Introduction

Blood donation helps save lives. Donated blood is used in surgeries, cancer treatments, accidents, and for people with serious illnesses. Every day, hospitals need a steady supply of healthy blood. To keep both the donor and the patient safe, there are clear rules about who can give blood.

At the same time, more people are starting or continuing testosterone therapy. Testosterone therapy, sometimes called TT, is a treatment used for several medical reasons. It helps people with low testosterone levels, including those with a condition called hypogonadism. It is also part of gender-affirming hormone therapy for many transgender men and non-binary individuals. Some people are on testosterone because they have a natural medical need, while others may be prescribed it after certain surgeries or health changes.

As testosterone therapy becomes more common, questions about blood donation while using it are also increasing. Many people want to know if they can still give blood when taking testosterone. The short answer is: it depends. Several factors play a role in whether someone on testosterone is allowed to donate blood.

Understanding the rules around blood donation is important. Most blood centers follow guidelines from national and international health groups, such as the U.S. Food and Drug Administration (FDA), the World Health Organization (WHO), and organizations like the American Red Cross. These groups set basic health standards for blood donors. They also provide special instructions for people taking certain medications, including hormone therapy.

When someone takes testosterone, it affects how the body works. One of the main effects is that it can raise red blood cell levels. This might cause a condition called polycythemia, where the blood becomes thicker than normal. In some cases, this can raise health risks and may also affect whether a person can safely give blood. Blood donation centers often check a person’s hemoglobin or hematocrit levels, which are linked to red blood cell count. If the levels are too high, a person may not be able to donate until they return to normal.

Another important point is how the body responds to long-term testosterone use. Over time, testosterone therapy may lead to changes in blood pressure, blood thickness, or other health issues. These changes can make blood donation riskier if not managed properly. That is why regular medical monitoring is usually part of testosterone therapy. A doctor often checks blood levels and adjusts the dose if needed. For someone planning to give blood, it is useful to know these values and discuss them with both a healthcare provider and the blood center staff.

Some people on testosterone therapy are not donating blood just to help others — they might also be doing it as a form of treatment. This is called therapeutic phlebotomy. In this case, blood is removed to reduce high red blood cell levels caused by testosterone. However, this kind of blood is not always used for medical donation because it may not meet safety or storage rules.

It’s also important to understand that not everyone on testosterone is treated the same way by donation centers. Rules can vary depending on where a person lives, how the testosterone is taken, and what their overall health looks like. Some centers may ask more questions or require extra testing. Others may have policies about gender identity and legal documents that affect how someone is classified in the system.

Because of all these factors, there is no one-size-fits-all answer. Still, many people on testosterone therapy do qualify to give blood, as long as they meet certain health and safety guidelines. Knowing the facts helps both the donor and the medical staff make the right decisions.

This guide explains everything someone needs to know about donating blood while on testosterone therapy. It answers common questions, clears up myths, and shares accurate medical information to help people make safe and informed choices.

What Is Testosterone Therapy and Who Needs It?

Testosterone therapy is a medical treatment that helps people who have low levels of the hormone testosterone. Testosterone is a natural hormone made mainly in the testicles in people assigned male at birth. It helps control many body functions, such as muscle growth, body hair, sex drive, mood, and the making of red blood cells. When testosterone levels are too low, the body may not work properly. This is when a doctor may suggest testosterone therapy.

There are several ways to give testosterone to the body. These include:

Injections: These are shots given in the muscle. They are often given every 1 to 2 weeks.
Gels or Creams: These are rubbed on the skin every day, usually on the arms or shoulders.
Patches: These are worn on the skin and replaced each day.
Pills or Tablets: These are taken by mouth, although this method is used less often.
Pellets: These are small implants placed under the skin by a doctor. They slowly release testosterone over time.

Each method works differently, and a doctor chooses the best one based on a person’s health, lifestyle, and needs.

There are several reasons why a person might need testosterone therapy. One of the most common is male hypogonadism. This is a condition where the body does not make enough testosterone. It can happen for many reasons. Some people are born with it, while others develop it later in life due to illness, injury, or aging.

Symptoms of low testosterone in hypogonadism may include:

Low energy or tiredness
Loss of muscle mass
Decreased sex drive
Trouble getting or keeping an erection
Mood changes or depression
Poor focus or memory
Increased body fat

When these symptoms are caused by low testosterone levels, therapy can help improve how a person feels and functions.

Another group of people who may take testosterone are transgender men and nonbinary individuals who use testosterone as part of gender-affirming hormone therapy. This treatment helps match their physical appearance to their gender identity. Testosterone helps deepen the voice, grow facial and body hair, and increase muscle mass. It also stops menstruation. These changes can help improve mental health, reduce gender dysphoria, and support overall well-being.

In some cases, testosterone therapy is also used in teenagers with delayed puberty. If the body has not started to develop by a certain age, doctors may use low-dose testosterone to help begin puberty. This helps the body grow and develop more normally.

While testosterone therapy can offer many benefits, it is not for everyone. Some people use it without a prescription, such as athletes or bodybuilders who want to increase muscle size or strength. This is called non-medical or illicit use. Using testosterone without a doctor’s guidance can be dangerous. It can cause serious health problems like liver damage, heart disease, and mood swings. It may also change cholesterol levels and increase the risk of blood clots. These risks are higher when testosterone is used in large doses or with other steroids.

Doctors carefully check testosterone levels before starting therapy. A blood test is needed to confirm that levels are truly low. The timing of the test is important because testosterone levels naturally change throughout the day. Most often, the test is done in the morning when levels are highest. If a person qualifies, the doctor will explain the benefits and risks before beginning treatment.

Once therapy begins, regular check-ups are important. Doctors will monitor testosterone levels, blood pressure, red blood cell count, and other health markers. This helps make sure the treatment is safe and working well.

Testosterone therapy is a useful treatment for people with low hormone levels or those undergoing gender transition. When used under medical care, it can improve many parts of a person’s life. However, because it can affect the blood and other systems in the body, it is important to use it only when needed and with regular medical follow-up.

General Blood Donation Requirements

Donating blood helps save lives. Hospitals and emergency rooms use donated blood for surgeries, accidents, cancer treatments, and people with certain medical conditions. But not everyone can give blood. Blood centers follow rules to make sure donations are safe for both the donor and the person receiving the blood. These rules are set by health organizations like the U.S. Food and Drug Administration (FDA), the American Red Cross, and the World Health Organization (WHO).

Here are the most common blood donation requirements:

Age and Weight

Most blood banks require donors to be at least 17 years old. In some places, 16-year-olds can donate with a parent’s or guardian’s permission.
There is also a minimum weight requirement. Donors must weigh at least 110 pounds (50 kg). This rule helps make sure the donor’s body can handle losing about one pint of blood without becoming too weak or lightheaded.

Hemoglobin and Iron Levels

Before each donation, blood centers check the hemoglobin level. Hemoglobin is a protein in red blood cells that carries oxygen. A healthy level means the body has enough red blood cells to donate safely.
For most blood centers in the U.S., the minimum hemoglobin level must be:

12.5 g/dL for women
13.0 g/dL for men

If hemoglobin is too low, it may mean there is not enough iron in the body. Low iron can make a person feel tired or dizzy. If someone’s level is below the limit, they will be asked to wait and try again another time.

General Health and Medical Conditions

To donate blood, a person must feel well on the day of donation. People who have a cold, fever, or infection will be asked to come back when they are healthy.
Some health conditions may cause a permanent deferral (not allowed to donate at all). These include:

HIV or AIDS
Hepatitis B or C
Certain types of cancer
Heart disease or stroke, depending on the case

Other conditions may require a waiting period before donating. For example, a person who recently had surgery or received a blood transfusion must wait a certain number of months.

Medications

Some medications can affect whether a person can donate blood. A few medicines require a temporary deferral, while others may cause a longer delay.
Examples include:

Isotretinoin (used for acne): Wait 1 month
Finasteride (used for hair loss or prostate issues): Wait 1 month
Blood thinners like warfarin: often not allowed
Each medicine is checked to make sure it will not harm the donor or the person receiving the blood.

Even if a medication does not cause deferral, it still needs to be reported during the donor screening.

Travel and Risk Factors

Traveling to certain countries may increase the risk of diseases like malaria, Zika virus, or mad cow disease (variant Creutzfeldt-Jakob disease). Depending on where and when a person traveled, they may need to wait before donating.
Other risk factors include:

Recent tattoos or piercings (usually a 3-month wait unless done in a licensed facility)
High-risk sexual behavior
Drug use through needles
These questions are asked to protect the safety of the blood supply.

Donation Frequency

There are limits to how often someone can donate. This gives the body time to make new blood cells.

Whole blood donations: every 56 days (8 weeks)
Platelets: every 7 days, up to 24 times a year
Plasma: every 28 days, up to 13 times a year
Double red cell donations: every 112 days (16 weeks)

Each type of donation has its own rules, and blood centers will help track the time between visits.

These general rules help protect both the donor and the person receiving the blood. Blood centers follow strict guidelines, and trained staff members check each donor carefully. Even if someone meets all the basic requirements, additional questions may come up during the screening, especially if they are taking certain medications like testosterone. This is why honesty during the donor interview is very important.

Can You Donate Blood While on Testosterone Therapy?

Many people take testosterone therapy for different health reasons. Some use it to treat low testosterone levels. Others use it as part of gender-affirming care. A common question is whether it is safe or allowed to donate blood while taking testosterone. The short answer is yes, most people on testosterone therapy can donate blood, but there are some rules and important details to understand first.

Testosterone Does Not Automatically Disqualify a Donor

Testosterone is not on the list of medications that automatically block someone from donating blood. Most major blood donation organizations, like the American Red Cross and the U.S. Food and Drug Administration (FDA), do not consider testosterone itself to be a reason to defer a donor. That means just being on testosterone therapy does not mean someone cannot give blood.

Still, it is important to meet all other standard rules for donating. These include being in good general health, being at least 17 years old in most states (or 16 with parental consent), and weighing at least 110 pounds (50 kg). A person must also pass a short health check and a questionnaire at the donation center.

The Main Concern: Blood Thickness and Hematocrit

Even though testosterone does not disqualify a person by itself, it can cause changes in the body that may affect eligibility. One of the most common side effects of testosterone therapy is a condition called polycythemia, which means the body makes too many red blood cells. This causes the blood to become thicker than normal.

When blood is too thick, there is a higher risk of problems like blood clots, heart strain, or strokes. For this reason, blood donation centers check hematocrit and hemoglobin levels before every donation. Hematocrit measures how much of the blood is made up of red blood cells. Hemoglobin is the protein in red cells that carries oxygen. If either level is too high, it can be unsafe to donate.

Each blood donation center sets its own safe ranges, but many follow general guidelines. For example, the hematocrit level is often required to be below 54% for men and 50% for women. People taking testosterone, especially by injection, often have hematocrit levels that go above this range. If the level is too high, the donor will be deferred temporarily and asked to come back after lowering the number.

Different Forms of Testosterone May Have Different Effects

Not all forms of testosterone have the same impact on the blood. Testosterone injections, especially long-acting types like testosterone cypionate or enanthate, are more likely to cause high hematocrit levels. This is because the hormone enters the body quickly in high doses, causing more red blood cells to be made.

Other types, like skin gels or patches, may have a lower risk of raising hematocrit, since the hormone enters the bloodstream more slowly and steadily. Still, every person is different. Some people on low-dose or non-injected testosterone can still have high levels, while others on injections may stay within normal ranges. This is why regular blood tests are important for people on testosterone therapy.

Blood Donation Can Sometimes Help Manage High Hematocrit

If someone’s hematocrit level becomes too high from testosterone therapy, doctors may recommend therapeutic phlebotomy. This is a medical procedure similar to blood donation, where blood is removed to lower red cell levels. Some blood centers allow this blood to be used for donation if the person meets all other rules. In this case, giving blood can be both helpful to others and helpful to the person on testosterone.

However, even if blood donation is used to manage hematocrit, the person still needs to pass the regular screening process. That includes checking blood pressure, temperature, hemoglobin, and general health.

Always Follow Blood Center Guidelines

Each donation center may have slightly different rules based on national or local regulations. For example, blood banks in the United States follow FDA rules, while those in other countries may have different standards. Some centers may be more cautious when accepting donors on hormone therapies, while others have no extra requirements.

It is important to be open and honest during the donor interview. Telling the staff about testosterone therapy helps ensure safety for both the donor and the person receiving the blood. Staff members can explain if any extra steps are needed or if a temporary delay is necessary.

Most people on testosterone therapy can donate blood if they are healthy and meet standard donation requirements. The therapy itself does not block someone from donating, but it can cause high hematocrit or hemoglobin levels. These levels must be checked before giving blood. If they are too high, the donation will be delayed until it is safe. Being honest with donation staff and keeping up with regular blood tests makes the process safe for everyone involved.

Why Might Testosterone Therapy Affect Blood Donation Eligibility?

Testosterone therapy can affect blood donation eligibility because it changes how the body makes red blood cells. Testosterone is a hormone that plays many roles in the body, including helping the body make more red blood cells. When someone takes testosterone—especially in long-term or high-dose therapy—it can cause a condition called polycythemia. This condition means there are too many red blood cells in the blood. It makes the blood thicker and can raise the risk of health problems.

What Is Polycythemia?

Polycythemia happens when the red blood cell count, hematocrit, or hemoglobin levels are too high. Hematocrit is the percentage of blood that is made up of red blood cells. Hemoglobin is the protein inside red blood cells that carries oxygen. Blood banks test these levels before someone donates blood. If the levels are too high, the person may not be allowed to donate.

Normal hematocrit levels depend on age, sex, and lab standards. For most adult men, normal hematocrit ranges from about 38% to 50%. If someone has a hematocrit above 54%, it may be considered too high for donation. Some blood centers use even stricter cutoffs.

Testosterone therapy, especially in injected forms, can cause the body to increase red blood cell production. This rise in red blood cells is called secondary erythrocytosis. It is not caused by a disease in the bone marrow but instead by a hormone signal that tells the body to make more red blood cells.

Why Is High Hematocrit a Concern?

When the blood becomes thicker due to high red blood cell levels, it does not flow as easily through blood vessels. This can make it harder for the heart to pump blood and can increase the risk of:

Blood clots
Heart attack
Stroke
Deep vein thrombosis (DVT)
Pulmonary embolism (a clot in the lungs)

For these reasons, many doctors monitor red blood cell levels in people taking testosterone. If the levels go too high, doctors may lower the testosterone dose, change the form of treatment, or recommend therapeutic phlebotomy, which is a medical blood removal to bring red blood cell counts down.

Blood donation centers also care about hematocrit and hemoglobin levels because thick blood can make the donation process less safe. Blood must flow smoothly through the needle and tubing. High hematocrit can also affect how useful the donated blood is for patients who receive it. If the blood is too thick, it may not meet the quality standards for transfusions.

Which Forms of Testosterone Increase Risk Most?

Not all forms of testosterone therapy raise red blood cell counts the same way. Studies show that:

Injectable testosterone, especially long-acting intramuscular injections like testosterone cypionate or enanthate, cause the largest increase in hematocrit.
Topical gels and patches tend to have a smaller effect.
Oral testosterone and pellet implants fall somewhere in between.

The body responds more strongly to sharp rises in testosterone, which often happen with injections. When levels rise quickly, the body may react by producing more red blood cells.

Doctors often check hematocrit levels before starting testosterone therapy and again every 3 to 6 months during treatment. Blood banks may also test for high hematocrit levels on the day of donation. If levels are too high, donation may be delayed or denied.

Testosterone therapy can make blood thicker by raising red blood cell levels. This can be dangerous and is one reason why some people on testosterone are not allowed to donate blood. Blood centers check hematocrit and hemoglobin to keep both the donor and the person receiving the blood safe. Injectable testosterone increases red blood cells the most, but all forms can have this effect. People on testosterone therapy should have their red blood cell levels monitored regularly and follow their doctor’s advice to lower the risk of complications.

What Blood Tests Are Required for Donors on Testosterone?

Before anyone can donate blood, certain blood tests must be done. These tests help make sure the blood is safe for others to receive. They also help make sure the donor is healthy enough to give blood. People who are taking testosterone therapy may need special attention during this process because testosterone can change how the body makes blood.

One of the main things that donation centers check is the amount of red blood cells in the blood. This is usually measured with a hematocrit or hemoglobin test.

Hematocrit and Hemoglobin Tests

The hematocrit test shows the percentage of red blood cells in the blood. The hemoglobin test measures the amount of hemoglobin, which is the protein in red blood cells that carries oxygen. These two tests are closely linked and are always checked before someone donates blood.

Most blood donation centers have a lower limit and sometimes an upper limit for these values. For example, in many places:

The hemoglobin must be at least 12.5 g/dL for women and 13.0 g/dL for men.
The hematocrit usually must be at least 38% or higher, depending on the center’s policy.

These values can vary slightly depending on the country or blood bank rules.

Why Hematocrit Levels Matter for People on Testosterone

Testosterone therapy can cause the body to produce more red blood cells than normal. This condition is called polycythemia. It is more common in people who take testosterone injections, especially at high doses or over a long time.

If the hematocrit level gets too high, the blood becomes thicker than usual. Thick blood can make it harder for the heart to pump and may raise the risk of blood clots, heart attack, or stroke.

Because of this, donation centers will check to make sure the hematocrit is not only high enough to donate but also not too high. Some centers may have an upper limit, such as 54% for men. If the hematocrit is above that number, the person may be turned away until the level drops to a safer range.

Extra Monitoring May Be Needed

People who are on long-term testosterone therapy may need to get their blood checked more often than other donors. Their doctors may already be watching their hematocrit and hemoglobin levels during routine check-ups. If these levels are too high, the doctor may recommend adjusting the testosterone dose or using another treatment, like therapeutic phlebotomy, to lower the red blood cell count.

For blood donation centers, there is no special test only for people on testosterone. However, the existing tests for hemoglobin and hematocrit become more important. If the person is on testosterone, the donation staff might ask about how long they have been on it, what form they are using (such as injections or gel), and whether they have had any recent lab work done.

Frequency of Blood Testing

A healthy person who donates blood may only get tested during donation. But someone on testosterone might have regular blood tests ordered by their doctor every few months. These tests help track the effects of testosterone and avoid problems like thick blood or high blood pressure.

Even if a person feels healthy, it is important to follow testing schedules and not skip them. Blood tests help doctors and blood centers make safe choices about donation.

What Happens if the Levels Are Too High or Too Low

If a donor’s hemoglobin or hematocrit level is too low, the blood center will not allow donation that day. This protects the donor from feeling weak or dizzy after giving blood. If the level is too high, the donor may also be turned away. This is to protect both the donor and the person who would receive the blood.

In both cases, the person can often try again later. The staff may recommend checking with a doctor to find out why the levels are off. Sometimes, changes in testosterone therapy can help bring levels back into a safe range.

Blood tests like hemoglobin and hematocrit are very important for anyone who wants to donate blood, especially those on testosterone therapy. Testosterone can raise red blood cell levels, so donation centers need to be careful. Safe blood donation depends on healthy lab values, regular testing, and honest conversations between donors and medical staff.

How Often Can Someone on Testosterone Therapy Donate Blood?

People who take testosterone may wonder how often they are allowed to donate blood. The answer depends on a few important things, including the type of donation, the person’s red blood cell levels, and whether they are donating for health reasons or just to help others. Understanding these rules helps ensure that both the donor and the person receiving the blood stay safe.

General Blood Donation Frequency

Most healthy adults are allowed to donate whole blood every 56 days (about 8 weeks). This is the standard rule followed by most blood donation centers, including the American Red Cross. Whole blood donation removes red blood cells, white blood cells, platelets, and plasma all at once. After a whole blood donation, the body needs time to make more red blood cells, which is why there is a waiting period.

There are other types of blood donations, too:

Platelet donation can often be done every 7 days, up to 24 times per year.
Plasma donation can usually be done every 28 days.
Double red cell donation, which removes more red blood cells than a regular donation, is only allowed every 112 days (about 16 weeks).

People on testosterone therapy must follow these same time limits unless a doctor or blood center gives different advice based on their health.

How Testosterone Affects Blood Levels

Testosterone therapy can increase the number of red blood cells in the body. This can raise hematocrit and hemoglobin levels. Hematocrit is the percentage of red blood cells in the blood. Hemoglobin is the protein in red blood cells that carries oxygen. If these levels become too high, the blood can become thicker. Thick blood makes it harder for the heart to pump and can increase the risk of blood clots or strokes.

Doctors call this condition secondary erythrocytosis. It is a common side effect of long-term testosterone therapy, especially with injectable forms like testosterone cypionate or enanthate. Some people may not notice symptoms, but others may feel headaches, fatigue, dizziness, or chest pain. If left untreated, high red blood cell counts can be dangerous.

Because of this, many doctors check hematocrit and hemoglobin levels regularly for people who are taking testosterone. If the levels get too high, the doctor may suggest taking a break from testosterone or giving blood more often to lower the red cell count.

Can People on Testosterone Donate Blood More Often?

In some cases, people on testosterone therapy are advised to donate blood more often than usual. This is usually done under medical supervision and is called therapeutic phlebotomy. This type of blood removal is meant to treat high red blood cell levels, not just to help others. However, if the person’s blood meets donation center standards, the blood may still be used to help patients in need.

Regular donation under these circumstances can help lower hematocrit to safe levels. For example, someone who develops secondary erythrocytosis may be told to donate blood every 2 to 3 months. In special cases, donation may be done more frequently, such as every 4 to 6 weeks, but only with a doctor’s approval.

Blood donation centers may not allow more frequent donations unless there is a medical reason. This is because donating too often without enough time to recover can lead to low iron levels or anemia. People on testosterone who want to donate more often should ask their doctor to order blood tests and provide guidance.

Monitoring Is Important

Before every blood donation, centers check a person’s hemoglobin level. If it is too high or too low, the donation will not be allowed. For someone on testosterone therapy, it is helpful to know their levels before arriving at the center. Doctors may also recommend regular blood tests, especially if the person has been on testosterone for many months or years.

If hematocrit or hemoglobin is above the limit, the person will be told to wait and come back later. Most blood banks in the United States require a hemoglobin level of at least 12.5 g/dL and hematocrit no higher than 54% for males. Some places may have slightly different rules.

People taking testosterone can usually donate blood as often as healthy individuals, following the normal guidelines. However, because testosterone can raise red blood cell counts, some people may need to donate more often to keep their levels safe. This should only be done with a doctor’s help and regular testing. The key is to make sure hematocrit and hemoglobin are within the safe range before every donation. This protects both the donor and the person receiving the blood.

Therapeutic Phlebotomy vs. Blood Donation: What’s the Difference?

Therapeutic phlebotomy and blood donation may look the same at first. Both involve removing blood from the body. Both use similar equipment and often take place in similar settings. However, the purpose, process, and outcome of each are very different. It is important to understand how they differ, especially for people who take testosterone therapy.

Therapeutic Phlebotomy: A Medical Treatment

Therapeutic phlebotomy is a medical treatment. It is ordered by a doctor to treat certain health conditions. One of the most common reasons for this treatment is high red blood cell levels, also called secondary erythrocytosis. This can happen as a side effect of testosterone therapy.

Testosterone helps the body produce more red blood cells. Sometimes, the body makes too many. When the red blood cell count becomes too high, the blood becomes thicker. Thick blood flows more slowly and increases the risk of problems like blood clots, stroke, or heart attack.

To lower the red blood cell count, a doctor may recommend therapeutic phlebotomy. This treatment involves drawing a set amount of blood, usually around 500 milliliters (about one pint), just like in regular blood donation. However, the goal is not to help others but to protect the health of the patient.

Therapeutic phlebotomy can be done once or may be needed regularly, depending on blood test results. The schedule is based on how high the hematocrit and hemoglobin levels are and how the patient responds to treatment. The procedure is often done at a hospital or clinic.

Blood Donation: A Volunteer Act

Blood donation is done by healthy people who want to help others. Donated blood is used in hospitals for surgeries, emergencies, or for patients with certain diseases. Blood banks only accept blood that is safe for patients to receive.

During a blood donation, about one pint of blood is collected. Before donating, the donor must meet several health and safety guidelines. These rules protect both the donor and the person who may receive the blood.

A person on testosterone therapy can donate blood if their hemoglobin and hematocrit levels are within a normal range. If these levels are too high, the person may be told to wait or may not be allowed to donate. This is to prevent health risks to the donor and ensure the blood is safe to use.

Key Differences Between the Two

The biggest difference between therapeutic phlebotomy and blood donation is the purpose. Therapeutic phlebotomy is used as a treatment for medical conditions. Blood donation is used to collect blood for others who need it.

Another key difference is what happens to the blood. Blood collected through therapeutic phlebotomy is usually thrown away. It cannot be used for transfusion because it was drawn for medical reasons, not donation. In contrast, donated blood is tested, stored, and sent to hospitals for patient care.

People receiving therapeutic phlebotomy do not always have a choice to donate that blood. Blood banks must follow strict rules. If a person’s blood contains high hormone levels, such as testosterone, or if it was removed to treat a condition like erythrocytosis, it may not be accepted for donation.

Overlap for Some Patients

In rare cases, some people on testosterone therapy may be allowed to give blood that also helps lower their red blood cell count. This depends on their test results, health history, and the policies of the blood donation center. Some centers allow a person with high hematocrit to donate more often, which may serve both purposes. However, not all centers allow this, and it is never guaranteed.

To decide whether blood can be donated or must be removed as a medical treatment, doctors and blood centers review several factors. These include the person’s blood test results, reason for the blood removal, and overall health.

Medical Advice Matters

Anyone on testosterone therapy who develops high red blood cell counts should talk to a doctor. Only a healthcare provider can decide whether therapeutic phlebotomy is needed. It is also important to check with the local blood bank to see if donation is allowed. Some blood centers have their own rules based on national guidelines.

Understanding the difference between therapeutic phlebotomy and blood donation helps ensure that the right action is taken for both the individual’s health and the safety of the blood supply.

Gender-Affirming Hormone Therapy and Blood Donation

Many people who take testosterone are transgender men or nonbinary individuals undergoing gender-affirming hormone therapy. These individuals often ask if they can donate blood while using testosterone. Blood donation rules can be confusing, especially when it comes to gender identity and hormone use. This section explains how blood donation works for transgender people, what rules apply, and what to expect during the donation process.

Understanding Gender Markers and Blood Donation Systems

Blood centers usually ask donors to provide information such as age, weight, medical history, and sex. Most donation forms ask for "sex assigned at birth" or simply "male" or "female" without offering a place for gender identity. This can create confusion for transgender donors.

For example, someone who was assigned female at birth but now identifies and lives as male may take testosterone as part of gender-affirming care. Testosterone changes the body in many ways, including muscle growth, fat distribution, and red blood cell levels. These physical changes can also affect eligibility for blood donation.

The sex listed on the blood donor form matters because it determines the acceptable hemoglobin levels for donation. Blood centers often use different hemoglobin cutoffs for males and females. In the United States, the minimum hemoglobin level is usually 13.0 g/dL for males and 12.5 g/dL for females. If a transgender man is listed as female in the system, a higher hemoglobin level due to testosterone use might wrongly disqualify the donation. Or, the cutoff used might not reflect the donor’s current physiology.

Because of this, transgender individuals are encouraged to check how their blood donation center handles gender markers. Some centers allow donors to self-identify their gender. Others may still use sex assigned at birth, especially if their system has not been updated. This can be frustrating, but policies are slowly changing to be more inclusive.

How Testosterone Affects Blood Donation in Transgender People

Testosterone therapy increases the amount of red blood cells in the body. This can raise hematocrit and hemoglobin levels, sometimes above the safe range. High red blood cell levels are called erythrocytosis. While this can happen in both cisgender and transgender men, it is a common reason why someone taking testosterone may be temporarily deferred from donating blood.

Blood banks check hemoglobin or hematocrit levels before each donation. If levels are too high, the donor may be asked to wait and try again later. This rule is not specific to transgender people; it applies to anyone, regardless of gender, taking testosterone.

Some transgender men may be advised by their doctors to donate blood more often, or to undergo therapeutic phlebotomy, if their hematocrit becomes too high. This is done to lower the risk of blood clots or other complications.

It is important to remember that having a high hematocrit from testosterone use does not always mean the donor is unhealthy. However, blood donation centers must follow safety rules to protect both the donor and the person receiving the blood.

Current Guidelines in Different Countries

Blood donation rules for transgender individuals can vary depending on the country and organization.

In the United States, the FDA does not have a separate blood donation policy for transgender people. Most donation centers follow general guidelines and may use the gender listed on the donor’s ID or medical record.
In Canada, Canadian Blood Services allows donors to update their gender marker and uses self-identified gender when checking eligibility.
In the United Kingdom, NHS Blood and Transplant permits donors to self-identify gender. They also provide guidance to ensure transgender donors are treated with respect and their medical needs are considered.

Each organization must ensure that the collected blood is safe and that donation procedures are fair. However, practices and systems are still catching up in many places, and not all staff may be fully trained on transgender health issues. For this reason, some donors may have different experiences depending on the center they visit.

Privacy and Respect at the Donation Center

It is important that all donors, including those who are transgender, are treated with respect and privacy. Blood donation staff are trained to handle personal information carefully. If a donor is taking testosterone, they may be asked follow-up questions about their health and medication. This is not to judge, but to make sure the donation is safe.

Transgender donors are not required to share their entire medical history with staff, but honesty about hormone use is important. Knowing about testosterone therapy helps staff make the right decisions about eligibility and safety.

Transgender people who take testosterone can often donate blood, but there are a few extra things to keep in mind. Hormone therapy can change hemoglobin levels, and the gender listed with the blood center can affect screening results. Guidelines vary between countries, but many blood donation systems are working to become more inclusive. Checking with the local donation center before arriving can help prevent confusion or delays.

Medications That May Affect Blood Donation Eligibility

Many medications can affect whether someone is allowed to donate blood. Some medicines cause a temporary delay, while others may stop donation completely. Each blood center follows rules to make sure blood is safe for the person donating and for the person receiving it. These rules are often set by national health agencies, like the U.S. Food and Drug Administration (FDA).

Testosterone and Medication Screening

Testosterone is a hormone used in testosterone therapy. It is usually given through injections, gels, patches, or tablets. It is a prescription medication, but being on testosterone does not always mean someone cannot donate blood. Still, it is important to know that testosterone might lead to a closer check of eligibility during the donation process.

Testosterone itself is not listed as a medication that automatically blocks someone from donating blood. However, blood banks may ask follow-up questions about the reason for taking it and any side effects that have been seen. The main concern with testosterone use is how it may raise the number of red blood cells in the body, leading to a condition called polycythemia. If red blood cell levels are too high, it can raise the risk of health problems such as blood clots or stroke. These risks are also important for blood donation, since high red cell counts can affect the safety of the donated blood.

How Other Medications Affect Blood Donation

Unlike testosterone, there are several medicines that clearly delay or stop blood donation. These include:

Blood thinners like warfarin or heparin, which affect clotting and can cause bleeding.
Isotretinoin (Accutane) for acne, which requires a wait time of at least one month after stopping before donating. This is because it can cause birth defects if given to pregnant patients through transfusion.
Antibiotics may delay donation until the infection has cleared.
Medications for cancer or chemotherapy often cause a long-term or permanent block on blood donation.
HIV medications or antiretrovirals are also often part of deferral rules due to safety concerns.

Some drugs are not allowed in donated blood because they can harm people who receive it, especially babies or pregnant women. Others affect the health of the donor during or after the process. Blood centers always try to keep both the donor and the recipient safe.

Why It’s Important to Report Testosterone Use

Anyone taking testosterone should tell the blood bank before donating. The donation staff will check hemoglobin and hematocrit levels with a fingerstick test. If the numbers are too high, the person may be asked to wait or be referred to a doctor. In some cases, donation may still be allowed, but with special care.

Telling the truth during screening protects both the donor and the person receiving blood. Hiding the use of testosterone could lead to health problems. The blood center will not judge the reason for using testosterone, whether it is for low testosterone (hypogonadism), gender-affirming therapy, or another medical reason. The main goal is to keep blood safe.

Medical Documentation and Testosterone Use

Most of the time, people on testosterone do not need to bring proof of their prescription. However, if the blood bank has questions, they may ask about dosage, form (such as injections or gels), and how long the person has been on the medicine. This helps them understand the possible effect on blood levels.

If a doctor is monitoring the treatment, blood test results from recent checkups may also help. Some donors bring lab reports showing their hematocrit or hemoglobin numbers to support their case. While this is not required by all blood banks, it may help speed up the process if concerns come up.

Testosterone is a medication that does not automatically stop someone from giving blood, but it does require honest reporting and close review. Unlike certain other drugs that have clear waiting periods or bans, testosterone is reviewed based on how it affects red blood cell levels and overall health. Being open with donation staff and having regular health checks can help ensure a safe and successful blood donation.

What to Tell the Blood Bank if Taking Testosterone

When donating blood, it is important to share all relevant health information with the staff at the donation center. This includes any prescription medications being taken, especially hormone treatments like testosterone. Sharing this information helps protect both the person donating and the patient who may receive the blood.

Be Honest About Testosterone Use

Before giving blood, every donor must answer a list of health questions. These questions help determine if it is safe to donate. One of the questions will ask if the donor is currently taking any medications. Testosterone is a prescription hormone. Whether it is taken as a gel, patch, injection, or tablet, it must be listed during the screening process.

Testosterone therapy can affect the body in several ways. One of the most important effects is that it can raise the number of red blood cells. This condition is called erythrocytosis or polycythemia. Too many red blood cells can make the blood thicker. Thicker blood can increase the risk of problems such as high blood pressure, strokes, or blood clots. Because of this, blood centers check red blood cell levels before donation. Letting the staff know about testosterone use allows them to better understand any test results that may be out of the normal range.

Failing to tell the blood bank about hormone use can be risky. If testosterone use causes a high hematocrit or hemoglobin level, and that is not reported, donation may still be allowed by mistake. This can harm the donor or lead to blood that may not be suitable for transfusion. Being honest about hormone use helps make sure the donation is safe for everyone.

How to Share Testosterone Information

When asked about medications, the donor should clearly name testosterone as one of them. Some centers may ask for the brand or type, such as testosterone enanthate, cypionate, or gel form. The method of taking testosterone (injection, patch, gel, or pill) can also be helpful. If unsure of the exact name or details, it is helpful to bring a medication label or prescription bottle.

Sometimes the staff may ask how long the person has been on testosterone therapy. This is to understand how it may be affecting the donor's blood levels. Donors who have just started treatment may not have had changes in their blood yet, but people who have been on therapy for many months may have higher red blood cell counts. This is especially common with injectable forms, which can raise blood levels quickly.

What Documents Might Be Needed

Most blood centers do not require a doctor's note to give blood while on testosterone. However, if a person is receiving testosterone through a medical program—such as for hypogonadism or gender-affirming care—it can help to bring medical documentation. This is not always required, but it may answer questions if there is any concern about why testosterone is being used. Some blood banks may ask for a doctor's contact information in case they need to confirm anything.

Also, if a person is undergoing therapeutic phlebotomy as part of testosterone treatment, that is not the same as donating blood for others. Therapeutic phlebotomy removes blood to lower red blood cell levels, but this blood is usually not used for transfusions. Blood banks need to know if someone is giving blood for treatment or for donation to others.

Why Sharing Testosterone Use Matters

The main goal of the blood donation process is to keep everyone safe. Testosterone is not a banned substance when it comes to blood donation. However, because of its effects on red blood cell levels, it must be handled with care. Blood that is too thick may not be safe to give to a patient, especially one who is very ill.

Sharing testosterone use also helps protect the donor. If blood levels are too high, giving blood might lead to lightheadedness or other symptoms. In some cases, the donation center may suggest waiting or checking with a doctor before donating.

Providing complete and truthful information during the donor screening allows the blood center to make the right choice. It also helps maintain trust between donors and staff and ensures that the blood supply remains safe for everyone who needs it.

Conclusion

Many people who take testosterone therapy wonder if they are allowed to donate blood. The short answer is yes—most people who are on testosterone can donate blood, but there are some rules to follow. It is important to understand how testosterone therapy may affect the body and how that could change blood donation eligibility. Being honest with the blood center and knowing what to expect can help make the process smooth and safe. Testosterone therapy, often called TT, is used to treat medical conditions like low testosterone levels in men. It is also used by transgender men as part of gender-affirming care. Testosterone helps the body build muscle, increase red blood cells, and develop male characteristics. While this treatment is helpful for many people, it can sometimes cause a side effect called polycythemia, which means the body makes too many red blood cells.

When red blood cell levels go up too high, the blood becomes thicker. This thick blood can raise the risk of problems like blood clots, strokes, or heart attacks. That is why blood donation centers check red blood cell levels before accepting a donation. The two numbers they look at are hematocrit and hemoglobin. If these numbers are too high, the donor may be turned away until their levels return to normal.

Some people on testosterone may be asked to wait to donate blood until their hematocrit or hemoglobin drops. Others might still be able to donate regularly if their levels stay within the safe range. Regular testing by a doctor can help track these numbers over time. Donating blood may also help manage high red blood cell levels in some people taking testosterone.

Sometimes, people with high red blood cell counts due to testosterone therapy are told to have a medical treatment called therapeutic phlebotomy. This is not the same as regular blood donation. In therapeutic phlebotomy, a doctor removes a unit of blood to reduce the red cell count and prevent health problems. This blood is usually thrown away and not used for patients who need transfusions. Blood from regular donors, on the other hand, is stored and used to help people in hospitals. If the person on testosterone therapy meets all the donation requirements, they may be allowed to donate instead of having therapeutic phlebotomy—but this must be approved by both the blood bank and their doctor.

Another thing to remember is that blood donation policies can vary depending on the country and the blood collection agency. Some organizations have clear rules for people on hormone therapy, while others may review each case individually. For transgender people on testosterone, rules about gender markers and donation guidelines may also apply. Most blood banks will ask the donor to pick a gender that matches the one listed on their government ID. This matters because blood tests use different standards for men and women.

People who are taking testosterone should always tell the blood donation center about it. This is usually done during a short health interview before giving blood. The staff may ask for more information or for the name of the medication. Testosterone is not on the list of drugs that require automatic deferral, like blood thinners or certain acne medicines. However, sharing all prescription drugs helps ensure the donation is safe for both the donor and the person receiving the blood.

Being open and honest about testosterone therapy also helps protect the donor’s health. If the red blood cell count is too high, donating could make the person feel faint, dizzy, or unwell. In some cases, the blood center may suggest seeing a doctor before trying again.

In summary, people on testosterone therapy can often donate blood as long as they meet the basic health and blood count requirements. Checking red blood cell levels, being honest with the donation center, and following local rules will help make the process safe. Blood donation saves lives, and with the right steps, people on testosterone therapy can still take part in this important act of giving.

Q1: Can I donate blood while on testosterone therapy?

Q2: Why might testosterone therapy affect blood donation eligibility?

Q3: Does the method of testosterone delivery (injections, gel, patch) affect blood donation eligibility?

Q4: What is the maximum hematocrit level allowed to donate blood?

Q5: Can donating blood help manage high hematocrit from testosterone therapy?

Q6: Do I need to inform the blood donation center that I’m on testosterone therapy?

Q7: How often can someone on testosterone therapy donate blood?

Q8: Will taking testosterone disqualify me from donating plasma or platelets?

Q9: Can testosterone therapy be used as a reason for therapeutic blood removal?

Q10: What should I do if I’m unsure about my eligibility to donate blood while on testosterone?

Can You Donate Blood While on Testosterone Therapy? A Complete Guide