, too.

Equality Bodies such as the Non-Discrimination Ombudsman can play a key role in changing administrative regulations and practices which violate equality legislation, without the need for legislation change or the involvement of policy-makers. Sometimes change can take time, but a more equal society is always worth pursuing.

The views on this blog are always the authors’ and they do not necessarily reflect Equinet’s position.