Sexual and gender minorities frequently face structural inequities within organ and tissue donation and transplantation systems. To assess the current landscape of policy and care, an interdisciplinary team of researchers, including CVC faculty member David Collister, MD, PhD (he/him/his), conducted a cross-sectional survey of Canadian healthcare workers in 2024, led by Murdoch Leeies, MD, MSc, from the University of Manitoba.
Analyzing responses from 123 verified healthcare workers, primarily organ and tissue donation coordinators and physicians, the study revealed a strong clinical consensus on the urgent need for evidence-based policy reform. A notable 97% of those surveyed found the current Health Canada policy that designates men who have sex with men within the past 12 months as having an increased risk of transmitting human immunodeficiency virus (HIV) through donation to be discriminatory. This regulation effectively blocks standard organ and tissue donation outside of the exceptional distribution process. Rather than relying on identity-based exclusions, 77% of respondents supported gender-neutral, behavior-focused assessments, concluding that they present minimal to no infection risk to transplant recipients. At the same time, in the absence of an official policy, participants expressed varying opinions on how a donor’s use of HIV pre-exposure prophylaxis (PrEP) should factor into risk evaluations.
Beyond donor eligibility protocols, the survey identified critical systemic gaps in education. Only 11% of respondents reported receiving targeted training in cultural humility for the care of Two-Spirit, Lesbian, Gay, Bisexual, Transgender, and Queer (2SLGBTQ+) patients.
Ultimately, the healthcare workers surveyed advocate replacing identity-based restrictions with gender-neutral, behavior-focused risk assessments that reflect contemporary screening practices. Embracing these data-driven changes is a critical step toward ensuring that future donation and transplantation regulations are truly evidence-based and equitable across Canada.
