Organ and tissue donation and sexual and gender minoritized persons: time for positive change

Organ transplantation was one of the great medical innovations of the twentieth century. Overcoming challenges associated with transplant surgery, graft rejection, and infection represents a culmination of medical knowledge and technologic advancement. Since the 1980s, preventing graft-transmitted serious infections (specifically those with the human immunodeficiency virus [HIV], hepatitis B virus [HBV], and hepatitis C virus [HCV]) has been accomplished via excluding donors with active infection, screening potential donors for infection, and restricting potential donors deemed at high risk of these infections (since the window period prior to detection precludes perfect accuracy in detecting recently acquired infections). These policies have disproportionately targeted sexual- and gender-minoritized (SGM) persons and have been criticized as being stigmatizing and discriminatory and has been recently subject to a legal challenge.¹ Although technical aspects of transplantation have progressed rapidly in the last 30 years, policy has unfortunately been much slower to evolve. …