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# Transgender and non-binary individuals - Whole blood and components

## Essential information

Definition/s

  Transgender and non-binary individuals:

  Trans is an umbrella term to describe people whose gender is not the same as, or does not sit comfortably with, the sex they were assigned at birth. Trans people may describe themselves using one or more of a wide variety of terms including (but not limited to) transgender, non-binary or gender queer. Gender-affirming hormone therapy may be used as part of transition by transgender and non-binary individuals.

Discretionary
  1. If the donor is taking masculinising hormone therapy (e.g. testosterone) to support their transition, the donor is well and the donor has been on treatment for more than 12 months, accept.
  2. If the donor is taking feminising hormone therapy, and the donor is well, accept.

## Supporting information

See if relevant
  - Anti-androgens
  - Haemoglobin estimation
  - Surgery
Additional information

  The higher haemoglobin concentration of men, compared to women, is related to testosterone levels. Testosterone therapy will result in the haemoglobin concentration rising. The opposite will be true if a person is taking feminising therapy. Donors should be counselled regarding the association between sex hormones (both endogenous and exogenous) and haemoglobin, and the significance in terms of ensuring safe haemoglobin assessment. This is particularly important where haemoglobin is being assessed using the wider limits (125 g/L to 180 g/L) for donors who have note disclosed their sex.

  Services may offer donors who have been established on gender-affirming hormone therapy a revised haemoglobin screening range. This range should be consistent with their therapy (e.g. haemoglobin 135 g/L to 180 g/L for donors taking testosterone, and 125 g/L to 165 g/L for donors taking feminising therapy). Further guidance for haemoglobin assessment for transgender and non-binary donors is included in the JPAC position statement 'Donor selection and donation management for transgender and non-binary donors' available on the Position statements page.

  Donors should be advised to inform the Blood Service if their treatment changes or discontinues.

  A high haemoglobin (polycythaemia) can be a complication of masculinising therapy and blood donation may mean this complication is not recognised. Waiting 12 months after starting masculinising hormone therapy ensures that donation does not interfere with the assessment and laboratory monitoring of their treatment.

  As well as hormones, donors may take other medication to modify the effect of sex hormones as part of gender-affirming treatment. This may include hormone blockers, such as anti-androgens, which could affect the donor’s eligibility.

  For blood services that use leucocyte antibody screening as a transfusion-related acute lung injury (TRALI) risk reduction measure, donors who were assigned female at birth should be included.

Reason for change:
  Additional information that donors should be counselled regarding the significance of sex and hormone therapy in haemoglobin assessment. Clarification that donors taking feminising or masculinising therapy may be offered individualised haemoglobin assessment. The See if Relevant section has been updated.
Version:
  Transgender and Non-Binary Individuals
Version details:

  WB-DSG Edition 203 Release 79 (17 February 2026)

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