Questionnaire issues again

(Warning: some frank talk about sex here.)

In the NYT on the 13th, a news brief from Washington, “F.D.A. Proposal Would End Ban on Blood Donation” by Sabrina Tavernise. In its entirety, with the crucial phrase boldfaced:

The Food and Drug Administration on Tuesday released its proposal for scrapping a decades-old lifetime ban on blood donation by gay and bisexual men. The proposal was criticized when it was first announced, in December, because men who have had sex with men in the last 12 months would still not be allowed to give blood. The limited prohibition is comparable to rules in many European countries, but critics said it did not take into account modern diagnostic tools that can detect H.I.V. infection as early as nine to 11 days after exposure. The contested part of the proposal remains unchanged in Tuesday’s version, which details the policy and is open to public comment for 60 days before a final decision. In a nod to transgender Americans, the proposal allows donors to report their gender; under current policy, eligibility is determined strictly based on a donor’s sex at birth.

My comments here are not about the substance of the policy (for the record, I agree with the critics of the new “limited” prohibition), but about the interpretation of “men who have sex with men”: what, exactly, do people who use this expression mean by “have sex with”, and how do those who hear it or read it understand it?

It turns out that the interview protocol the FDA uses doesn’t ask about “having sex with” another man but about “having sexual contact” with another man — but without explaining what that expression means.

I’ve been in this territory on this blog before, about “having sex with” versus “having sexual relations with” someone in questionnaires.

From my earlier posting:

Then there’s “having sexual relations with” someone vs. “having sex with” someone. Many people don’t understand these as equivalent, but treat “sexual relations” as taking in a great many acts past kissing (even deep kissing) but short of oral sex or intercourse (vaginal or anal) — licking, sucking, and stroking various body parts, finger fucking (vaginal or anal), using dildos, etc. — and some would withhold the label “had sex with” from oral sex or intercourse in which neither partner comes, but would still say that they “had sexual relations with” a partner in such cases. Some would say that they “had sex with” another person only if one of the partners is fucked (by a penis), and would treat oral sex as “having sexual relations with” their partner, but not “having sex with” them.

… the wording of the questionnaire is crucial, *and* it’s crucial to know how the respondents understand the questions.

Now the FDA has introduced “have sexual contact” as another variant to cope with. If they’d said “have sexual relations with” a man, I would have guessed they meant to refer to anal intercourse (in either role) or fellatio (in either rule), but not to any other acts. But “have sexual contact with” men sounds like it takes in a wider set of acts, for instance masturbation of or by another man, or men masturbating themselves in company with one another, or frottage.

These are serious issues, and the FDA needs to clarify its intent. Be specific; give examples.

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