The 7 words banned by the Trump administration at multiple HHS agencies
Employees were instructed to avoid these words when drafting budget documents
Adapted from a story by The Washington Post’s Lena H. Sun and Juliet Eilperin.
During a meeting on Thursday, officials at the Centers for Disease Control and Prevention were given a list of seven words or phrases to avoid in official documents being drafted for next year’s budget.
The prohibited words are: “vulnerable,” “entitlement,” “diversity,” “transgender,” “fetus,” “evidence-based” and “science-based.”
The CDC is part of the Department of Health and Human Services, and it wasn’t the only HHS agency instructed to avoid such words by the Trump administration while drafting budget documents.
A second HHS agency received similar guidance, according to an official who took part in a briefing earlier in the week. For budget-related documents at this particular agency:
- The words “entitlement,” “diversity” and “vulnerable” are out.
- Participants were told to use “Obamacare” instead of ACA, or the Affordable Care Act.
- To describe the venues where people can purchase health insurance, the agency was told to use “exchanges” instead of “marketplaces.”
The HHS official spoke on the condition of anonymity because the language change information was supposed to be “close hold.” The person did not want to name the agency to protect the identity of officials involved in the talks.
Meanwhile, at the State Department, certain documents now refer to sex education as “sexual risk avoidance.”
Where did the language change information come from?
The colleague who provided the briefing at the second HHS agency relied on a document from the Office of Management and Budget detailing guidance for the fiscal 2019 budget, said the official in an interview Saturday. No explanations were given for the language changes.
The OMB oversees the process that culminates in the president’s annual budget proposal to Congress. That budget document, usually several volumes, is generally shaped to reflect an administration’s priorities. An OMB spokesman did not respond to a request for comment.
Will other federal agencies adhere to these guidelines?
It’s not clear whether other federal agencies have been instructed to avoid certain words, and if so, to what extent, in preparing their budget documents for next year. Officials interviewed at the two HHS agencies said the language restriction was unusual and a departure from previous years.
Why are scientific groups concerned?
One of the words to avoid is “transgender.” Mara Keisling, executive director of the National Center for Transgender Equality, noted that CDC’s own research suggests that transgender people face a higher risk of being infected with HIV.
A CDC study published in August, which analyzed 9 million agency-funded HIV tests, determined that transgender women “had the highest percentage of confirmed positive results (2.7%) of any gender category.”
“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, and not just to transgender people,” Keisling said in an email.
Rush Holt, chief executive of the American Association for the Advancement of Science, said: “Among the words forbidden to be used in CDC budget documents are ‘evidence-based’ and ‘science-based.’ I suppose one must not think those things either. Here’s a word that’s still allowed: ridiculous.”
CDC Director Brenda Fitzgerald emailed staff late Saturday reassuring them that the agency has a history of making public health and budget decisions based on the best available science and will continue to do so.
“I want to assure you that CDC remains committed to our public health mission as a science- and evidence-based institution,” she wrote.
A CDC analyst who attended the meeting on Thursday said it was clear to participants that they were to avoid those seven words — but only in drafting budget documents.
In a statement, HHS spokesman Matt Lloyd said:
“The assertion that HHS has ‘banned words’ is a complete mischaracterization of discussions regarding the budget formulation process. 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.”
Lloyd declined to identify any specific inaccuracies in The Washington Post’s report about words that are prohibited in CDC budget documents.
What’s going on at the State Department?
On Wednesday, State Department employees received a guidance document that outlined how they should develop country operating plans under the President’s Plan for Emergency AIDS Relief (PEPFAR) for 2018.
This document repeatedly uses the phrase “sexual risk avoidance,” which has been defined in recent congressional funding bills as abstinence-only practices until marriage, as the primary form of sex education.
Jen Kates, vice president and director of global health and HIV policy at the Kaiser Family Foundation, said in an interview Saturday that while the document does not specifically change how much money should be spent on abstinence-only programs under PEPFAR, the heavy emphasis on it could shift priorities on how money is spent overseas.
“It’s a change, and the language in these documents does matter, because that’s what’s communicated to the teams in the field,” Kates said, adding that it’s “too early to tell” how this might translate into funding changes.
The same guidance document includes a line touting the efficacy of abstinence-only programs, referring to “abstinence as a highly effective form of prevention.”
Several public health experts questioned that assertion, noting that multiple studies have shown that there is little evidence this form of education either delays sexual activity or reduces the number of sexual partners a person has. A nine-year congressionally mandated study concluded in 2007 that teenagers enrolled in abstinence-only programs were no more likely to refrain from having sex than those who did not enroll. Among those who did have sex, the study found, there was no difference in when they began to engage in this activity or how many partners teens in each group had.
