Word ban at CDC includes 'vulnerable,' 'fetus,' 'transgender'

WASHINGTON -- Health leaders say they are alarmed about a report that officials at the nation's top public health agency are being told not to use certain words or phrases in official budget documents, including "fetus," ''transgender" and "science-based."

The health community was reacting to a story in The Washington Post, which, published late Friday citing an anonymous source, said the prohibition was made at a recent meeting of senior budget officials at the U.S. Centers for Disease Control and Prevention. The seven words and phrases - "diversity," ''entitlement," ''fetus," transgender," ''vulnerable," ''evidence-based" and "science-based" - were not to be used in documents that are to be circulated within the federal government and Congress in preparation of the next presidential budget proposal, the paper reported.

On Saturday, a CDC official confirmed there was a recent meeting in which CDC officials were given feedback from the higher ranks of the federal government to reconsider language in draft budget documents. But she said she did not know if there was any specific prohibition about using those seven words. She spoke on condition of anonymity, saying she was not authorized to talk about what happened.

A spokesman at the U.S. Department of Health and Human Services, which oversees CDC, said in a statement that it's a mischaracterization to say the CDC was banned from using certain words. But HHS officials did not clarify or answer any other questions.

The Atlanta-based CDC is in charge of responding to infectious disease outbreaks, like Ebola and Zika, and tracking a wide range of chronic diseases and other health problems.

For decades, the agency has had a mostly sterling reputation as a source of scientific information. So the idea that the agency is censoring certain language sparked alarm and anger from some science and public health experts.

"Here's a word that's still allowed: 'ridiculous,'" said Rush Holt, chief executive officer of the American Association for the Advancement of Science, in a statement reacting to the report.

Dr. Sandro Galea, dean of Boston University's School of Public Health, says these things matter "because the words that we use ultimately describe what we care about and what we think are priorities."

"If you are saying you cannot use words like 'transgender' and 'diversity,' it's a clear statement that you cannot pay attention to these issues."

The CDC official who spoke to The Associated Press said the feedback to reconsider budget language came from "higher-ups" in the federal government, and not from anyone at the CDC. But she said she was not at the meeting and did not know who made the language suggestions.

Since President Donald Trump took office, a number of federal agencies have moved to downscale data collection on topics like climate change and homeless people who are gay, lesbian, bisexual and transgender and to remove from some government websites information on such topics.

The CDC has in the past seemed to signal an interest in less talk and data on certain subjects. Earlier this year, for example, the HHS proposed deleting a question of sexuality form a federal data-collecting survey. It was restored after an outcry by advocates for the LGBT community.

In a statement responding to the Post story, 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."

An HHS official did not respond to any additional questions.

A spokesman for the Office of Management and Budget could not be reached for comment.

The CDC is in a sensitive position. The White House and some Republican lawmakers have proposed dramatic reductions to the agency's $7 billion discretionary budget.

"Everybody in the public health community recognizes that there is a slowly growing timidity by colleagues whose budgets are dependent on the federal government. I have a deep sympathy for the predicament that they are in," Dr. Galea said.

One medical leader from an outside agency, who works closely with CDC employees, said a CDC ban on certain words and terms may not be limited to budget documents. He said two CDC employees told him agency workers have been told not to use, in presentations or public talks, the term "health equity." The term refers to a goal of removing obstacles like poverty and racial discrimination in making sure everyone has an equal chance to be healthy.

There's no written directive about not using the term; it's only been communicated verbally, said the medical leader, who spoke on condition of anonymity because he did not want to jeopardize a working relationship with CDC officials.

"What is clearly happening is those people are afraid to use those words in any talks or papers. Everybody's afraid to do their job right now," he said.

A CDC spokeswoman said she is not aware of any guidance that prohibits CDC scientists from using "health equity" or any other words or phrases in presentations or talks.

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