Last Thanksgiving, while the rest of us were trying not to start a fight at the dinner table, President Trump started one on the internet. He took to Truth Social to call Minnesota Gov. Tim Walz “seriously retarded.” When a reporter later pointed out that many people consider the term a slur, Trump doubled down. “Yeah,” he said. “I think there’s something wrong with him.”
Soon, use of the R-word on X had tripled, according to research by two professors at Montclair State University. This is part of a pattern, study co-author Bond Benton told me. “The use of slurs in general is up,” he explained. “But nothing comes near the numbers we’re seeing on the R-word.”
The upswing actually kicked off 10 months before Trump’s Thanksgiving rant, when his frenemy Elon Musk responded to a critic on X by deploying the slur. That also caused its use on the platform to triple, according to an earlier report by Benton and his colleagues.
Musk’s embrace of the term struck me as particularly foreboding, because he has publicly described himself as having Asperger’s — a now-retired autism diagnosis that specifically excluded people with intellectual disability. His role in the R-word’s revival reads to me like a man trying to prove he’s the right kind of neurodivergent. The genius kind. The productive kind.
The resurgence of the R-word, I have come to believe, is fueled by a foundational American contradiction. We insist that every human life has equal worth. Then, when deciding who deserves the government’s help, we make clear that a person’s worth is something you earn. The intellectually disabled — many of whom, through no fault of their own, can’t support themselves — force us to confront that contradiction.
Since returning to office, Trump has signed the largest cuts to Medicaid in the program’s history — which will likely force states to slash the services disabled people rely on to live at home. His administration has also proposed a Social Security rule that will cut or eliminate benefits for as many as 400,000 disabled and elderly recipients who live with relatives. Perhaps most insidiously, the Justice Department recently issued a legal opinion rejecting the long-standing view that federal disability law requires states to provide services in integrated settings, weakening protections against unnecessary institutionalization.
In this light, Trump’s championing of the R-word seems almost strategic. Our bully-in-chief is signaling who counts and who can be mocked freely — clearing the cultural ground so that the suffering to come will be easier to stomach.
All of this is personal to me. Ever since learning several years ago that I’m neurodivergent (I’m face blind) I have promoted the idea that our deficits often come with gifts. Behold: the autistic engineer, the dyslexic CEO, the entrepreneur with ADHD. The revival of the R-word has forced me to see the problems with this line of reasoning. At root, I have been making the same case that Trump and Musk have implicitly advanced: that we need to separate the bright from the burdensome, and that the only neurodivergent people worth celebrating are the useful ones.
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The 1970s and ’80s marked a major transformation in American attitudes toward intellectual disability. The Special Olympics became a national movement. Television audiences met Corky Thatcher on “Life Goes On,” the first major recurring character with Down syndrome, played by an actor with the condition. School assemblies preached inclusion. Teachers emphasized acceptance.
Undergirding this cultural shift were sweeping legal and structural changes. State institutions that had warehoused people with intellectual disabilities for generations were the subject of exposés, which triggered a wave of reform. The institutions began to empty out; tens of thousands of people who had spent their lives behind locked doors moved back into their communities — often into group homes or other supportive housing. Then, in 1975, Congress passed the Education for All Handicapped Children Act, declaring that disabled children had a legal right to a free public education.
The law required schools, “to the maximum extent appropriate,” to educate disabled children alongside their nondisabled peers. But in practice, that mandate went largely unenforced. Disabled kids were inside the school building, but not, for the most part, inside the classroom. They were routed into special-education wings, taught by separate teachers and, most visibly, delivered each morning on their own smaller buses. It wasn’t until a string of lawsuits in the 1980s and ’90s that the law’s integration mandate began to be enforced in earnest.
It’s hard to imagine a better incubator for a slur. Before 1975, nondisabled children rarely encountered a child with an intellectual disability; the institutions had made sure of that. Now those kids were everywhere — on the playground, down the hall, across the cafeteria. It was a group that nondisabled kids could see and point to but generally did not interact with. Neurotypical children needed a word for these people, and the vocabulary was sitting right there: “Mentally retarded” was the official clinical term.
It was, in retrospect, a story of both progress and backlash. Americans were becoming more comfortable seeing people with intellectual disabilities in public but did not accept them as equals. And so the kids who grew up alongside classmates with intellectual disabilities turned the R-word into a ubiquitous slur.
Eventually, the word became so widespread that it lost its moorings to intellectual disability and became a catch-all insult for anything considered stupid, uncool or embarrassing. Often, kids who used it weren’t consciously trying to mock people with intellectual disabilities. But the slur depended on the shared assumption that being likened to someone with an intellectual disability was inherently degrading.
This fact isn’t lost on the intellectually disabled. Even when the R-word is not being aimed directly at people with intellectual disabilities, it’s still hurtful, says Madeline Stuart, a model with Down syndrome. “Jokes are meant to be funny, so if you are using this word, you are making us feel like we are the joke,” she told me via email.
For a while, the R-word operated as both a slur and a technical term. The same word that snotty kids were using as an insult was the word a clinician would write down in earnest. The first major organized effort to retire it — a public-service campaign called “Spread the Word to End the Word”— launched in 2009. The R-word ceased to be the official federal term the following year, though it remained a clinical term until 2013, when the psychiatry bible known as the DSM (Diagnostic and Statistical Manual of Mental Disorders) finally swapped it for “intellectual disability.”
The campaigns of the 2000s and 2010s succeeded in changing the R-word’s social status. The problem was that they didn’t uproot the hierarchy beneath it. After all, “idiot,” “moron” and “imbecile” — words that also once served as technical terms for intellectual disability — were still part of everyday language. Well before Trump, a low IQ was viewed as a character defect, a punch line, an insult. The intellectually disabled are probably the last category of human beings whom polite society still treats as inherently contemptible. And that left the R-word ready to be revived by a political movement eager to say aloud what many already believed.
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Keith MacCallum, 67, spent the better part of the last decade trying to move his sister Dawn, 57, from Florida to Maryland, where he lives. Dawn has an intellectual disability and a seizure disorder, and she requires expensive, full-time care. After many years on Florida’s wait list, she received an “HCBS waiver” granting her access to home- and community-based services — an alternative to being institutionalized. But Medicaid’s home- and community-based services are administered state by state; her Florida benefits could not simply follow her across the border.
Dawn spent years cycling through institutions — and that changed her, MacCallum says. “She was a lot more vivacious and outgoing and interactive earlier,” he says. “She’s been through group homes and hospitals ... and I think all that just, you know, wears you down.”
Eventually, Dawn was able to get a waiver in Maryland, allowing her to move. Currently, however, more than 600,000 people are on waiting lists for these waivers nationwide and that number is likely to balloon now that Trump’s One Big Beautiful Bill will reduce federal Medicaid spending by $911 billion over the next 10 years.
Underlying these policy changes is the idea that people who cannot contribute to the economy are merely costs to be managed, not fellow citizens in need. You can always count on Health and Human Services Secretary Robert F. Kennedy Jr. to say the quiet part out loud. Consider his (inaccurate) description of autistic children: “These are kids who will never pay taxes, they’ll never hold a job, they’ll never play baseball, they’ll never write a poem, they’ll never go out on a date. Many of them will never use a toilet unassisted.” Notice what came first in his list: taxes and a job.
The neurodiversity community immediately pushed back. Two of RFK Jr.’s cousins are advocates for disability rights — Anthony Shriver founded Best Buddies International, which helps people with intellectual disabilities, and Timothy Shriver chairs the Special Olympics — and they wrote a joint statement pointing out that autistic people “can and will continue to date, hold jobs, marry, and pay taxes.” Several autistic people, including Dani Bowman of Netflix’s “Love on the Spectrum,” pointed to their own lives as counterexamples, noting their jobs and achievements.
While these rebuttals were powerful, I couldn’t help but notice who they de-emphasized: people who will never hold jobs, earn degrees or pay taxes. When we do this, we effectively concede a dangerous point: that some people’s lives are more valuable than others’ and that a person’s productivity determines their worth.
It can be hard to pack both ideas into the same sound bite, as Colin Killick, the executive director of the Autistic Self Advocacy Network, pointed out to me recently. One strategy, he said, is to include intellectually disabled people in your litany of counterexamples. “I think it is important for us to remember to speak for and to the entire community,” he told me. “And I do think that highlighting autistic people’s achievements, especially the capacities of autistic people who are nonspeakers or who have an intellectual disability, is really critically important.”
I agree, but I think it’s even more important to state what we are all supposed to believe: Every human life has equal value. I know it feels preachy and obvious, but when that principle is under explicit attack, saying it matters.
Dawn will never write code or start a company. She will never pay taxes or hold a job. And none of that has anything to do with what she is owed: food, health care, community, safety, dignity and respect. Until we can say that — and mean it and fund it — we haven’t ended the slur. We’ve only kept it from being pointed at us.
Sadie Dingfelder is a neurodiversity advocate and author of “Do I Know You? A Faceblind Reporter’s Journey into the Science of Sight, Memory and Imagination.”