I have only heard it uttered by Trump and people talking about Trump. Wikipedia tells me there really is a specific criminal enterprise commonly known as MS-13 that’s a real thing with real leadership conducting real violent criminal activities. But at the same time it seems like it’s a racial slur. I think it’s kind of like “mafia”, a word that once referred to a specific criminal organization but that turned into a sort of racial scare word as people started to assume that Italians were all mobbed up.
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