A 2017 guideline permanently bars gay men, transgender persons and sex workers from donating blood in India. In March 2026, the Supreme Court signalled it would not intervene. We spoke to the petitioners, the lawyers and those living the exclusion.
On March 13, 2026, Sharif Rangnekar attended a blood donation camp in his residential colony, organised by a young woman to address what everyone agreed was a real problem. India has an acute shortage of blood. Rangnekar, a petitioner in one of three Supreme Court cases seeking to lift the ban on blood donation by gay men, was glad the drive was happening. And then he felt something else entirely.
“I was both happy, but I was also irked at that moment that I can’t participate,” he says. “Had I gone, no one would have stopped me. But when I raised this issue, that you’re doing a great thing, but unfortunately I can’t participate because I’m homosexual, some people expressed surprise. Some were unaware that there’s even a need for your blood to be tested before it is given to anyone.”
What followed in that WhatsApp group was a microcosm of the larger national conversation: confusion, defensiveness, and one doctor who insisted the ban was simply a safeguard. “I said, safeguards are exactly what we’re asking for,” Rangnekar recalls. “This is not a safeguard. This is ensuring that we are banned, when there is technology in many parts of the world for safeguarding the interests of everyone.”
India’s prohibition on blood donation by gay men, transgender persons and female sex workers is codified in Clauses 12 and 51 of the Guidelines for Blood Donor Selection and Blood Donor Referral, 2017, jointly issued by the National Blood Transfusion Council and NACO. Clause 12 classifies these groups as permanently “at risk.” Clause 51 mandates a lifetime deferral, no waiting period, no individual assessment, no path to eligibility. The logic dates to the AIDS epidemic of the late 1970s and early 1980s. Nearly five decades on, neither the science nor the testing technology is the same. The guidelines are.
The legal challenge was brought as a PIL in 2021 by Thangjam Santa Singh, the Manipur-based transgender activist known as Santa Khurai, represented by senior advocate Jayna Kothari. Rangnekar and activist Harish Iyer subsequently filed related petitions. Together, the three cases challenge the blanket exclusion as a violation of Articles 14, 15 and 21 of the Constitution. In May 2025, the Supreme Court directed the government to constitute an expert committee to review the policy. By August, the committee reported that the 2017 guidelines were “firmly rooted in national and international research.” On 13 March 2026, the Centre told the court that diluting the ban “would be injurious to public interest.” The bench, led by Chief Justice Surya Kant, appeared largely persuaded.
The hearing’s most consequential moment was not a ruling but an observation. Chief Justice Kant asked Kothari: “Tell us one good reason that we should issue a direction. After all, there are millions and millions of poor people who take free blood facilities. They cannot afford private hospitals. If there is even a one per cent chance of infection, why should they suffer?” Kothari’s response was direct: all donated blood is tested before use, including for HIV, and Nucleic Acid Testing exists precisely to close the gap the government invokes. She also flagged the central inconsistency: a gay man in a monogamous relationship cannot donate blood, while a heterosexual man engaging in unprotected sex with multiple partners faces no restriction at all.
Advocate Rahul Sangwan, who has worked on the legal arguments in higher courts, puts the constitutional problem plainly: “The ban is not rationally connected to the objective of blood safety. It presumes that an entire class of people is unsafe, without any evidence tied to individual conduct. What this ban does is penalise people for their sexual orientation, which is intrinsically against the identity and dignity of an individual, as held in Navtej Singh Johar.”
There was a second observation that provoked a sharper response. Reports from Live Law and Bar & Bench quoted the bench characterising the petition as a “luxury.” The framing drew immediate comparisons to 2013, when a previous bench described queer Indians as a “miniscule minority”, a formulation that preceded the recriminalisation of homosexuality under Section 377, and which the court itself repudiated in Navtej Singh Johar in 2018. Rangnekar was direct: “Is the shortage of blood an elite issue? The blood that we donate goes into a blood bank. After that, it doesn’t decide who it goes to based on caste or religion.” Sangwan was unequivocal: “Equality is not a luxury. Calling a petition that challenges identity-based exclusion a luxury petition trivialises the constitutional promise of equality.”
The government’s case rests partly on the absence of Nucleic Acid Testing at most Indian blood banks, and a testing window of up to 33 days during which an infection may not be detectable. These are real limitations, but petitioners argue they indict the system, not the donors. “There is already contaminated blood in the system,” Harish Iyer, another petitioner at the Supreme Court, says. “There are cases of people getting contaminated blood; sometimes it’s not even checked. That is not because of anything other than the fact that we have not yet got a proper testing system in place. And knowing how governments work when systems don’t function properly, they would rather let people be ignorant and carry on with the bias.”
A public health expert with fifteen years in HIV intervention programmes, trans, queer, and asked not to be named, offered a systemic critique: “When we look at trans people, trans women, hijra women especially, we look at them from the lens that they do sex work, they have STIs, they spread HIV. That gaze still continues in our programmes; it is evident from NACO’s guidelines, which mandate the permanent deferment of trans people on the basis of high-risk behaviour. We pick up one identity from the LGBTQIA+ community and ask, is this group at high risk of HIV? That is dehumanising. It reduces people to their risk of transmitting HIV rather than looking at their holistic health.”
For those the ban excludes, the effects are not abstract. Priyanka Das, a transgender rights worker in Bhubaneswar, describes the question her younger community members ask her: “Didi, if we’re good enough to vote and pay taxes, why are we not good enough to donate blood?” In Sonagachi, Kolkata, Rukmini, a sex worker and peer educator, is direct: “Most of us are connected to health programmes and get tested regularly. If someone wants to know whether my blood is safe, test my blood. Don’t decide based on my profession.” ImranKhan, a hotel management student in Lucknow who donated blood during a college camp before coming out, says: “Nothing about my health has changed. Whenever there’s a tragedy and blood donation drives happen, I feel conflicted. You want to contribute, but you’re constantly reminded that society sees your identity before it sees your intentions.”
Sangwan argues the policy undermines the very goals it claims to protect: “When people feel stigmatised, they are less willing to engage with public health. Where there should be honest disclosure and broader participation, this discriminatory policy is not protecting anyone. A non-discriminatory policy can actually protect both equality and blood safety.”
No final order has been passed. The constitutional arguments are still before the court, and the petitioners have not stopped fighting. But the language of March 2026, “one per cent risk,” “luxury”, echoes a pattern: “miniscule minority” in 2013, “elite” in 2023, “luxury” now. Each formulation has been used to delay a reckoning. Each has eventually been repudiated. Rangnekar’s reading is unsparing: “This is a social bias against the community. It’s a bias which stems from history, but it also works electorally. We are saying: get the systems in place, get the testing in place. Don’t ban.” The country is bleeding, and it keeps turning the same people away.
Sahil Pradhan
Courtesy : Local Samosa
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