By Lacretia Pearson and Jeremy Hough
Words Matter in Public Health
In 2017, the U.S. Centers for Disease Control and Prevention reportedly advised staff to avoid words such as “transgender,” “diversity,” and even “evidence‑based” in official budget documents [1]. Eight years later, the fallout is measurable: marginalized communities are omitted from surveillance systems, grant proposals, and targeted outreach. Language is the first diagnostic; when we silence words, we risk silencing lives.
Censorship Creates Blind Spots
Sidestepping terms like *equity*, *LGBTQ*, or *implicit bias* doesn’t just limit academic debate—it disrupts core public‑health functions. Reduced visibility means prevention messages about PrEP, STI screening, or mpox vaccination never reach the people who need them most. Stigma grows as affirming language disappears, and data quality suffers when demographic fields are stripped from electronic records. As one community advocate notes, “When data doesn’t name us, policy doesn’t serve us.”
The Data Disappears, but the Risk Grows
Consider three data points that reveal the cost of erasure:
- 44 % of new global HIV infections in 2023 were among women and girls; in sub‑Saharan Africa the share was 62 % [5].
- $240 million in stalled medical cargo—including antiretrovirals, TB, and malaria drugs—sat idle in 2024 because of a temporary foreign‑aid pause [2, 3].
- Patients in Zambia reported rationing HIV medication despite formal “exemptions,” underscoring the human toll of supply disruptions [10]
California is hardly immune. San Francisco’s Ward 86, the nation’s first outpatient HIV clinic, and Stanford’s open‑access HIV Drug Resistance Database have saved countless lives worldwide [6, 7]. Yet even these centers of excellence feel the downstream effects when language changes threaten program funding and visibility.
Censorship Compromises Equity
When identity‑based terminology disappears, multiple harms follow: public‑health campaigns become vague, mental‑health outcomes worsen through reinforced isolation, and clinicians lose critical social‑risk cues that guide screening and care. Inaccurate or incomplete data lead to misallocated resources, leaving high‑risk populations underfunded and underserved.
What Public‑Health Leaders Must Do
- Maintain inclusive terminology in data tools. Ensure demographic questions capture gender identity, sexual orientation, and cultural identity.
- Protect community‑based data. Fund grassroots organizations to collect qualitative and quantitative insights.
- Ensure messaging specificity. Develop campaigns that acknowledge and directly address at‑risk populations.
- Train staff to recognize linguistic erasure. Empower teams to push back on harmful language changes.
- Link measurable gap metrics—not euphemisms—to funding decisions.
- Collaborate across disciplines. Work with legal and advocacy partners to keep inclusive terminology embedded in public‑health infrastructure.
Call to Action: Say It Clearly, Save Lives
Censorship isn’t neutral. When communities remain unnamed, they go underserved; when disparities stay unspoken, they deepen. From HIV to maternal health to mental well‑being, the integrity of public health rests on clear, precise, and inclusive language. Health leaders must speak up—because in public health, clarity isn’t just best practice; it’s life‑saving policy.
How You Can Make a Personal Impact
| Action | What it looks like in real life | Why it matters |
| Use precise, inclusive language—out loud and on paper. | Say “sexual‑ and gender‑diverse people” instead of shorthand; add pronouns to email signatures. | Normalizes visibility and prevents data erasure. |
| Share vetted resources. | Forward CDC LGBT Health fact sheets or Trevor Project crisis‑line info; post QR codes for local STI clinics. | Connects colleagues to evidence‑based support quickly. |
| Offer “micro‑mentorship.” | Schedule a 30‑minute coffee with a junior staffer who may feel isolated; ask how you can help. | One ally lowers turnover risk and boosts mental‑health outcomes. |
| Audit one form or policy you control. | Add an inclusive gender option to an intake or HR form. | Inclusive paperwork creates inclusive datasets. |
| Model respectful correction. | Briefly correct misused pronouns or stigmatic remarks and move on. | Maintains psychological safety without confrontation fatigue. |
| Host a five‑minute “data drop.” | Share one stat (e.g., 44 % of new HIV infections in women) at a huddle along with a patient‑safety takeaway. | Keeps teams outcome‑focused, not opinion‑driven. |
| Channel dollars where words fall short. | Donate one day of PTO pay—or the cost of a latte—to an LGBTQ+ youth shelter or global ARV nonprofit. | Micro‑giving aggregates quickly and stays apolitical. |
| Practice responsible amplification online. | Verify sources before sharing; add an evidence link (CDC, WHO, peer‑reviewed). | Sustains credibility and stifles misinformation. |
| Keep learning, then teach one thing forward. | Read a Lancet or JAMA brief each quarter; share an insight at a staff meeting. | Continuous learning diffuses expertise across teams. |
The way forward
Institutional challenges will persist wherever we serve, yet every effort to name disparities and widen access increases the net well‑being of our communities. As researcher‑storyteller Brené Brown has observed, “hope is a muscle”—one we strengthen by setting clear goals, persevering together, and believing in our collective capacity to change outcomes [11]. Let’s keep training that muscle.
References
- Sun L. CDC gets list of forbidden words: fetus, transgender, diversity. The Washington Post. 2017.
- Dyer O. US foreign aid pause disrupts HIV treatment. BMJ. 2024.
- World Health Organization. Statement on Global HIV Supply Chain Disruption. 2024.
- PEPFAR. Annual Report to Congress on HIV/AIDS Programs. Office of the U.S. Global AIDS Coordinator. 2024.
- UNAIDS. Global HIV & AIDS Statistics – Fact Sheet. 2023.
- UCSF Ward 86. About the Clinic. 2024.
- Stanford HIV Drug Resistance Database. Global Impact Report. 2024.
- Movement Advancement Project. Mapping LGBTQ Policy Gaps in Public Health. 2024.
- GLAAD. State of LGBTQ Visibility in Public Health Communications. 2023.
- Aizenman N. HIV drugs are stuck at ports and teens in Zambia are rationing their meds. NPR Goats & Soda. 20 Apr 2025.
- Brown B. *Braving the Wilderness: The Quest for True Belonging and the Courage to Stand Alone*. Random House; 2017.
