Recently, the FDA issued an edict advising sperm banks to bar as donors men who have had sex with other men within five years prior to donation. I have searched through the medical literature for a sound scientific basis for this directive, yet the only reasoning behind the recommendation is the fact that homosexual men are at high risk of HIV. If this were the rationale, though, it follows that the FDA should bar other high-risk donors such as men who have used IV drugs or have had sex with prostitutes. This, however, is not the case. Considering the (increasingly) stringent testing procedures employed by sperm banks, the glaring inconsistency suggests the FDA is influenced by ideology, concerned more with sexual preference than with risky behavior. Here's why, using California Cryobank, the nation's leading sperm bank, as a model:
All donated sperm, regardless of the sexual orientation of the donor, is frozen and quarantined, allowing for ample time to retest both donor and sample -- every three months -- for not only HIV but gonorrhea, syphilis, hepatitis, and a host of other sexually transmitted diseases (STDs). In addition, donors must pass a battery of tests for genetic diseases such as cystic fibrosis, Tay-Sachs, Thalassemia, canavan disease, Fanconi anemia, and various chromosome abnormalities to name a few. Also, each donor's medical history is documented, as is that of his parents, grandparents, siblings, and cousins. The donor must have gone to a four-year college, commit to donating routinely for one to two years, and undergo blood tests and physical exams every three months. Interestingly, once all is said and done, less than 5% of hopeful sperm donors are accepted.
Given this rigorous screening from which no donor is exempt, why would the FDA add to the "Eligibility Determination for Donors of Human Cells, Tissues, and Cellular and Tissue-Based Products" docket the recommendation that only sexually active homosexual men be screened out of the donor process? This certainly won't obviate the need to test all specimens anyway. I would hope that even the man who passes all the above tests with flying colors, a genetic masterpiece who attended Harvard and Yale and who has never been ill a day in his life, would be tested for HIV, regardless of claims that he had never used intravenous drugs, had sex with a man, or received a blood transfusion before HIV testing became routine.
And that raises another baffling point about the FDA policy: enforcement. Are sperm banks now to take the claims and promises of hopeful donors on faith alone? Are we to assume that Mr. X is telling the truth about his sexual past and just let him and his sperm pass through the gates? If he wants to be a sperm donor and will say anything to be accepted, he could easily lie about his sexual orientation.
What is accomplished by barring homosexuals from donating sperm? Does it save money? I don't see how. Will it save lives? Nope. Is it mere bias? It seems so, given the fact that while homosexual men do have a higher risk of HIV -- tests for which are now extremely accurate -- heterosexual men are by no means without risk. The policy seems to be a throwback to the days when HIV was deemed a "gay plague." I had hoped the FDA had made more progress than that.
Then again, this isn't the first FDA ruling that appeared to be based more on ideology than science. Let us not forget the May 2004 refusal to grant over-the-counter access to Plan B -- also known as "the morning after pill" -- an unprecedented move after a 23-4 vote of approval by the FDA's scientific advisory panel. Just recently, Senators called for an investigation into the possibility that a memo from Dr. David Hager -- a Bush administration FDA appointee whose staunch opposition to birth control, abortion, and premarital sex is rooted in his ardent evangelical piety -- influenced the rejection of the pill.
The FDA always faces pressure from a variety of interest groups. Let us hope that the agency is not caving into pressure from homophobic moralists in its recommendation to bar sperm donations by gay men. That would truly be a disservice to the public from a supposedly science-based regulatory body.
Aubrey Stimola is the Assistant Director of Public Health at the American Council on Science and Health.
