The CDC’s Silence Will Harm Trans People
by Harper Jean Tobin and Jay Wu
The Centers for Disease Control and Prevention (CDC)’s Pledge to the American People states that the Centers will “base all public health decisions on the highest quality scientific data that is derived openly and objectively” and “treat all persons with dignity, honesty, and respect.”
Late Friday, the Washington Post broke the news that contrary to these commitments, the CDC has banned the word “transgender” — as well as the words “science-based,” “vulnerable,” “entitlement,” “diversity,” “fetus,” and “evidence-based” — from official documents.
This is not the Trump administration’s first attempt to ignore the diversity of the United States population and pretend that LGBTQ people don’t exist. In March, the Department of Health and Human Services — the CDC’s parent agency — announced that it would stop collecting LGBTQ data in its national survey of older adults before partially backtracking under pressure from advocacy groups.
Agencies like the CDC are not supposed to be politically motivated. The scientists and public health professionals at the CDC are simply charged with protecting people from health threats, without any caveats. However, these actions come as less of a surprise when placed into the context of this administration’s anti-LGBTQ, and more specifically anti-transgender, agenda.
Transgender people will still exist and still have a unique set of public health needs, even if the federal government chooses not to acknowledge either of those facts. When this kind of politically-motivated silence around vulnerable populations has driven federal public health policy in the past, it has been deadly.
The federal government’s response to the 1980s HIV/AIDS epidemic paints a picture of the potential effects of the CDC’s actions today. People died from HIV/AIDS-related illnesses every day while the government refused to even say the words “gay” or “AIDS.”
The only way the United States made progress on the HIV/AIDS epidemic was by breaking that silence, acknowledging that the epidemic was happening, and naming the population it disproportionately affected. The stark lesson of that time is that public health threats have to be named and described clearly to be addressed — and that the consequences of not doing so are fatal.
Today, the history of silence around transgender people’s lives continues to drive numerous health disparities — including in HIV/AIDS. Respondents to the 2015 U.S. Transgender Survey were almost five times more likely than people in the general U.S. population to have HIV (1.4 percent vs. 0.3 percent)— and an astonishing 1 in 5 Black transgender women were living with HIV.
Over the last decade, the CDC has done important science- and evidence-based work to overcome the effects of that silence. Acknowledging transgender people and our specific health needs has allowed the CDC to conduct research that informs public policy decisions, improves health outcomes for transgender people, and ultimately saves lives. For example:
- Without data from the CDC’s Behavioral Risk Factor Surveillance System (BRFSS), we would not have reliable estimates of the transgender population across the country.
- CDC data have documented the high prevalence of HIV in transgender populations, low rates of HIV testing as the barriers that contribute to them
- The National HIV/AIDS Strategy identifies transgender people as a key population for prevention and treatment efforts. Last year, a CDC Issue Brief stated that: “Transgender populations are a core priority for nearly all of CDC’s major HIV prevention funding programs.”
- The CDC has worked for years to help state and local health departments and community organizations around the country prevent HIV among transgender people with evidence-based programs and interventions like pre-exposure prophylaxis (PrEP).
- The CDC has helped study the most effective ways to prevent HIV among transgender people, and has used the evidence to tailor the content of its public education campaigns, in part, to reach transgender people.
- A new paper published this month using CDC data showed that transgender people were more likely than their non-transgender counterparts to have no health insurance, no primary care provider, and no routine checkup in the past year.
The CDC works to improve health, and hampering that work can cost lives. Transgender people will still exist if the CDC refuses to talk about us — but we will experience more illnesses and shorter lives. That runs counter to the CDC’s stated mission of “[saving] lives and [protecting] people from health threats.”
Harper Jean Tobin is the Director of Policy at NCTE.
Jay Wu is the Communications Manager at NCTE.
