Understanding community perspectives for advancing inclusion of trans and gender-diverse people in blood donation in Australia.

Background and objectives: Trans and gender-diverse people who wish to donate blood face significant barriers with policies and procedures differing across countries. It remains critical to explore the experiences and perspectives of trans and gender-diverse people in different locations to understand challenges in local systems. We undertook a qualitative study focussed on procedures and processes affecting trans and gender-diverse people in Australia, and their views about needed change.

Materials and methods: Stakeholders collaborated with the researchers to refine the focus of and design the research. Semi-structured interviews were conducted with 14 trans and gender-diverse people who were current, past or potential donors. The interviews comprised open-ended questions about donation experiences, knowledge of current policies and procedures and preferences for change. Interviews were analysed using thematic analysis.

Results: Participants reported varied and inconsistent donation experiences. When compared with current practice, participants preferred a two-step approach to donor registration that asks for sex reported at birth followed by gender identity. However, they also expressed concern that the two-step approach could deter new donors and stressed the importance of only collecting information relevant to eligibility assessment. Participants were supportive of a gender-neutral approach to assess eligibility to donate.

Conclusion: Our study highlights significant barriers and procedural inconsistencies for trans and gender-diverse individuals when (considering) donating blood. We recommend more inclusive practices including clear communication about data use, rigorous staff training on gender diversity, registration processes that respect all gender identities and adopting a gender-neutral approach to donor screening.