But times change, and Mr. Palen is now taking a more antagonistic approach. “All Types Welcome” is a condemnation of blood donation rules set by the Food and Drug Administration that prohibit most gay or bisexual men from giving; before donating, they have to forgo same-sex sexual encounters for at least a year, a contentious precaution resulting from concerns about H.I.V.
“It’s exclusion, and it’s ridiculous, and it’s discriminatory,” Ms. Lepore said in an interview.
Mark Burg, the producer who has helped steer the “Saw” franchise, was even more blunt. “We want this policy changed,” he said.
An F.D.A. spokeswoman, Lyndsay Meyer, noted that the celibacy rule, enacted in 2015, replaced a more restrictive policy. “While acknowledging at the time that the change to a 12-month deferral was less than hoped for by some, the F.D.A. considered this to be a first step,” Ms. Meyer said, adding that studies are underway to “help inform further changes to policy.”
The Red Cross, the nation’s largest blood supplier, has also drawn fire for its approach to transgender donors. Until recently, federal guidelines recommended that trans people be required to register at blood centers under the gender they were assigned at birth.
“The Red Cross believes all potential blood donors should be treated with fairness, equality and respect,” Jodi D. Sheedy, a Red Cross spokeswoman, said in an email.
She added, “Accurate donor histories and medically supported donor deferral criteria are critical” to blood supply safety.
Mr. Palen is one of Hollywood’s savviest marketers, and his latest campaign reflects several trends, including a focus on diversity. In the past, Mr. Palen has cast young women (most often white) as nurse mascots for the “Saw” blood drives. “Now we have different races, genders, ages and sexual orientations,” he said. Joining Ms. Lepore and Mr. Ross as twisted nurses are people like Nyakim Gatwech, a Sudanese model; a YouTube and Instagram star named Mykie; and the sexagenarian event producer Susanne Bartsch.
While inclusion remains far from Hollywood’s strength, many consumer brands have started to loudly ring the representation bell. Last year, for instance, CoverGirl named its first “cover boy” and made a beauty blogger, Nura Afia, its first hijab-wearing cosmetics ambassador.
It is also notable that Mr. Palen is tapping into rage culture. Hollywood marketers are mostly allergic to controversy, but nothing lights a fire on social media like indignation, and a growing number of advertisers are trying to spark thought-provoking discussions. The North Face, for instance, indirectly references President Trump’s plans for a Mexico border wall with its new “Walls Are Meant for Climbing” brand campaign.
The topical approach can backfire. Just ask Pepsi and Kendall Jenner. “It’s easy to be provocative,” Mr. Palen said. “It’s less easy to be provocative in a way that inspires people to see your movie.”
The “Saw” nurses were an early example of what Hollywood types now like to call “world building.” There are no major nurse characters in the movies (some of which are also not particularly bloody). Rather, Mr. Palen’s creations are meant to add a layer of immersion for fans. The first “Saw” nurse was a Lionsgate executive; Mr. Palen took her photo in his backyard and posted the image online to promote the blood drive.
“Maybe a few horror fan sites covered it,” he said. “There was no such thing as going viral back then.”
In a snapshot of how powerful the internet has come as a marketing tool, Lionsgate now has roughly 420 million followers on platforms like Instagram, Facebook and Twitter. To gain additional reach for the “All Types Welcome” effort, Mr. Palen recruited the eight social media stars. “Everyone’s making content, everyone’s a creator, everyone has a microphone,” he said. “So to have the nurse campaign play in that space and have personalities feel some ownership in the campaign felt like a great way to evolve.”
And no more backyard shoots for Mr. Palen, who took over a cavernous stage for two days — complete with a D.J. and an open bar — this time around. As the Pharrell Williams song “Marilyn Monroe” played toward the end of the second day, Ms. Lepore teetered on a stack of metallic boxes in white spike heels. “Sexy, fetish nurse doll” is how Mr. Palen had described her look.
“Amazing,” he murmured, standing on tiptoe to take her picture.
When Mr. Palen was done, the 16 people in the room clapped, and Ms. Lepore did a little curtsy.