The neurodivergent blood donor: Fairness, discrimination, screening, and behavior

BACKGROUND: We broaden the ongoing drive to diversify blood donor panels by proposing and testing a framework to explore neurodivergence and blood donation. Drawing on a range of theoretical perspectives, we predict that neurodivergent people will be underrepresented in donor panels, donate less frequently, perceive donor selection as less fair and more discriminatory, be more likely to guess when answering screening questions, and find these questions upsetting. STUDY DESIGN AND METHODS: 4376 members of the UK general-public and 8668 NHSBT blood donors indicated if they had a formal or self-diagnosis of Autism, ADHD, or Dyslexia. Participants answered online questions about travel and sexual and social behavior from the NHSBT Donation Safety Check (DSC) as if they were donating. For each question, participants indicated whether it was emotionally upsetting, whether it was appropriate and necessary for recipient safety, and whether their answer was a guess/accurate. They also reported their perceived fairness/discrimination in donor selection and their donation frequency. We also assessed outcomes by age, sex, and ethnicity. RESULTS: Reported neurodiverse donors make fewer donations and are underrepresented in donors relative to non-donors (7.6% vs. 13.3%). Neurodivergent donors and non-donors indicated they were more likely to guess, especially on travel questions and are more likely to report that the DSC questions are emotionally upsetting. All neurodivergent respondents (donors and non-donors) report blood donor selection as less fair and more discriminatory. DISCUSSION: Blood services need to make reasonable adjustments to accommodate and attract neurodivergent people to be donors and to ensure recipient safety.