UC Nursing alum continues to further advocacy efforts for LGBTQ+ community

University of Cincinnati alum Cole Williams, BSN ’23, has continued to stay busy post-graduation. In addition to working at the med-surg floor at Tufts Medical Center, in Boston, he continues to make strides at Pride and Plasma, a group he founded in 2022 to advocate for revising blood and tissue donation guidelines. The group gained broader national attention in May 2023, when the U.S. Food and Drug Administration (FDA) announced new guidelines to include gender-inclusive language and individual-based risk assessments for blood donor eligibility. The recommendations—introduced a month after Williams’s presentation to the FDA’s Blood Products Advisory Committee—permit donations from anyone who does not report having new or multiple partners along with engaging in anal sex the previous three months and represent a step forward not only for queer men, but also for transgender, nonbinary and other gender-diverse donors. 

After their first win, Pride and Plasma expanded their advocacy agenda to include tissue donation. Tissue donation guidelines have been in place since 1994 and impose a five-year deferral period for men who have had sex with other men (MSM). Using a similar approach to their blood donation advocacy, the group submitted two research briefs on the five-year MSM deferment policy to the FDA’s Cellular, Tissue, and Gene Therapies Advisory Committee in 2023 and now hope the FDA will consider the research, as well as similar global advances, to draft new policies. 

In May 2024, Pride and Plasma spoke again before the Blood Products Advisory Committee, this time addressing the lack of federal guidelines for screening, testing and interacting with gender-diverse blood donors. 

"The experiences of transgender, non-binary and gender-fluid donors vary from blood bank to blood bank” Williams says. “The goal should be creating a welcoming environment, not only because this the right thing to do, but also because that encourages all donors to come back.”  

The group reached out to blood centers across the country to assess current practices, including UC’s own Hoxworth Blood Center, followed by literature review on the topic. They then became aware of blood centers with programs for therapeutic phlebotomy—the practice of prescribing blood donations to individuals with increased red blood cell production, namely cisgender men undergoing testosterone replacement therapy—a practice that may be beneficial for transgender men taking the same medications.

“This is the same hormone replacement therapy transgender male and gender diverse individuals are going through,” Williams says. “So, they should be dealing with similar, if not the same, side effect of extra red blood cell production and could donate more often, but the lack of federal guidance and inclusive environments are negatively impacting these potential donors.” 

Another flaw in current blood donation screening guidelines links gender with the potential inability to donate platelets or plasma due to Human Leukocyte Antigen (HLA) antibody production during pregnancy. The presence of HLA antibodies in plasma or platelet donations can cause transfusion related acute lung injuries (TRALIs), the second cause of transfusion-related mortality in the country for the past five years.  

“There is a chance that transgender men and non-binary individuals are not being screened for pregnancy and fall through the cracks for TRALI prevention.” 

In their recent presentation to the Blood Advisory Committee, Pride and Plasma assembled a comprehensive brief including TRALI data, research from hormone administration programs and definitions of gender identities from the American Psychological Association. The next step is to create a public, accessible version of the brief to share on their website and social media channels to increase awareness.