HHS agencies told to avoid use of certain words

List given to CDC includes ‘diversity’ and ‘transgender.’

WASHINGTON — The Trump administration has informed multiple divisions within the Department of Health and Human Services that they should avoid using certain words or phrases in official documents being drafted for next year’s budget.

Officials at the Centers for Disease Control and Prevention, which is part of HHS, were given a list of seven prohibited words or phrases during a meeting Thursday with senior CDC officials who oversee the budget. The words to avoid: “vulnerable,” “entitlement,” “diversity,” “transgender,” “fetus,” “evidence-based” and “science-based.”

A second HHS agency received similar guidance to avoid using “entitlement,” “diversity” and “vulnerable,” according to an official who took part in a briefing earlier in the week. Participants at that agency were also told to use “Obamacare” instead of ACA, or the Affordable Care Act, and to use “exchanges” instead of “marketplaces” to describe the venues where people can purchase health insurance.

At the State Department, meanwhile, certain documents now refer to sex education as “sexual risk avoidance.”

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 HHS official spoke on the condition of anonymity because the language change information was supposed to be “close hold.”

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.

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.

News of the directives to stop using these words and phrases drew outcry from scientific groups, researchers and advocacy organizations who took to Twitter and other social media.

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.

While HHS staffers were directly notified about how they must change the language they use when preparing budget documents, a shift is happening in other departments as well.

At the State Department, for example, employees received a guidance document on Wednesday 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.