Who Needs Facts Anyway? The New Era Of ‘Ignorance Is Strength’
This commentary is a repost from “Sex on Wednesdays” by Martha Kempner on Substack. Find her other articles on The Queen Zone here.
In my increasingly failing efforts to focus my outrage on one thing at a time, I spent this week horrified by the scrubbing of useful resources from government websites (while trying to ignore the myriad of other power grabs).
The Government’s New Favorite Hobby: Erasing Reality
In addition to putting a gag order on the CDC, the Trump administration ordered the purging of information while websites were reviewed. The target appeared to be any words or phrases that acknowledged the existence of trans people (like LGBTQ or pregnant people), but the implications went far beyond that.
Hope You Didn’t Need Those STI Guidelines, Because They’re Gone
The prescribing guidelines for contraception and the screening and treatment guidelines for STIs were unavailable on the CDC site for some time last week. Though I use these resources quite frequently in my work (because let’s make this all about me), they’re really designed for clinicians who need to know what tests to order and what medications to prescribe.
HIV.gov Is Now a Nostalgia Site—Welcome Back to 2020!
In another (all about me) example, I went to HIV.gov to see what had changed. A few years ago I helped create an informational website about HIV for a client. One of the foundational pages explained the government’s response to the HIV epidemic and plans for reducing new infections in the United States by 90% by 2030. With PrEP to prevent transmission and drugs for people living with HIV that suppress the virus to the point that it is undetectable and untransmissible, we have the tools to do that.
Trump’s Plan vs. Biden’s Plan: They Coexisted… Until Now
In his first administration, Trump created a plan to end the epidemic and invested in it. The plan pushed resources toward geographic areas of the country (like the South) with high HIV rates. It was a good first step. What the plan didn’t do was focus on gay men, communities of color, and other marginalized communities that also face high HIV rates. The Biden administration came in and added to it. That strategic plan put an emphasis on reducing HIV-related disparities and health inequities.
Trump’s plan, which he’d announced in the 2019 State of the Union Address, already had a lot of funding tied to it, and programs had started when Biden took office in 2021. Biden did not cancel that plan or pull the funding from those programs. The two plans lived in harmony during the Biden administration because there’s no need to be politically petty when you’re making public health progress.
The Latest Update: Just Kidding, It’s 2019 Again
As you can imagine, that’s not the case today. HIV.gov was sent back to 2020 and talks only about the “bold plan put in place by President Trump.” Worse, when you click the link labeled “the impact of HIV on racial and ethnic minorities,” you get a big fat “404: Page Not Found” error.
Congratulations, Private Organizations! You’re Now the CDC
Organizations and individuals are stepping up to the plate to make sure that the information once housed on government websites is not lost forever. The American College of Obstetricians and Gynecologists (ACOG) has said it will host certain pages that its members rely in including the CDC’s U.S. Medical Eligibility Criteria for Contraceptive Use, the U.S. Selected Practice Recommendations for Contraceptive Use, and the 2021 Sexually Transmitted Infections Treatment Guidelines. The American Sexually Transmitted Disease Association (ASTDA) has posted CDC data sets, STI Surveillance Reports dating back to 1997, and clinical guidelines to its site. Journalist and abortion rights advocate Jessica Valenti is also hosting CDC documents on her Substack site Abortion, Everyday. The Skimm, a daily newsletter, brought back all of the information on ReproductiveRights.gov which was completely taken offline. The content of the site as it was on January 15th (before our national nightmare began in earnest) can now be found at reproductiverightsdotgov.com.
A Judge Stepped In! Will the Government Pretend to Care?
As I was writing this, U.S. District Judge John Bates in Washington issued a temporary injunction that directed the Office of Personnel Management and HHS (which includes the CDC and the FDA) to restore the websites for now. This decision was part of a case brought by Doctors for America, a not-for-profit group representing more than 27,000 physicians and medical trainees.
The group’s attorneys pointed to two members who were directly impacted by the missing information: a Yale School of Medicine doctor who relies on CDC resources about contraceptives and sexually transmitted infections and a Chicago clinic doctor who would have consulted CDC resources to address a chlamydia outbreak in a local high school. (I’m hoping the attorneys also noted how many more high school chlamydia outbreaks we’re gonna get if we combine missing information with the inevitable return of abstinence-only-until-marriage programs, but I doubt the arguments went there.)
A Shocking Twist: Deleting Public Health Data Is Bad for Public Health
The Judge agreed that the scrubbing of information harmed everyday Americans. He wrote, “If those doctors cannot provide these individuals the care they need (and deserve) within the scheduled and often limited time frame, there is a chance that some individuals will not receive treatment, including for severe, life-threatening conditions.”
Just Because a Court Said “Put It Back” Doesn’t Mean They Will
This is potentially good news, but we were reminded this week that court decisions rely on the same gentleman’s agreement to follow the rules that kept the pre-McConnell Congress in check. The Musk administration (see what I did there) has declared itself above the law, and Vance argued that the judiciary isn’t allowed to control the executives legitimate power. This had me up at night thinking about the Hobbesian State of Nature and how we all agree to be bound by laws because without them life would be solitary, nasty, brutish, and short. What happens when the people at the top stop abiding by that agreement? In another game-time update, Trump just said he would abide by the courts while whining about how slow the appeals process is. (I only feel mildly less terrified.)
Even if the administration does follow Judge Bates’s decision and restores all websites to their mid-January glory, we will have a problem going forward. These websites are meant to give us the most up-to-date information, and it’s very unclear what government agencies will be allowed to do/say/update moving forward. Will the CDC keep tracking infectious disease at all? Will it keep tabs on bird flu but not STIs? Will it track STIs but not in gay men? Will everything it publishes be carefully reviewed by political appointees to the point that we don’t trust what it says?
Science Can’t Science If Scientists Aren’t Allowed to Speak
Inside Medicine reported this week that the CDC has instructed scientist to pause the publication of any research manuscript that is being considered by any medical or scientific journal. That means pulling these studies from external peer review so they can be internally reviewed for the use of those forbidden terms which also include gender, non-binary, assigned female at birth, etc. This is causing outrage and a hell of a lot of confusion. Pretty much all scientific papers start with the demographics of the participants and most ask for gender (though to further confuse us all, the answer is often more about biological sex).
The Plan to “Make Americans Healthy Again” Sounds a Lot Like “Stop Collecting Data”
According to some people inside the CDC, researchers are being overly cautious about what to pull. One CDC staff called it “vorauseilender Gehorsam,” a German phrase that translates to “preemptive obedience.” And because the gag order is still in place, once anyone pulls their paper, they can’t resubmit it.
RFK, Jr. has vowed to Make Americans Healthy Again, but this plan feels more like “Stop Collecting Data and Then We Won’t Know if Americans Are Healthy or Not.” I guess SCDATWWKIAAHON doesn’t have the same ring.
