Here is an interesting topic from AABB 2004 Baltimore.

A donor presents to your center. This donor indicates that she is a female. During the interview process she indicates that she was born genetically a male. Post 1977 and until present she has had male sex partners, including while she was a biologic male.

She now will not be asked if she has had sex with a man even once since 1977. Also if her prior relationships as a man where monogamous, she might not answer that she had sex with a male who had sex with a man even once since 1977.

So, what would you do? If you were to defer her, what would be your logic?

If you have information that as a male, she (he) had sex even once with another male since 1977 then you would be obligated to defer indefinitely. That would be required if she had answered truthfully during medical history review or subsequently during her collection.

I would just document on medical history that she fell under the FDA regulations during the time she was still a male, which is considered high risk behavoir and an immediate indefinite deferral and will continue until such time as the FDA changes their rules.

As for if she never divulged the information, well... then we have no information that this happened so this question is moot.