The CDC word ban: an attack on the patients I treat

When I read the Washington Post article about the CDC censoring seven words last Friday night, my mind immediately jumped to the youth I take care of every day in my Baltimore clinic.  It felt like a direct attack on the very patients I became a doctor to treat: the transgender young person initiating gender-affirming hormone treatment; the young woman seeking inpatient addiction treatment for the first time after watching her best friend die by overdose; the young man who stopped antidepressants after losing his health insurance, only to find solace in the mind-numbing blur of heroin.  These diverse, vulnerable, yet resilient youth stand at such a critical turning point in their lives. They have too often been made to feel invisible, and offering them evidence-based clinical care can be life-saving.

Science and evidence are the backbones of medicine and public health. As the nation’s foremost public health agency, the CDC serves as a trusted source of health information for physicians and patients alike, on topics ranging from teen pregnancy prevention and LGBT care, to school-based health centers and health disparities.  CDC funded research and grant programs serve a vital role in the expansion and dissemination of knowledge. Thus yes, we can take some reassurance in CDC Director Brenda Fitzgerald’s announcement that the CDC will continue to value science and evidence.

I remain worried, however, about the five other words included in that initial list: “vulnerable,” “entitlement,” “diversity,” “transgender,” and “fetus;” not a day goes by that I do not provide medical care directly related to one of them. In the several days following the initial Washington Post article, we have heard explanations that these words are not “banned,” but were merely “suggestions” to CDC employees about what to avoid writing about so that the GOP-dominated Congress will like their budgets. This explanation is no more comforting.  Adolescents like my patients have unique needs and require developmentally and culturally appropriate care. Funding for the research needed to develop, implement, and disseminate best practices related to that care is already far too limited.  We cannot afford to lose any additional resources because scientists and administrators are discouraged from or afraid to propose projects for political reasons.  By writing them out of government budgets, these people are being treated as if they are unimportant or invisible.

When the people who need help the most are abandoned by their government to satisfy the ideological demands of a select few, their voices are being silenced.  Those voices deserve to be heard: in the newspaper, in the medical journals, on the radio, on our government’s websites, and in government-funded programing and grants. In today’s heated political climate, it is easy to adopt an “us versus them approach,” to see these seven words as a dividing line. But valuing diversity and protecting the rights of the vulnerable is not a political agenda – it is a human agenda. As American citizens and humans, we must stick together and show those that threaten these freedoms that we will not let the vulnerable be erased.

Rachel Alinsky is an adolescent medicine physician.

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