Information for transgender donors

If you’re joining the register or have been asked to donate to a patient or for Medical Research and Treatments, you may have some questions about the donation process. We’ve put together this information from our medical team to help you know what to expect if you are transgender, and how this may impact on your donation so that you can make an informed choice about whether to go ahead.

Will I be able to join the register?

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Transgender and non-binary people can absolutely join the Anthony Nolan register. This page will help you to understand the process for donation and why we do things a certain way so that you can feel informed and happy to proceed.

You will be able to record your gender identity on the application form (options are male, female, non-binary, I prefer to self-describe, I prefer not to say).

The donation procedure also requires that your sex registered at birth must be recorded on our database at the application stage, and this will remain on your record throughout the process.

Why do you need to record my sex registered at birth?

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The sex (medically understood as the underlying biology of a person) of a potential donor is one of the factors that clinicians consider when identifying the best donor for their patient. This is because outcomes can differ depending on the sex of the donor and patient. Evidence also suggests that outcomes for the patient can differ if the donor has been pregnant in the past, so this is also taken into account in decision making when choosing a donor.

How will I be referred to if I donate?

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If you have not shared your gender identity on your application form, we will email you to ask if your gender identity is the same as your sex identified at birth. We do this so that we can make sure that all of our communications with you will be based on your gender identity. We do not explicitly ask about pronouns but you can share this information with us via email or on the phone and your pronouns will be updated on your record and used going forwards.

Will I be able to complete the donation process without disclosing that I am transgender?

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Unfortunately, the transplant centre (looking after the patient) and collection centre (where you will donate your cells) will both need be told your sex registered at birth. The transplant centre must know this to ensure they have selected the best donor based on patient outcomes, as explained above. The collection centre is responsible for your wellbeing and so they will ask you about your medical history and need to discuss any surgeries (past and planned) and/or current medications with you. They will be respectful and sensitive with this information.

Reference ranges for standard blood tests also need to be interpreted in line with your current medications and any surgeries that may impact these.

What information is shared if I come up as a match?

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The transplant centre is informed of your sex assigned at birth and their age. You can receive similar information about the recipient of your cells if you want to. The transplant centre will usually share this information about the donor with the patient.

Can the patient and transplant centre be informed about my gender identity?

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The transplant centre can be informed of your gender identity if you request this at the time of a donation. The information will be passed to the medical team responsible for the recipient and they are then responsible for what information is passed to the recipient. We cannot therefore guarantee that the patient will have been informed about your gender identity should they choose to make contact in the future. 

Please inform your donor provision coordinator or the follow up team via email or over the phone, if you wish for this information to be passed on. Please be aware that confidentiality of the patient and donor is very important within this process as it protects the safety of both parties. Telling the transplant centre this information may make it more likely for you to be identified, particularly if you choose to post about the process on social media. Please do feel free to discuss this further with our team if you are unsure.

Can gender affirming care affect my ability to donate?

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Hormones

It is important to disclose any medications that you are taking, in particular hormonal medications. This is because these may alter some of the normal ranges for the standard blood tests that we require. These will not prevent you from donating and they should not impact on your donation. However, if you are taking any injectable medications we will just need to ensure that these are being prescribed and issued by licensed practitioners.

Surgery

In general, seven days should be allowed before donation after minor procedures (such as dental procedures and excision of skin lesions) and four months after major surgical procedures.

This time period may be shortened if all wounds are fully healed, any post-operative infection is fully resolved, normal mobility is regained, and regular post-operative follow-up is no longer required.

Why do you require pregnancy tests?

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All donors who were assigned female at birth will be required to perform multiple pregnancy tests throughout the process; at the medical appointment, prior to the patient starting their chemotherapy pre-transplant, and prior to the donor starting their G-CSF injections. The only exclusion to this is donors who have had a hysterectomy. This is a safety measure to prevent any late cancellations to the procedure as pregnant people cannot proceed with a donation. If you feel this will be distressing for you, please do not feel you have to proceed with the donation. Your wellbeing is our priority. We are also happy to discuss any measures that could make this easier for you, so please do not hesitate to discuss this with our coordinators.

Why am I asked about whether I have any new partners?

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Questions regarding sexual activity are asked to all donors to ascertain risk of transmission of certain viruses, such as HIV, which could be detrimental to the recipient. Please see the following donor information regarding sex and relationships.

Can I communicate with the person I have donated to?

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For the first two years after the transplant, you may be able to exchange anonymous letters or cards with the patient for them to say thank you or tell you how the transplant went. You do not have to receive these or reply. You won’t know the patients’ contact details, so the letter will need to be passed on by the team at the transplant centre via Anthony Nolan’s Donor Follow Up team. After two years, if you and the patient agree, you may be able to have direct contact: exchanging names, contact details, and perhaps meet in person. Direct contact can only be initiated by the patient. If the patient is under 18, a parent or legal guardian can contact you on the patient’s behalf.