The Indian Supreme Court on May 14 ordered the central government to consult experts and address policies that label transgender people as “high-risk” blood donors, a designation rooted in assumptions rather than scientific evidence.

“Are we going to brand all transgender individuals as risky and stigmatize them?” said Justices Surya Kant and Nongmeikapam Kotiswar Singh. “You cannot say that all transgender individuals are indulging in sexual activity.”

These restrictions stem from guidelines that the National Blood Transfusion Services, under India’s Health and Family Welfare Ministry, issued on Oct. 11, 2017. The regulations categorize trans people, men who have sex with men, female sex workers, IV drug users, and those with multiple sexual partners as ineligible to donate blood due to presumed risks of HIV, Hepatitis B or C, and require clearance by a medical officer.

The justices considered a petition that contested the constitutional validity of Sections 12 and 51 of the guidelines.

Solicitor General Aishwarya Bhati, representing the central government, stated the rules, which the National Blood Transfusion Council’s panel of medical experts crafted, aimed to prioritize public health and safety without intending to stigmatize any group. The justices during the hearing noted barring trans people from donating blood reinforces their social exclusion, questioning whether these restrictions deepen existing societal biases.

“Just think of something that such feeling does not come, and health standards are not compromised,” they said, granting the government time to address these concerns while maintaining medical safety.

The justices further observed that evolving times and emerging medical technologies offer solutions to screen blood donations for infections without excluding entire groups, allowing broader participation in civic programs.

Bhati said she would relay the court’s recommendations to medical experts for consideration. She explained that donated blood goes directly to blood banks, critical for thalassemia patients and other vulnerable groups who depend entirely on these supplies for their survival.

“As a group, transgenders are considered a high-risk group the world over, with certain exceptions,”Bhati told the justices. “There is a period within which infection has to be identified, and the risk window has to be carefully considered. Nobody can claim to have a fundamental right to donate blood. These guidelines must be seen from the perspective of public health as the idea is not to stigmatize anyone.”

The Washington Blade on Aug. 28, 2024, reported Shariff D. Rangnekar, a gay man from Delhi and director of the Rainbow Literature Festival, challenged the constitutionality of India’s blood donor rules, which bar trans people, MSM, female sex workers, and others from donating blood due to presumed health risks.  

The Supreme Court on July 30, 2024, agreed to hear Rangnekar’s petition that Ibad Mushtaq filed and lawyer Rohin Bhatt wrote. It questions the policy’s reliance on outdated stereotypes from the 1980s. Rangnekar notes the U.S., the U.K., Canada, and Israel are among the countries that have updated their blood donor policies. He urged India to adopt individualized risk assessments. 

South Asian countries have varying blood donation policies for trans people and gay men, with some avoiding blanket bans and others enforcing them. 

Equaldex notes Nepal allows MSM to donate blood without specific restrictions based on sexual orientation or gender identity, suggesting trans people and gay men face no categorical bans. Bangladesh also lacks a specific ban on such donors, although its policies remain ambiguous due to limited documentation.

Pakistan, Sri Lanka, and Malaysia ban MSM and trans people from donating blood, categorizing them as high-risk groups for HIV and other infections.

“It is not just LGBTQIA+ people whose blood can test positive for infections, it could be anybody. All blood that is transfused needs to be tested before transfusion,” said Harish Iyer, a prominent LGBTQ activist in India. “If that is not happening, we have much reason to worry. There is no test on fidelity, regardless of the sex, gender, or sexual orientation. There are open marriages and clandestine affairs that happen in every sexuality. The solution is to speak of safe sex practices and not to take anyone’s word and to test every packet of blood before transfusion.”

Iyer told the Blade that branding and banishing minorities by stereotyping them is an underlying cause of hate crimes. He highlighted that MSM and trans people for years have been seen as simply vectors of HIV, and not as people who lead happy, fulfilling lives. Iyer added the blood donor ban further accentuates this divide and further marginalizes the community.

Iyer said the government should enhance public awareness campaigns around safer sex practices and ensure that all blood undergoes rigorous testing before transfusion. Ankit Bhupatani, a global DEI leader and LGBTQ activist, told the Blade the justices’ directive represents a long-overdue recognition that India’s blood donation guidelines require scientific scrutiny rather than perpetuating stigma.

“By asking the government to seek expert opinion, the bench has opened a path toward evidence-based policy reform. The bench’s observation that labeling all transgender persons as ‘risky’ is troubling, shows judicial wisdom in identifying how these guidelines institutionalize prejudice,” said Bhupatani. “This intervention creates an opportunity to align our healthcare policies with constitutional values of equality and dignity while maintaining necessary medical safeguards.”

He said the 2017 guidelines are a form of structural discrimination.

“Such policies do not merely restrict access to a civic activity; they codify stigma into our healthcare system and reinforce harmful stereotypes about LGBT individuals,” said Bhupatani. “The international trend has indeed moved toward individual risk assessment rather than categorical exclusions. India’s policy remains anachronistic in its approach.” 

“The government absolutely should implement individualized medical screening based on specific behaviors rather than identity,” he added. “The current policy creates the paradoxical situation where a heterosexual person engaging in high-risk behaviors faces less scrutiny than a transgender person in a monogamous relationship. The selective application of supposed ‘public health concerns’ reveals that these guidelines are more informed by social prejudice than medical evidence. Rigorous individual screening would better protect our blood supply while eliminating discriminatory practices.”

Cuban lawmakers are reportedly poised to consider a proposal that would allow transgender people to legally change the gender marker on their ID documents without surgery.

Cubadebate, a government-run website, on May 11 referenced the proposal in an article about an International Day Against Homophobia, Biphobia, and Transphobia march in Havana that the National Center for Sexual Education organized.

Mariela Castro, the daughter of former Cuban President Raúl Castro who spearheads LGBTQ issues on the island, is CENESEX’s director.

Cubadebate notes the National Assembly in July will consider an amendment to the country’s Civil Registry Law that “for the first time would allow citizens to determine the sex on their identification cards without the need for a court order or gender assignment surgery.”

Argentina, Uruguay, Germany, and Malta are among the countries that allow trans people to legally change their name and gender without surgery.

Cuba’s national health care system has offered free sex-reassignment surgery since 2008, but activists who are critical of Mariela Castro and CENESEX have said access to these procedures is limited. Mariela Castro, who is also a member of the National Assembly, in 2013 voted against a measure to add sexual orientation to Cuba’s labor code because it did not include gender identity.

The Cuban constitution bans discrimination based on sexual orientation and gender identity, among other factors. Authorities routinely harass and detain activists who publicly criticize the government.

The Chilean Chamber of Deputies on May 15 approved a report that recommends the immediate suspension of a program that provides psychosocial support to transgender and gender non-conforming children and adolescents and their parents.

The 56-31 vote in favor of the Investigation Commission No. 57’s recommendations for the Gender Identity Support Program sparked outrage among activists in Chile and around the world. Six lawmakers abstained.

The report proposes the Health Ministry issue a resolution against puberty blockers, cross-hormonalization, and other hormonal treatments for minors, regardless of whether they have been diagnosed with gender dysphoria. The report also suggests Chilean educational institutions should not respect trans students’ chosen names.

The report, among other recommendations, calls for a review of the background of all minors who are currently receiving hormone treatments. The report also calls for the reformulation of hormone therapy guidelines and sending this background information to the comptroller general.

Report ‘sets an ominous precedent’

Frente Amplio Congresswoman Emilia Schneider, the first trans woman elected to the Chilean Congress and a member of the commission, sharply criticized her colleagues who voted for the report.

“Today in the Chamber of Deputies the report of hatred against trans people was approved; a report that seeks to roll back programs so relevant for children, for youth, such as the Gender Identity Support Program; a program that, in addition, comes from the government of (the late-President) Sebastián Piñera,” Schneider told the Washington Blade. ”This is unacceptable because the right-wing yields to the pressures of the ultra-right and leaves the trans community in a very complex position.”

Schneider noted “this report is not binding; that is, its recommendations do not necessarily have to be taken into account, but it sets an ominous precedent.” 

“We are going backwards on such basic issues as the recognition of the social name of trans students in educational establishments,” she said.

Ignacia Oyarzún, president of Organizing Trans Diversities, a Chilean trans rights group, echoed Schneider’s criticisms. commented to the Blade. 

“We regret today’s shameful action in the Chamber of Deputies, where the CEI-57 report issued by the Republican Party was approved in a context of lies, misinformation and misrepresentation of reality,” Oyarzún told the Blade. “This only promotes the regression of public policies and conquered rights that have managed to save the lives of thousands of children in the last time.” 

Oyarzún added the “slogan ‘children first’ proves to be an empty phrase without content used by those who today promote measures that push to suicide a significant number of children for the fact of being trans.”

The Movement for Homosexual Integration and Liberation, a Chilean LGBTQ rights group known by the acronym Movilh also condemned the approval of the report, calling it “transphobic” and accusing the commission of omitting the opinions of organizations and families that support the current policies. 

Movilh notes lawmakers approved both the Gender Identity Law and Circular 812, which promotes respect for trans students’ rights, within the framework of an agreement with the Inter-American Commission on Human Rights.

“The text of the approved report is scandalous, because it seeks to take away the access to health to trans minors, including denying them the psychosocial accompaniment that also includes their respective families,” said María José Cumplido, executive director of Fundación Iguales, another Chilean LGBTQ advocacy group. “Likewise, it attempts against school inclusion, since it intends to eliminate something as essential as the use of the social name in educational spaces. In short, it takes away rights and freedoms to trans people, especially to minors.”

Cumplido, like Schneider, pointed out that “although its content is not binding, we will be alert to the political and legislative consequences that it may produce and we will continue working to avoid setbacks with respect to the rights of trans people.”

The report’s approval reflects a global trend that has seen neighboring Argentina, the U.S., and other countries reserve policies for trans and nonbinary young people. The Peruvian Health Ministry recently classified gender identity as a mental illness, and lawmakers have passed a law that prevents trans people from using public restrooms based on their identity.

Experts and human rights activists warn the suspension of Chile’s Gender Identity Support Program and other programs could adversely impact the mental health of trans and nonbinary children who already face high levels of discrimination and are at heightened risk to die by suicide.

“We will defend the Gender Identity Support Program and the right to exist of trans children and youth across the country,” said Schneider. “I want to reassure the trans families of our country that we will not rest until our rights are respected and that we can continue advancing because there is still much to be conquered.”