The "T Box"

giving blood transgender
Sometimes you just want to help out and it gets complicated.
1 Comments / 4 Shares


The tall blond nurse’s eyes sweep past me and look for someone else, even though I’m alone in the blood bank lobby. I stand up.

“That’s me,” I say.

I had taken testosterone for three months, and my face shape had shifted—I looked somewhere between what people thought a woman should look like and a man should look like. My voice had cracked down a bit but not enough, and I could rely on it to give me away as not your average guy.

She gives an awkward breath of a laugh and her eyes go straight to her clipboard. She checks her form, and then she asks me to follow her, voice full of forced cheer.

I am just here to get poked with needles and get a free cookie. It should be a simple visit, but the fluttering in my stomach knows better.

The nurse leads me to a small office with floor to ceiling windows, my back watched by all the staff walking by. She closes the door behind me, checks my blood pressure, (a little high, but okay,) takes a drop of blood from my finger, and while she tests my blood’s iron, she hands me the form she had kept checking.

In the top corner is a bold F in a box, in case I forgot what gender I’m supposed to be. I roll my eyes and look at the questions I’m supposed to fill out.

By every question are little boxes to check yes or no, and the checks would diagnose whether my blood is worth collecting. “Do you feel sick today?” “Did you get a tattoo within a year?” “Do you have HIV?” “Have you had sexual contact with anyone who’s had HIV?”

I dutifully check my nos. No, I didn’t feel sick, I have no tattoos. I don’t even know anyone positive for HIV, and I know I’m not at risk.

“Have you been pregnant or are pregnant now?” For these gendered questions, you have three options: Yes, no, and the nebulous non-answer, “I am male.”

You’re supposed to check one. But I’m not pregnant and I am male, so I check both of those.

Then there’s a male-only question: “Since 1977, have you had sexual contact with another male, even once?” There’s a matching female-only question: “In the past year, have you had sexual contact with a man who has had sex with a man, even once?”

Why does having sex with a man taint men for life, but a woman can recover? Do they think AIDS is generated by queer male sex, but it bounces off women? When were these questions written?

Why are they even asking these questions? They’re segregating out an already-marginalized group who’s giving them something for free, and they’re going to test everything for HIV anyway.

I know what answer I have to check, but I can’t do it in good conscience without bothering the nurse, head down in front of her computer.

“Excuse me,” I say. “I’ve done this.” I show her the form. She opens her mouth to apologize for evacuating me from the premises—if you say yes, yes I am a queer man, then now it’s her job to turn you away and never let you in the door again, but she doesn’t see me as a man, she knows what form she printed for me, so I have a year to redeem myself, abstain from queer men and cleanse my body with straightness until my blood is as pure as a straight woman’s, but before she says any of this, I interrupt her: “All the guys—my ex, his ex—they’re all trans.”

The nurse takes a minute, looking closer at the form. “Do you mean they want to be women, or they want to be men?”

Red flags up. Now I have a choice: I could complain about her dismissing people’s genders as mere “wants”—like some 7-year old who wants to be President—and nothing will be gained, or I can be a good trans person and play along.

“They’re men.” That’s not going to help her. “They were designated female at birth, and transitioned to men.”

She turns back to her computer. “Just put that they’re female.”

Apparently, my relationship with my ex was simply two lesbians male posturing at each other. Meanwhile, the implication is it wouldn’t be okay if my ex had been a trans woman. You know, if I had a straight relationship with a straight woman with straight male exes. That’s not straight enough for this form.

I check that I am a male who's never slept with other males. I also check that I am a female who's never slept with a male who's slept with a male.

I also check the “I am male” opt out from that question.

I’m not in any of the other oppressed groups they’re weeding out so I assert those various privileges, (No, I was not born in Africa, no, I have not received money or drugs for sex) and I pass the form to her.

The nurse takes it, looks down my answers, and her naturally brown brows narrow together. “Why did you check more than one box in a row?”

I might as well say it. It should be obvious enough already.

“I’m transgender,” I say. Her head tilts, right up in my face across the narrow desk, but eyes averted. “I’m sorry for messing up the form. If this is going to cause you some paper work problems, I’ll play along and fill out just the female questions on another form.”

She doesn’t go for my white flag. She studies my questionnaire, and still can’t look me in the face.

“Well, you’re not male, right?”

Where was this going? “Yes, I am.”

“But have you done anything to become male?”

Almost exactly 22 years ago, I was born a male. What the doctor said doesn't matter, what my parents said or how they raised me doesn't matter. I know the truth.

Sure, my clothes transitioned, my hormones transitioned, the words people called me transitioned.

But me? I've always been male.

Instead of telling the nurse any of this, I say, "I've started testosterone."

She wants me to say that I’ve had a “sex change operation,” but she doesn’t know that a magical one-shot gender change surgery doesn’t exist, and this middle ground of hormone therapy doesn’t seem like enough for her. She looks over my paper, mumbles the word “transgendered” to herself (which isn’t a word,) and says, “I’ve just never worked with one before.”

I’m looking at middle distance out the office windows.

“Have I offended you?” she says finally.

“Yeah, a little bit.”

She excuses herself, and closes the door on me and my thoughts. I clean my glasses. I come up with something to text one of my queer friends.

She returns with another nurse, bald but young, and he sits her at the computer and looks over her shoulder. “You click that gender drop down,” he says, “and click that one.”

She prints a form, and for a moment I think I’ve been finally seen—they’re going to gender me as male. He passes me the paper. In the gender box, it says, “T.”

I slouch a little. “What is this?” but I can guess.

“It stands for transgender. Ignore ‘I am male/female’ opt-out boxes,” he says. He crosses them out in case I go rogue again. “Just fill out every question, every time.”

I dutifully complete the form as instructed. The blond nurse drops me off at the big pleather chairs, and scurries away. Another nurse preps the big clear Caprisun pouch to receive my blood.

She smacks a label on it. It has my name, my A+ blood type, a bunch of ID numbers, and Gender: T.

My blood got through the system, queerness on the label.


Two years later, the FDA updated their policy on blood donations from queer people.

Though sex between two men is still considered an inherent HIV-risk that will get you screened from donating, regardless of long-term monogamy or regular testing or condom-use, now the policy matches the women who have sex with queer men: One year of abstaining makes you eligible to give blood again. You’re not barred for life.

As for the trans policy, transgender people can now self-identify as male or female. (Who knows what the genderqueers and other non-binary people will do. Is the T option still available?) However, the language on the sexual history questions still ignores trans people, and will force their partners to misgender them.

I spoke to a couple of directors at my blood bank, and I was told that they were going to happily comply with the new standards and planned to implement them in a few months. That said—they don’t have to.

The FDA has allowed blood banks to be “more conservative” in their policies towards queer people. If they want trans people to be labeled based on their gender assigned at birth, they can do that. If they want queer men to abstain from queer sex for five years, they can require that. If they still want to defer queer men for life, they can do that.

I keep thinking about that blond nurse, who meant well, and tried to help me, but was too ignorant to know what I was or how to treat me with respect. People like her are going to decide if there’s anything valuable in the veins of people like me. I don’t know what they’re going to choose.

Comment on this story using Facebook.