The research behind gender-neutral assessments

On April 20, 2026, Lifeblood changed the sexual activity eligibility questions to be gender-neutral. Join us to explore the research behind the change.

What is a gender-neutral assessment?

Gender-neutral assessment refers to removing any gender-based sexual activity rules for eligibility to donate blood. 

How many people will be impacted by the gender-neutral assessments?

We surveyed 7,938 Australians who’d attempted to donate at least once in the 12 months before March 2024. Only 0.6% of them would be ineligible to donate under the gender-neutral criteria (that is, they’d had more than one sexual partner, a new partner and had engaged in anal sex within the last 3 months). The few who were ineligible tended to be younger and were less likely to identify as heterosexual.

Only 4.2% of the survey group had recently had more than one partner and/or a new partner. That means only approximately 1 in 24 potential donors will ever be asked about anal sex under the gender-neutral approach.

How do people feel about gender-neutral assessments?

In the same survey, over 70% of Australians were not deterred from donating by answering questions about their sexual activity as part of a gender-neutral assessment. Approximately 13% said that questions about new or multiple sexual partners would cause them to stop, or be quite likely to cause them to stop attempting to donate, and 11% said the same regarding questions about anal sex. However, only 4.2% of the survey group had had more than one partner and/or a new partner. That means only approximately 1 in 24 potential donors will ever be asked about anal sex under the gender-neutral approach.

We’ve also dug deeper with active donors, with long format interviews finding that donors place greater significance on the safety of the Australian blood supply than any potential self-discomfort due to sexual activity screening questions. In general, active donors remain highly comfortable with our systems to determine eligibility, with 87% reporting comfort with the previous system, and 89% with the new gender-neutral system.

Will these changes mean some people stop donating?

We asked existing donors if their motivation to donate would change under a gender-neutral assessment. Motivation to donate remained very high at 95.96 out of 100 under the new proposal, compared with 96.88 out of 100 under the existing rules.

Our survey of over 7,938 donors found that only 0.6%, or roughly 476 people, would be unable to donate blood under a gender-neutral assessment. But thanks to the Plasma Pathway, they may still be eligible to donate plasma.

Why are we asking two questions instead of one?

As part of extensive research with both non-donors and donors, we proposed three scenarios, including the gender-neutral questions. Research participants agreed that the set of questions Lifeblood chose were the best, least confusing, and most inclusive. Interviewees shared that they preferred gender neutral questions, as they don’t require people to identify as male or female when answering.

What’s the impact of gender-neutral assessments on blood supply safety?

Blood donor eligibility criteria are in place to minimise risk to blood recipients while ensuring there is a sufficient national blood supply. 

International evidence and Lifeblood’s own modelling have demonstrated that gender-neutral assessments will not negatively impact the safety of Australia’s blood supply, and will not result in mass deferral of donors eligible under the prior assessment criteria. Gender-neutral assessments have already been implemented in England, Argentina and Canada, with no changes to blood supply safety reported (NHSBT, 2023; Blanco S et al., 2020; Goldman M et al., 2024 respectively).

Will these changes solve blood shortages in Australia?

As demand for blood and plasma continues to grow, we will continue to see periods where additional blood and plasma donors will be needed. Here’s some fast facts:

• Only 1 in 30 age-eligible Australians donates blood or plasma, and while these expanded eligibility criteria are a fantastic step we know that around 30% of new donors don’t return to donate again within two years. That’s 30,000 people every year. 
• Some people self-exclude themselves from donating even though they could – our latest research shows that 1.6 million Australians are eligible to donate, but have ruled themselves out. And another 1.6 million eligible people don’t know if they’re eligible. If even just half of them donated, we’d more than double the number of people donating blood.
   

What are the early results from the Plasma Pathway?

Between 4 August and 16 December 2025 the Plasma Pathway enabled 6,995 donations from 2,875 donors who would’ve been otherwise ineligible to donate. There were no donations made that tested positive for any transfusion-transmissible disease, including HIV. Over three quarters of those nearly 7,000 donations were made by men who have sex with other men (46.1% not using PrEP and 30.9% using PrEP). PrEP stands for pre-exposure prophylaxis, it's an antiretroviral medication taken to prevent HIV infection.

We surveyed 405 men who have sex with men who donated via the Plasma Pathway and early estimates suggest that 54.3% of them will be unrestricted to donate under the new gender-neutral approach. 

Although most donors using the Plasma Pathway are expected to become eligible under gender neutral assessments, the Plasma Pathway will remain a key component of Lifeblood’s inclusivity policy, enabling those using PrEP or with multiple sexual partners having anal sex to donate plasma.