Here's a quick test: if I asked you to name the closest blood donation centre, you could probably rattle off an address. Most of us have given blood, know someone who has, or at least understand the basic process – roll up your sleeve, squeeze a stress ball, eat a Tim Tam, save three lives. It's become beautifully routine, and for good reason – blood donation saves thousands of lives every year.

But what about stem cell donation? The conversation would likely get a lot quieter, punctuated by someone mentioning something vague about "bone marrow" and "really painful procedures."

It's interesting, really. We've done an incredible job normalising one life-saving donation process, but somehow left another shrouded in medical mystery and outdated misconceptions. Despite stem cell transplants being the last-chance treatment for thousands of Australians with blood cancer each year, most of us know surprisingly little about how they actually work.

It's September – Blood Cancer Awareness Month – and every 27 minutes, someone in Australia gets a blood cancer diagnosis. For many of them, finding a stem cell donor isn't just helpful; it's literally the difference between "we can treat this" and "we need to have some difficult conversations." Yet only 1.2% of eligible Australians aged 18-35 are registered as potential donors.

That gap isn't because we don't care - when TDA partnered with Stem Cell Donors Australia this June, and 165 of you signed up to the registry, we showed we do care. Rather, it's because we're operating on information that's about as accurate as thinking I’m only going to have one coffee today (cute).

I think it’s important to mention that we chatted through how to approach this explanation with the team at Stem Cell Donors Australia, and they told us the situation is so critical that we should tackle the myths head-on. They think we can beat the last group of 165, and I think they’re right.

So let's start with the big one - the idea that stem cell donation involves someone drilling into your spine while you're wide awake, gripping the hospital bed rails and counting ceiling tiles.

This is completely wrong.

Over 90% of stem cell donations happen through the blood, which is almost identical to donating plasma. You sit in what's essentially a really comfortable recliner for 4-6 hours while a machine draws blood from one arm, picks out the stem cells like a very careful nightclub bouncer, and returns everything else through your other arm. The biggest decision you'll make is whether to binge The Office or finally start that podcast everyone's been recommending (...our one).

A quick note on the remaining 10% who donate bone marrow directly: for this group, you're completely under general anaesthetic. The procedure takes about 45 minutes, involves extracting liquid marrow from your hip bone (not your spine, despite what every medical drama has taught us), and most people go home the same day. The most painful part is often the IV insertion before the anaesthetic.

Then there’s the idea that a donation leaves you permanently short of some crucial cells. Your body replaces the donated cells within weeks, just like after giving blood. Most donors are back to normal activities within a couple of days – one donor even ran a marathon a week later.

There's also the persistent myth that LGBTQ+ people can't join the registry. They absolutely can - the only requirements are being aged 18-35, reasonably healthy, and willing to help save someone's life if you're matched.

Part of this is a branding problem. "Bone marrow" and “stem cells” sound daunting, scientific and experimental. According to Stem Cell Donors Australia, the medical terminology hasn't kept pace with the increasing routine and safety of the process.

But there's also the matching complexity that makes everything feel more intense. Blood donation works with eight possible blood types - relatively straightforward to make sense of. Stem cell matching involves special genetic markers called HLA, meaning your perfect match could be one person in thousands, or millions. That rarity makes the whole thing feel like a medical miracle, which it is, but not in the "experimental surgery" way.

There’s also a difference in the process of understanding who is receiving your donation. Regular blood donation helps an anonymous recipient (or many of them!). Stem cell donation involves a specific person whose life depends on your willingness to show up and donate. That knowledge can make a simple procedure feel momentous, even when the physical experience is manageable.

Around 1,200 Australian patients will need stem cell transplants in 2025. But most (79%) need to get their stem cells from overseas donors. We're literally shipping in life-saving treatments because we don't have enough local matches.

In good news, there are already 177,000 people on Australia’s registry, which sounds impressive until you realise how genetics actually works. If you're looking for someone who matches a South East Asian, Pasifika, Middle Eastern, or Aboriginal or Torres Strait Islander patient, that pool shrinks dramatically. Australia is beautifully diverse, but the makeup of our donor registry doesn’t reflect this yet.

Every new person aged 18-35 who joins genuinely increases someone's chances of survival. Younger donors are medically preferred because patient survival rates drop by 3% for every decade of donor age. Male donors are particularly valuable, since their larger bodies typically produce more stem cells.

The registration process takes about five minutes online. They mail you a cheek swab. You send it back. Done. Kapeesh.

Then you wait. You could get matched in six months, or six years. If you do get the call, you'll undergo relatively standard health checks, have plenty of time to ask questions, and then proceed with donation through one of those two straightforward methods.

The registry keeps in touch regularly – not to harass you about donating, but to make sure they can actually reach you if you're someone's match. Being available when needed matters just as much as being registered in the first place.

Even if you're outside that age range, this affects your world. Blood cancer hits kids, parents, grandparents, friends and colleagues. The more robust our donor registry becomes, the better the chances for everyone who needs this treatment.

Stem cell donation isn't trivial – you're potentially saving someone's life. But it's also not the medieval procedure that somehow lives in our collective imagination. Sometimes the gap between perception and reality is the biggest barrier to doing something genuinely meaningful, which could one day save the people we love.

This newsletter is supported by Stem Cell Donors Australia, the only stem cell registry in the country

They've provided the research and insights that helped us cut through the myths and understand what stem cell donation actually involves.

If you're aged 18-35 and want to join, it takes about five minutes at stemcelldonors.org.au. If you registered years ago but have since moved house, changed phone numbers, or experienced other major changes, updating your contact details takes even less time but could be just as important.