Guest Blogger

Not Welcome: A Transwoman and the Plasma Center

Filed By Guest Blogger | March 04, 2011 2:00 PM | comments

Filed in: Living, Transgender & Intersex
Tags: blood donation, gender reassignment, medical, plasma donation

Editors' Note: Guest blogger Sera Wohldmann is a 23-year old recently post-operative transgender lesbian, a working musician by day, and a security guard by night. She currently lives in Hollywood, CA with her unemployed trans fiancée just trying to scrape by.

Sera-Wohldmann.jpgIt comes as a surprise to very few friends of mine that, financially, things are very difficult lately. I am at least a week, typically 2.5 weeks, behind on any one given bill. I work a low income 32-hour a week job, and my fiancée, Elizabeth, is still unemployed. Many of my efforts to supplement my income and stay above water have fallen short in one way or another. This attempt was no different.

Back in my birth town of St. Peters, Missouri, there was a girl. A friend of mine, once upon a time, we'll just call her A. She was a hemophiliac, and as a result, it was no secret to me that she required various blood products when she had what would be to us only minor injuries. But I had heard that it was difficult to donate if you were in any way queer, so I had not given it any consideration.

A short week before my January 4, 2011 vaginoplasty trip to Bangkok, I was riding the LA Metro bus on my way to work. I saw an advertisement for Cangene Plasma Center. They were seeking new donors, and the programs were compensated. Elizabeth and I talked over the idea, but decided at the time that, as I was so close to my surgery, I shouldn't do anything that may compromise recovery. Not that I think it would have, but we wanted to be careful. All the same, I filed it away for future consideration.

Fast forward, then, to March 2nd, 2011.

I had called the day before to schedule an appointment to donate. The questions they asked me over the phone did not disqualify me, so they asked me to come in. It was a very clean facility, and I was greeted by the front desk technician. He had me fill in the necessary preliminary paperwork to get the process started.

One of the things they covered was HIV/AIDS material. Included in it was the FDA's warning: "No male that has ever had sexual contact with another male, even once, since 1977, is ever allowed to donate blood or blood products, including plasma." I heeded that warning, however homophobic and archaic it may be, but as I was not a male, I hoped it would not be an issue.

I filled out a computer based "risk history" questionnaire. The only question I even answered in the positive related to various medications, and as I had taken Finasteride (Proscar) at the beginning of my hormone therapy, I answered yes. However, it also said that I had to be off the medicine for a month. I had not taken Finasteride in 11 months or so, so I was fine. I returned to my seat.

I was called for an entry interview by the on-site doctor shortly after taking a preliminary blood platelet count draw. This is the part where it all about went to the Hells. He asked if I had been hospitalized for anything, including cosmetic surgery, in the past year. As I was in an examination room, I figured I would get a full physical, and it was possible they would notice that I had a cosmetically altered vagina. I told the truth.

"Yes, I had cosmetic surgery just 2 months ago," I replied.

"What procedure did you have?"

I blushed, hesitating a bit. "Male to Female realignment surgery."

The doctor began writing on a post-it note. He underlined MALE twice, very strongly. I was already quite uncomfortable. "Did you have the whole procedure, or just breasts?"

"I didn't have breast surgery, just vaginoplasty," I replied.

He seemed confused at this, but continued. "While you were...previously a male, had you ever had sex with a man?"

I knew where he was going with this. I could easily argue that, as my partners had been transwomen, that no, I had not, but I didn't volunteer that information. I had also been a virgin for a bit longer than average, to top it off. So I lied a little. "No, I did not."

That shocked him. "You never once, before your surgery, had sex with a man?"

"No, doctor, I did not," I said, shifting uncomfortably in my seat. "You seem surprised? It's not too impossible to believe. That is my fiancée in the waiting room, after all."

"Now I'm confused, you say that's your 'fiancée,' right? That would be a guy?"
"No, my fiancée is a woman."

"A biological woman?"

Side rant: I hate that fucking word! Last I checked, I was just as biologically sound as anyone else. "Yes," I said anyways. Also a bit of a lie, but fuck they didn't need to know that. Besides, I should argue that he meant, "cisgender," anyways. What should it matter? I was clean, perfectly healthy, and I'm here to do you a fucking favor!

I was dismissed back to the waiting room for a short while. Elizabeth could tell something had happened, and asked if it was okay. "I'll tell you later." I knew I couldn't say anything where it was within staff earshot. I wanted to finish this process first and avoid unnecessary controversy. I wouldn't get the chance. I was called back into the exam room 5 minutes later.

"Unfortunately, Ms. Wohldmann, we have a bit of a problem. You see, our system tested you on the 'female' questionnaire," the doctor began.

"As I am female, this would be correct," I pointed out.

"Yes and also no. Because you had a history as a male, some of those questions are not accurate. They don't cover everything."

"Sounds like a problem with the system, not my health."

"Well, we can't go back and test you on the male system, as well, because we're not designed for that."

"Again, that sounds like a problem with your system."

"The questions are all from the FDA guidelines, and we can't change them."

"I'm not asking you to change the questions, just to realize that it's a bit absurd to think that, with all of the mutations you, as a doctor, should be aware of, that there are more than 2 classifiable sexes, correct? What if I had been intersex? What would you do, then?"

"Believe me, miss, I actually have dealt with that," he replied. Funny, though, that he didn't say what he did. He probably turned hir away for no reason, like I felt was about to happen to me.

"Also, you're not the first person to go through this process, but it's a little different for you. I don't know if it's just LA, or what, but we've had this happen before. You're just the first one to have gone through the full surgery. And that changes things."

"Well, consider also, that one of the bigger transgender clubs in the area is right here in Van Nuys," I pointed out.

"I didn't know that, but that would probably explain it. Anyways, for most people like this, we can just register them as males, as they legally are, and there is no problem. The problem is, that you had several years as a male, and now you're female, legally. We have no way to categorize this."

"So, what you're saying, is that you have a perfectly healthy donor sitting right in front of you, and because of your archaic system, you're going to turn away a willing donor?"

"I'm sorry, but that's all I can do."

I explained at this point that I was aware there were constraints on some things related to blood and plasma donations, but that there was absolutely no evidence that this was going to be an issue. No one talks about it. So, of course I'm going to try.

I'm running out of options for supplementing my income, why wouldn't I try? I didn't tell him that part. Instead, I related the story of A to him. My heart may not have been in the most selfless of places, but he didn't need to know that. Most of the people in that room only did it for the money, anyways, I would be no different.

He showed me out to the waiting room again. As I approached Elizabeth, still reading the magazine, I mouthed, "Let's go." We walked out the front door. But not before I gave a parting gift of a single-fingered salute.


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Unfortunately trans people do tax the system, and people are more likely to respond by getting rid of the perceived problem (we can't take your blood) than fix their system.

I do hope you spoke with the doctor's manager or higher-up, whatever you could find.

I should probably clarify that my use of "tax" there was facetious. These systems are unable to deal with the need for flexibility in regards to gender. It's not the fault of trans people - it's the inability of faceless systems to make judgement calls and/or make room for variance as needed.

...and I think I just got the idea for my next Bilerico article. :D

I'm sorry. How do transpeople 'tax' the system exactly? If anything, the system taxes itself by excluding us from contributing to society. THEIR society. Cisgender society. I for one don't feel like a burden to the system or anybody else for that matter.

~BB~

Alexis Taylor | March 4, 2011 2:30 PM

I had a very similar experience in Columbus, Ohio, last fall. I answered all of the questions, and because my ID was still male, that is how I was presenting. I answered all of the questions honestly, including the one in which they ask if any of my medications had changed in the last 6 weeks. My anti-depressant had been adjusted, so I reported it. After 3 hours, I was sent into a room with a nurse, who asked me what medications had changed. I answered, and it was noted. I was then asked what other medications I may be taking, and I reported that I was also taking spironolactone and estradiol, and the quantities. At this point, I was asked, "What are you taking those for?"

This is the point to take pause. The chemical makeup of my blood wasn't altered by those too components in a way to make it unusable. Rather, what made it unusable was my answer, "I'm transgender." I was told that I couldn't donate, and was informed that as transgender, I'm 'high risk', even though I answered every question honestly about my sexual activity, lack of drug use, or tattoos.

In essence, what this said was "You are transgender, so we consider you to not only be sexually promiscuous, but likely to lie on the questionnaire."

By the way, I have not had any surgeries, and at the time was only on oral HRT. The determination, I confirmed with the nurse, based on a corporate guideline, which she showed me, that indicated that the transgender are prohibited simply because we are high risk.

Perhaps if there are two of us there are more? Any one care to make an issue of it? :)

I had a similar situation when I went to donate blood they asked me both the male and female questions to be extra sure (besides, the "have you ever had sex with a man" is stricter than the "have you ever had sex with a man who has had sex with a man" and I believe that's the only difference between the male and female form).

It really through them for a loop when I asked them what "sex" referred to. The nurse and her supervisor spent 45+ min trying to figure it out, and right before they were going to turn me away they found it. Lo and behold what I had done did not count as sex under that definition, so I thought I was in. Perhaps they didn't believe me, or perhaps they couldn't imagine a type of sex that wasn't oral, anal or vaginal. But they asked me to leave anyway, to be called by the regional manager a week later, who asked me again if I had oral, anal, or vaginal sex with a man. Since the answer at the time was 'no' she said I was welcome to come back, however, after that treatment, I decided not to return.

sarahallison48 | March 4, 2011 2:54 PM

So what do they do with cis-women? Do they not have sex with men? I don't see the problem here. All blood and plasma has to be tested anyways for any other numerous things as well, not just AIDS. As Tobi points out, it just did not seem to matter, it seems what mattered more was how do we label this?

That did seem to be the case, actually. Well, there were several women donating there at the time, I presume them to be cis, and likely having sex with men. As long as those men are not having sex with men, to their knowledge, no problem.

And, you're right, they do test all the donations anyways. So, really, the entire point, to me, came across as trying every way possible to justify their pointless fears.

(Note: I previously commented under my middle name, Taelyn, as my display name.)

I piss off the management at work whenever the Red Cross comes around. They want 100% participation and I tell them point blank "No. They won't allow gay men and trans women to donate, regardless of how clean our blood is." Some are always surprised at this. This is something I found out more than a decade ago and it hasn't changed. Screw them. I'll just keep my blood in it's original container, thank you very much.

It is only fair to point out that these discriminatory policies do not originate from the Red Cross; they are imposed on the Red Cross by the FDA. The Red Cross has unsuccessfully lobbied for years to get the restrictions lifted.

Except they do orginate from the Red Cross, as it played a huge role in getting them put in place. While they have changed their opinion on the matter in the last few years, their hands are not clean in this.

I would like to see credible documentation for this claim, please.

Om Kalthoum | March 4, 2011 7:01 PM

You gave 'em the finger 'cause they followed governmental regulations properly? I guess you showed them, huh?

They don't have to much such assholes about it though.

Following the rules is one thing. Being rude and insulting is another.

Patricia Harlow Patricia Harlow | March 4, 2011 8:56 PM

Lame. Last three times I tried to donate blood (not plasma) I was turned away: once for having mon at the time, once for having mono within a year, and last time I was informed my blood was banned for 5 years as I had been in Iraqi combat zones. After those 3 attempts I figured I'd never try again. This article only galvanizes my resolve to no longer even try to donate.

I know a pre-op transsexual that donates blood regularly. She told me she was truthful with them on the questionaire about her status and her prescriptions. She said that no one made a big deal about it and she was allowed to donate blood. Now compare her experience to yours by your own admission you admit to lying and becoming defensive. What would have happened if you had been truthful from the beginning? Right or wrong how did your actions benefit the next TS or TG person to go there? Sometimes our own actions cause the discrimination we face and the discrimination those who come after us face. When I need to be, painful as it may be, I'm truthful about myself and my situation and I do so with dignity. I appreciate the effort of those who came before me and I try to make it easier for the person who comes after me. Hopefully you learn a lesson from these comments.

I know Sera says that she "lied a little" but I don't see anything here that looks like a lie.

Have you had sex with men? No, only women. The fact that some of those women are trans does not make it a lie.

Is your fiancée a biological women? (With the implied question, were all your sexual partners biological women?) Yes. Again, the fact some of those women are trans does not mean that they aren't biological.

The interesting thing here is that everyone is pointing to those questions coming from the FDA -- I don't recall anything from the FDA asking about whether one's sexual partners are biological (...or mechanical? Synthetic? I'm not even sure what the alternative is.)

Additionally, while it might exist, there's no public record I can find of FDA guidelines requiring trans people's genders to be seen as invalid.

The individual workers can be said to be "following government guidelines" when they refuse men who have had sex with men, but NOT when they decide that all trans women count as men, or count as men before vaginoplasty, or count as both men or women, or count as synthetic, etc. As far as I can tell, the individual workers are making that up as they go.

I won't discuss my history. It's way too complicated to understand. I am pretty old. Let it suffice to say I can't give blood and I have always been up front about that to anyone who it might be important to.

I don't know if I'd want to be twenty-three again. I don't know how I survived that part of my life. I almost didn't. I had an incredibly difficult time. It has to be easier now but I doubt that's saying much. According to the "scientists" we're all liars. Some people don't think that's much to get worked up about. I do. I have always tried to be as honest as I can be without sacrificing myself for no good purpose.

You are legally female. The burden of proof is on them. It's up to them to prove you are not. There are reasons why people have to be proven guilty, not prove they're innocent. It's impossible to prove anyone's innocence. It is impossible to draw a line and say where one sex begins and one ends. If you came out of your mother's tummy the way you are now there wouldn't be any questions asked. I think you are making a mistake calling it cosmetic surgery. After you heal you might feel differently about it. I do. It takes a while for that area to re-connect to the rest of your body and discover how well everything fits together. Your endocrine system is forever changed. It is far more than superficial.

I had a colonoscopy, recently. I told them about the medication, I was on - estradiol because I think it is important for them to know. I always have. I also told them about other details of my medical history that I know are important. I held back on telling them about my surgery, though. They could tear open a fistula just as easily in any other woman as they could me.

One last thing about intersex, intersex is the result of naturally occurring variations of sex differentiation. There is more than Coke and Pepsi in this world. Intersex people are not mutants.

I had a look at this earlier today:

http://www.waynecountyredcross.org/docs/EligibilityGuide1005.pd

"The problem is, that you had several years as a male, and now you're female, legally. We have no way to categorize this."

The policy seems homophobic. I can't really blame the doctor. I hate the term "biologically female/male", too. I think the doctor is required to follow policy guidelines set elsewhere. I think his concerns were whether you had sex with someone who was legally male while you were legally male. You don't make that clear. The policy seems homophobic and probably racist, too.
The exclusions don't seem to be exclusively limited to those who have had male to male sex, either:

Blood Services
New York-Penn Region
Blood Donor
Eligibility Guide

• or your sexual partner were born in or lived in Cameroon,
Central African Republic, Chad, Congo, Equatorial
Guinea, Gabon, Niger, or Nigeria for ?ve years or more after 1977.

"As I am female, this would be correct," I pointed out.

"Yes and also no."

If you are legally female, I think the definitive answer is yes, not an ambiguous one. I don't think you can blame the doctor too much for the misunderstanding, though. There are not enough people firmly establishing that. If it were me and I were able to donate blood, I think the critical question is the legal sex at the time of previous relationships. I don't think that calls into question the legal validity of your legal sex at the present. It seems as though their actuarial assessment of risk results in de facto homophobia and racism, or at least selective xenophobia. This is painful to write about as a transsexual woman. It seems a painful question for gay men and people from the African countries, as well. All three categories of people seem to be the only ones excluded for reasons other than their health.


http://www.waynecountyredcross.org/docs/EligibilityGuide1005.pdf

I think this link works. Sorry about the one above. Don't know what was wrong with the other. The guidelines are for the N Y area. I don't know how up to date they are but they sound similar to the FDA guidelines you wrote about.

Dawn Storrud | March 5, 2011 7:42 AM

I am a regular blood donor, giving every eight weeks or sixteen if my last donation was a double. I have given 104 times now, not including the in between calls I sometimes get to give plasma. I am also post op. Being fairly footloose I give blood in seven states. Each blood donation region has different rules, but all of them now use or will be using the new CDC guidelines by April 7th. The rules for post op MtF call for the interviewer to ask both the male and the female questions of the potential donor.
The percentage of folk who give blood is so low that only the very bigotted will turn us away because we are not cis. Smile and answer all the question truthfully.

The last time I tried to donate blood was right after 9/11. I was turned down because when the woman asking the questions asked how I was, I told her "angry". Which I was. I was furious. And after she spent five minutes telling me how I shouldn't be angry and upset, thereby making me even more angry and upset, my blood pressure was elevated (Gee, wonder why?).

Sometimes answering the questions honestly isn't such a good idea... If I'd said "just fine", I'm sure I would have been accepted.

Not the same thing as having been turned down because of my gender or sexuality, but a pretty good example of how ridiculous the Red Cross can be when it comes to perfectly healthy potential donors.

I might point out that recent surgery resulting in blood transfusion in a high-incidence country with unknown screening and storage blood policies would be a reason to refuse blood donors. I am not familiar with Thai blood bank regulation, but do know that Thailand has extensive sex tourism, and a sizable number of HIV-positive poor people who might sell blood products for survival.

I didn't know that trans people couldn't donate blood, but I'm not surprised to hear.

I think that Alex's comment highlights the problem with the use of such an ambiguously all-inclusive term like "trans".

As can be seen from the comments, different folks in different situations, experienced different reactions from the various encounters with the blood banks.

Alex's conclusion was that he, "didn't know that trans people couldn't donate blood, but I'm not surprised to hear."

Yet it is clear from the comments that SOME "trans" folk have been able to donate blood on numerous occassions and in different locations.

So it would seem to me that "differences", DO in fact, make a difference. And yet....Alex seems NOT to have 'noticed' that. Makes me wonder why.

Sam,

I think it's less about what kind of "trans" an individual is and more about other things. Interestingly, Austen's recent post showed how instances like this can often be bolstered by bigotry but primarily motived by confusion and not understanding or not having clear policy.

In this case, there is no policy saying that trans people can't donate, but there's also no policy saying how to deal with trans people, and some staff at some clinics are flat out refusing trans folks of any kind.

Other places might only refuse trans folks who are quite visible as trans or who don't pass as cis. Other's might accept trans blood so long as you assent to being treated and categorized as your assigned sex. Others might just throw disrespectful and hurtful language at trans people, making it a hostile environment that many trans folks prefer to avoid.