Fetus? Transgender? When it makes sense to ban words (as the CDC apparently did).

According to the Washington Post, the Trump administration has a list of words that analysts at the Centers for Disease Control aren’t supposed to use in budget requests. While banning words can make sense, the words that these officials picked were a pretty dumb way to politicize a scientific organization.

Here’s what the Post wrote, in an article called “CDC gets list of forbidden words: Fetus, transgender, diversity

Policy analysts at the Centers for Disease Control and Prevention in Atlanta were told of the list of forbidden terms at a meeting Thursday with senior CDC officials who oversee the budget, according to an analyst who took part in the 90-minute briefing. The forbidden terms are “vulnerable,” “entitlement,” “diversity,” “transgender,” “fetus,” “evidence-based” and “science-based.”

In some instances, the analysts were given alternative phrases. Instead of “science-based” or ­“evidence-based,” the suggested phrase is “CDC bases its recommendations on science in consideration with community standards and wishes,” the person said. In other cases, no replacement words were immediately offered.

To be clear, there’s some dispute about what happened. Here’s what CDC director Brenda Fitzgerald wrote on Twitter:

I want to assure you there are no banned words at CDC. We will continue to talk about all our important public health programs.

You may be understandably concerned about recent media reports alleging that CDC is banned from using certain words in budget documents. I want to assure you that CDC remains committed to our public health mission as a science- and evidence-based institution.

As part of our commitment to provide for the common defense of the country against health threats, science is and will remain the foundation of our work.

CDC has a long-standing history of making public health and budget decisions that are based on the best available science and data and for the benefit of all people—and we will continue to do so.

HHS [Health and Human Services] statement addressing media reports: “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 statement addressing media reports, continued: “HHS also strongly encourages the use of outcome and evidence data in program evaluations and budget decisions.”

This doesn’t fully address what happened. Clearly, somebody said something about these words at a budget meeting with analysts. But if you believe these statements, there is no “ban” on the seven words.

Rather than get into he said, she said questions, let’s address the broader issue: is it appropriate for companies to ban words, and would it ever make sense for the government to ban CDC from these words in particular?

By recommending and banning words, an organization makes a statement about what it is

Does it ever make sense to ban words? Sure it does.

Your organization probably has a style guide. If you check it out, you’ll see that it typically suggests words to use and not to use.

For example, unless you work for racist, sexist losers, it’s likely that no one at your organization is permitted to use ethnic slurs or words that are offensive based on gender. The New York Police are going to write arrest reports that mention “prostitutes,” not “whores,” for example.

I’ve recommended banning (or at least reducing) jargon wherever possible. Perhaps your organization, in an attempt to promote clarity, could ban words like “omni-channel” or “digital transformation.”

When I joined Forrester, there was a ban on using the word “savvy” in reports. The CEO had noticed that it was proliferating to the point of absurdity, and recommended that we find another, more thoughtful way to express ourselves. I could make a similar recommendation about “deeply,” which is a clear signifier of bullshit.

There’s a clear principle in each of these cases:

  • The banned word is offensive, obscure, or otherwise out of sync with the organization’s goals.
  • Use of the banned word makes writing less clear, not clearer.
  • There is an alternative for the banned word. For example, “savvy” might be better phrased as “knowledgeable,” “comfortable with technology,” or “expert” depending on context.

When a style guide makes these recommendations, it should describe the reason that words are banned or deprecated, and how best to reword passages to create a higher degree of clarity.

It’s entirely reasonable to suggest words based on an organizational philosophy (for example, salesforce.com offers a service, not software, which is part of its brand). As long as these rules don’t interfere with clarity and there is a simple, better way to write things, these sorts of differences are an important way that an organization can differentiate itself.

Do the banned words at CDC make sense?

With this in mind, what’s behind the banned words at CDC? Let’s take a close look at why such words might be banned, and how writing around them would reflect the organization’s values.

  • Entitlement” is a common term for government payments (for example, Social Security, Medicare, Medicaid, Welfare, Food Stamps). From the CDC’s perspective, it’s a shorthand way to describe these government programs. But Republicans may wish to limit the idea that people are “entitled” to those payments. (Of course, in the case of Social Security and Medicare, those who receive them presumably paid taxes to fund them over their lifetimes.) I can see how analysts making budget requests could be better served by referring to specific programs such as Medicaid rather than with the blanket term “Entitlements.” I rate this policy “Defensible.”
  • Vulnerable” and “diversity” reflect a political philosophy. I haven’t read many CDC reports, but it’s entirely possible that they overuse words like “vulnerable” (to refer to populations particularly subject to certain diseases, like poor people) and “diversity” (presumably, to reflect people of many ethnic groups). It’s within the CDC’s purview to study such groups. If people in low-income housing are more likely to be exposed to tuberculosis, or there is a differential effect of high blood pressure in African Americans, the CDC needs to know what causes those differences and how to fix them. I’m not sure there’s a better way to say vulnerable (susceptible? at risk?). “Diversity” might easily be an overused word (like “savvy” at my previous employer) — but again, how would you write around it? “Of varying ethnic groups”? “With a variety of different genders and races”? Since these words are clearer than the alternatives, I rate this policy “Questionable.”
  • Transgender” is a term that describes a type of human. Perhaps you believe (as I do) that transgender people are expressing their innate gender identity. Or perhaps you believe (as some conservatives do) that this is a questionable choice people make. Regardless of your philosophy, there’s still a justification for the CDC to study transgender people — for example, whether health providers understand how to treat them effectively, or how much or how little their health coverage costs. “Transgender” is a descriptive term without a simple equivalent. If the purpose of this ban is to reject research on transgender people, banning the word is a cowardly way to do it. I rate this policy “Stupid.
  • Fetus.” The CDC has to study pregnant women and effects of medications and treatments on the health of those women and their fetuses. According to scientific terminology, an embryo becomes a fetus nine weeks after fertilization, when its basic structures are discernible. What are we supposed to call what’s in the woman’s uterus? While an abortion opponent might elect to call it a “pre-born baby,” such a description is less precise and certainly out of step with the scientific literature. I rate this policy “Stupid.”
  • Evidence-based” and “science-based” describe the mission of the CDC — sorting out folk wisdom and fervent beliefs from actual scientific fact. For example, it is an evidence-based belief that sharing needles causes the transmission of the AIDS virus. This is not a value judgment, it is a scientific fact proven through demographic studies. It’s also a science-based belief that African Americans are the main population suffering from sickle-cell anemia, and that obesity is associated with heart disease and diabetes. None of these descriptions are value judgments about the groups involved, and that’s the point. The purported suggestion that CDC say that it “bases its recommendations on science in consideration with community standards and wishes” undermines the purpose of the organization, which is to ignore politics and focus on science and evidence. I rate this policy “Reprehensible.”

Above, I said that it’s acceptable to ban words when it’s in line with the philosophy of the organization, and where it adds clarity. In these cases, the banned words are mostly at odds with the philosophy of the organization, and they reduce clarity and replace it with politics. Liberal commentators are making the administration pay for this stupidity, and they’ve got ample justification.

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  1. If you work for a west coast college or university you got a “list of words” that you could no longer use on campus 3 years ago. That list was from the left……

  2. In medicine, vulnerable populations and diverse populations are not routinely studied. If we quit referring to them as such, does that mean we don’t need to spend money studying them? Same with transgender – if we should pretend such people don’t exist, will they just go away?
    Medical studies are known to have disproportionally large white, male, middle-class subjects, so seeing if effects are different in minorities is already difficult.
    And some of the CDC recommendations are already getting away from science- and evidence-based decisions, and more those of political expediency.