Organ donation is built on generosity.

It’s about people helping people – often at the most difficult moments of life.

A new Canadian study is raising important questions about how fair and up-to-date our organ and tissue donation systems are, especially for people in the 2SLGBTQIA+ community.

About the study

The study, published in the Canadian Journal of Kidney Health and Disease, surveyed healthcare workers across Canada who are directly involved in organ and tissue donation and transplantation.

It explored their views on current policies and whether those policies reflect today’s science and standards of care.

What healthcare workers are saying

The findings point to a clear trend.

Among respondents:

• 97% felt that current policies affecting men who have sex with men are discriminatory
• Most supported a shift toward behaviour-based screening, focused on specific risk factors rather than identity
• Many felt current policies do not fully reflect modern testing or current evidence

The study also found that only a small number of healthcare workers reported receiving training specific to 2SLGBTQ+ care in the transplant system.

Why this matters

For some people, these policies can feel like a barrier.

Organ donation and transplantation rely on trust – trust that the system is fair, evidence-based, and respectful of everyone it serves.

When policies feel out of step with current knowledge, it can raise questions about whether that trust is being upheld.

A shared goal

At the same time, it’s important to recognize what everyone in this system is working toward:

Saving as many lives as possible, safely.

That includes:

• people waiting for a transplant
• people who want to donate
• and the healthcare teams who make transplantation possible

This shared goal is what shapes many of the decisions made within the system.

Why policies can be complex

There isn’t a single reason why policies look the way they do today.

Instead, they are shaped by a combination of factors.

Safety and risk management

Transplant recipients are often medically vulnerable. Policies are designed to minimize even very small risks, which can lead to cautious approaches.

Evolving science

Testing for infections like HIV has improved significantly. As evidence evolves, policies are reviewed – but changes take time.

Coordination across systems

In some situations, organs are shared across provinces – and occasionally between Canada and the United States – when it helps find the best match for a patient.

Because of this, transplant programs sometimes need to consider how policies align across different systems.

Different jurisdictions may:

• move at different speeds
• apply different standards
• or take different approaches to risk

This can add complexity when considering policy changes.

Training and guidance

The study highlights that many healthcare providers have not received specific training in 2SLGBTQ+ care within the transplant system.

Improving education and guidance is one area that could support more inclusive care.

Where things are heading

There are signs of change.

Across Canada and internationally:

• more experts are supporting behaviour-based approaches to donor screening
• policies are being reviewed in light of current evidence
• and conversations about inclusion are becoming more visible

The perspectives shared in this study reflect that shift.

Our commitment

As an organization, we are here for everyone affected by PKD.

That includes people of all:

• identities
• backgrounds
• and lived experiences

We believe that:

• access to organ donation and transplantation should be fair
• policies should be guided by the best available evidence
• and people should feel respected within the healthcare system

We also recognize that these are complex issues, and that thoughtful, respectful conversations are part of moving forward.

Reference

Lees, M., Hrymak, C., Mooney, O., et al. (2026). Sexual and Gender Minorities in Organ and Tissue Donation and Transplantation (OTDT): A Survey of Canadian OTDT Health Care Workers. Canadian Journal of Kidney Health and Disease.

Note: This summary was created with help from artificial intelligence (AI). We’ve done our best to make sure it’s clear and accurate, but it may still contain some errors. Always check with your healthcare provider or the original research (link above) if you have questions.