The CDC, Censorship, and MGM

by David Balashinsky

As has been widely reported during the past couple of days, the Trump administration has issued a list of words and phrases that scientists and policy analysts at the CDC are henceforth barred from using.  Among these verboten words are "science-based" and "evidence-based."  As the Washington Post reported this past Friday, "Instead of 'science-based' or ­'evidence-based,' the suggested phrase is 'CDC bases its recommendations on science in consideration with community standards and wishes.'"

This language is strikingly similar to that used by the American Academy of Pediatrics regarding its position on male genital mutilation.  The AAP has stated that "because the procedure is not essential to a child's current well-being, we recommend that the decision to circumcise is one best made by parents in consultation with their pediatrician taking into account what is in the best interests of the child, including medical, religious, cultural, and ethnic traditions."  In other words, the AAP's position regarding the pros and cons of MGM is that religious beliefs, cultural norms and ethnic traditions should be accorded just as much weight as scientific evidence (or more, since medical efficacy is only one of the four justifications offered here by the AAP).

Now the CDC, under the Trump administration, is likewise adopting an official position in which medical guidelines are to be established only insofar as they conform to prevailing cultural norms and religious beliefs which, it is not unreasonable to assume, is what is meant by the qualifier "in consideration with community standards and wishes."  With respect to MGM, this is not a change in actual policy by the CDC.  Way back in 2014, long before Putin's troll army swayed the election in favor of Trump (and Republican-engineered political gerrymandering swayed numerous down-ballot contests in favor of Republicans), the CDC came out strongly in support of MGM.  As the Associated Press reported at the time, although the CDC justified its proposed new guidelines ostensibly on the basis of the putative health benefits, the director of its National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention program, Jonathan Mermin, M.D., acknowledged, in a statement attributed to him by the AP (albeit not in a direct quote) that subjecting an infant to genital mutilation "is a personal decision that may involve religious or cultural preferences."

It is widely accepted that, in making its recommendation in support of MGM, the CDC was following the lead of the AAP.  And it is also widely accepted that the AAP's own 2012 policy statement recommending "access to this procedure for families who choose it"  reflected its own cultural bias in favor of MGM.  Thus, while it is not new that the CDC's pro-circumcision recommendations reflect a cultural and religious bias in favor of MGM, what is new is that it is now the explicit and official policy of the CDC, under Trump, that cultural and religious beliefs are to carry as much weight as science and ethics - if not more - in establishing this government agency's policies and recommendations.

For the cause of eradicating MGM, this could cut both ways.  On the one hand, it gives the CDC the Trump administration's imprimatur on behalf of issuing culture- and religion-based recommendations in support of MGM in the name of public health policy.  This could embolden the MGM enthusiasts within the CDC (as well as the AAP).  On the other hand, this new policy now means that not only is the CDC relieved of any obligation to justify its pro-MGM recommendations strictly on the basis of scientific evidence but it is now positively barred from doing so.  That should make it easier for intactivists to cite the religious and cultural bias inherent in the CDC's pro-MGM recommendations.