In a move that can’t be too much of a surprise for those who’ve been following the actions of Trump’s administration over the past year, the Department of Health and Human Services (HHS) apparently handed down a list of words that departments under their supervision, including the Centers For Disease Control and Prevention (CDC), should not use in documents being used officially for preparation of the budget for the next fiscal year.
Words on the list included “transgender” and “fetus,” as well as “diversity,” “science-based,” “evidence-based,” “vulnerable,” and “entitlement.” Officials were told not to refer to the “Affordable Care Act” but instead to “Obamacare,” and to call the places where people purchase health care “exchanges” rather than “marketplaces.”
CDC suggested the phrase “CDC bases its recommendations on science in consideration with community standards and wishes” as a replacement for “science-based” or “evidence-based,” according to an analyst involved in the briefing at which this guidance was released, who spoke to the Washington Post. No word on what sort of replacement is being offered for terms describing actual medical conditions, like the state of being a different gender than one was assigned at birth, or existing in a state somewhere between conception and birth. More specific terms like “transsexual” might work in the former case, while synonyms like “embryo” might be the most accurate replacements in the latter.
Alison Kelly, a senior official in CDC’s Office of Financial Services, led the meeting in which the list of terms was first presented. According to the official that spoke to the Washington Post, Kelly did not clarify the reasoning behind the creation of this list, and said she was just passing the info along. But according to the official, Kelly did say that “certain words” were being flagged in drafts of budget proposals and sent back to the CDC for correction. The flagging of specific terms led to the creation of this list. Kelly’s comments were, according to the analyst, greeted with “incredulous” amazement. “It was very much, ‘Are you serious? Are you kidding?’” they told the Washington Post.
Many fired back at the HHS dictates as soon as the information was made public. Among them was Mara Kiesling, executive director of the National Center for Transgender Equality. “To pretend and insist that transgender people do not exist, and to allow this lie to infect public health research and prevention is irrational and very dangerous,” she stated in a release. “The Trump administration is full of dangerous science deniers who have no business near American public health systems like the CDC. They are actually going to kill Americans if they do not stop.”
Rea Carey, executive director of the National LGBTQ Task Force, responded to the ban on the term “transgender” by saying, “It is disgraceful for a government to attempt to wipe away transgender people, women, and science. President Trump should be ashamed of himself.”
Dana Singiser, vice president of public policy and government affairs for Planned Parenthood, also addressed the issue this sort of denial creates for the transgender community and other marginalized communities, saying, “You must be able to acknowledge the humanity of transgender people in order to address their health care needs. You cannot erase health inequities faced by people of color simply by forbidding the use of the words ‘vulnerable’ or ‘diversity’.”
Even elected officials got into the act, with Democratic Senator Jeff Merkley of Oregon tweeting, “Banned words in Trump’s America apparently include “evidence-based,” “transgender,” and “vulnerable.” Are you kidding me?!?!” accompanied by the cover of George Orwell’s dystopian science fiction novel 1984.
HHS spokesman Matt Lloyd told ABC News, “The assertion that HHS has ‘banned words’ is a complete mischaracterization of discussions regarding the budget formulation process.” He continued, “HHS will continue to use the best scientific evidence available to improve the health of all Americans. HHS also strongly encourages the use of outcome and evidence data in program evaluations and budget decisions.”
Meanwhile, CNN obtained a memo from HHS director Brenda Fitzgerald in which Fitzgerald used multiple banned terms to refute these accusations, saying, “CDC remains committed to our public health mission as a science- and evidence-based institution.” While these official responses do not actually go so far as to deny that the ban on these terms has taken place, they do make clear that HHS and other government agencies don’t see such bans as compromising their ability to carry out their mission.
However, the real takeaway here is something no one has addressed directly–the fact that, as with many other Trump administration agencies, it appears that HHS is taking a head-in-sand approach to issues they find inconvenient. Ignore it, they figure, and it’ll go away. This calls to mind the behavior of an earlier presidential administration in regard to a health crisis plaguing marginalized populations they found inconvenient; President Ronald Reagan infamously never publicly mentioned AIDS until 1985, by which time over 5000 people–mostly gay men–had died of the disease. Time will tell what sort of effect the Trump administration’s attempts to ignore vulnerable (oops, I said it) populations will have on their overall health.