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    Hilary Cass Says U.S. Doctors Are ‘Out of Date’ on Youth Gender Medicine

    Dr. Hilary Cass published a landmark report that led to restrictions on youth gender care in Britain. U.S. health groups said it did not change their support of the care.After 30 years as one of England’s top pediatricians, Dr. Hilary Cass was hoping to begin her retirement by learning to play the saxophone.Instead, she took on a project that would throw her into an international fire: reviewing England’s treatment guidelines for the rapidly rising number of children with gender distress, known as dysphoria.At the time, in 2020, England’s sole youth gender clinic was in disarray. The waiting list had swelled, leaving many young patients waiting years for an appointment. Staff members who said they felt pressure to approve children for puberty-blocking drugs had filed whistle-blower complaints that had spilled into public view. And a former patient had sued the clinic, claiming that she had transitioned as a teenager “after a series of superficial conversations with social workers.”The National Health Service asked Dr. Cass, who had never treated children with gender dysphoria but had served as the president of the Royal College of Pediatrics and Child Health, to independently evaluate how the agency should proceed.Over the next four years, Dr. Cass commissioned systematic reviews of scientific studies on youth gender treatments and international guidelines of care. She also met with young patients and their families, transgender adults, people who had detransitioned, advocacy groups and clinicians.Her final report, published last month, concluded that the evidence supporting the use of puberty-blocking drugs and other hormonal medications in adolescents was “remarkably weak.” On her recommendation, the N.H.S. will no longer prescribe puberty blockers outside of clinical trials. Dr. Cass also recommended that testosterone and estrogen, which allow young people to develop the physical characteristics of the opposite sex, be prescribed with “extreme caution.”We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More

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    Richard Tandy, Keyboardist for Electric Light Orchestra, Dies at 76

    He helped shape the band’s futuristic sound, which blended Beatles-esque pop with orchestral arrangements.Richard Tandy, the keyboardist for the British rock band Electric Light Orchestra, who helped shape the futuristic blend of Beatles-esque pop and orchestral arrangements that catapulted the group to global fame in the 1970s, has died. He was 76.His death was announced by Jeff Lynne, the band’s frontman and leader, in a social media post. Mr. Lynne, who called Mr. Tandy his “longtime collaborator,” did not specify when Mr. Tandy had died or the cause of death.Born on March 26, 1948, in Birmingham, England, Mr. Tandy joined E.L.O. after the release of its first album in 1972. He initially played bass guitar but became the group’s keyboardist after another member left.Mr. Tandy remained a core member of the band through ever-changing lineups, alongside Mr. Lynne and the drummer Bev Bevan, until it disbanded in 1986. He was Mr. Lynne’s “multi-instrumentalist, co-orchestrator and valued musical partner,” the Rock & Roll Hall of Fame said when it inducted E.L.O. in 2017. When Mr. Lynne revived the band in the 2000s, Mr. Tandy was the only other longtime member to participate. More

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    The Question of Transgender Care

    Hilary Cass is the kind of hero the world needs today. She has entered one of the most toxic debates in our culture: how the medical community should respond to the growing numbers of young people who seek gender transition through medical treatments, including puberty blockers and hormone therapies. This month, after more than three years of research, Cass, a pediatrician, produced a report, commissioned by the National Health Service in England, that is remarkable for its empathy for people on all sides of this issue, for its humility in the face of complex social trends we don’t understand and for its intellectual integrity as we try to figure out which treatments actually work to serve those patients who are in distress. With incredible courage, she shows that careful scholarship can cut through debates that have been marked by vituperation and intimidation and possibly reset them on more rational grounds.Cass, a past president of Britain’s Royal College of Pediatrics and Child Health, is clear about the mission of her report: “This review is not about defining what it means to be trans, nor is it about undermining the validity of trans identities, challenging the right of people to express themselves or rolling back on people’s rights to health care. It is about what the health care approach should be, and how best to help the growing number of children and young people who are looking for support from the N.H.S. in relation to their gender identity.”This issue begins with a mystery. For reasons that are not clear, the number of adolescents who have sought to medically change their sex has been skyrocketing in recent years, though the overall number remains very small. For reasons that are also not clear, adolescents who were assigned female at birth are driving this trend, whereas before the late 2000s, it was mostly adolescents who were assigned male at birth who sought these treatments.Doctors and researchers have proposed various theories to try to explain these trends. One is that greater social acceptance of trans people has enabled people to seek these therapies. Another is that teenagers are being influenced by the popularity of searching and experimenting around identity. A third is that the rise of teen mental health issues may be contributing to gender dysphoria. In her report, Cass is skeptical of broad generalizations in the absence of clear evidence; these are individual children and adolescents who take their own routes to who they are.Some activists and medical practitioners on the left have come to see the surge in requests for medical transitioning as a piece of the new civil rights issue of our time — offering recognition to people of all gender identities. Transition through medical interventions was embraced by providers in the United States and Europe after a pair of small Dutch studies showed that such treatment improved patients’ well-being. But a 2022 Reuters investigation found that some American clinics were quite aggressive with treatment: None of the 18 U.S. clinics that Reuters looked at performed long assessments on their patients, and some prescribed puberty blockers on the first visit.Unfortunately, some researchers who questioned the Dutch approach were viciously attacked. This year, Sallie Baxendale, a professor of clinical neuropsychology at the University College London, published a review of studies looking at the impact of puberty blockers on brain development and concluded that “critical questions” about the therapy remain unanswered. She was immediately attacked. She recently told The Guardian, “I’ve been accused of being an anti-trans activist, and that now comes up on Google and is never going to go away.”We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More

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    ‘Extreme’ US anti-abortion group ramps up lobbying in Westminster

    A rightwing Christian lobby group that wants abortion to be banned has forged ties with an adviser to the prime minister and is drawing up ­policy briefings for politicians.The UK branch of the US-based Alliance Defending Freedom (ADF) has more than doubled its spending since 2020 and been appointed a stakeholder in a parliamentary group on religious freedoms in a role that grants it direct access to MPs.The ADF’s efforts to boost its UK influence are revealed as part of an Observer analysis that shows a surge in activity within the wider anti-­abortion movement.Ahead of a historic vote on abortion later this spring, in which MPs will vote on a law that would abolish the criminal offence associated with a woman ending her own pregnancy in England and Wales, several anti-abortion campaign groups have expanded their teams, ramped up advertising and coordinated mass letter-writing campaigns targeting MPs.The findings have led to calls for greater transparency and accountability over the groups’ funding and lobbying activities. The ADF in particular is an influential player on the US Christian right and part of a global network of hardline evangelical groups that were a driving force behind the repeal of Roe v Wade – the supreme court ruling that gave women the constitutional right to abortion and was overturned in 2022.The group – which also supports outlawing sexual acts between consenting LGBTQ+ adults and funds US fringe groups attacking gay, trans and abortion rights – has faced claims its funding is not transparent due to its use of donor advised funds: a loophole in US charity law that allows people to give millions anonymously.The latest financial accounts for its UK entity ADF International UK, published last week, show it spent almost £1m in the year to June 2023, up from £392,556 in 2020, and that its income almost doubled between 2022 and 2023, from £553,823 to £1,068,552.ADF International UK, which has argued publicly against decriminalising abortion, has sought to develop closer relationships with MPs. Its latest accounts show a focus of its UK activity has been attempting to engage with “significant decision-makers” and that staff provided “briefing material and legal analysis” to several MPs ahead of a vote on introducing buffer zones to prevent anti-abortion activity outside abortion clinics.In September 2023 it spent £1,737.92 flying the prime minister’s special envoy on freedom of religion and beliefs, Fiona Bruce MP, paying for her hotel and travel to attend an unspecified conference. Last month Bruce – who reports directly to Rishi Sunak – appeared at an event sponsored by ADF International on religious freedom, speaking remotely alongside two members of the charity.Number 10 did not respond to questions about the links between the ADF and Bruce, who declared the donations in the MPs register of interests and previously voted against legalising abortion and same-sex marriage in Northern Ireland. Calls and emails to her office went unanswered late last week.View image in fullscreenHeidi Beirich, co-founder of the Global Project Against Hate and Extremism, said the ADF had “ramped up its spending” in the UK and Europe “aggressively” in recent years and that there was “no transparency” around “where the money’s actually coming from”. She said its relationship with MPs raised “huge concerns”. “Why are politicians openly working with an organisation that has such a hateful agenda?”Rose Whiffen, senior research officer at Transparency International UK, said the donations to Bruce raised questions about conflicts of interest and that her association with the group could give it credibility in the UK.Andrew Copson, chief executive of Humanists UK, said it was “very concerning” that the UK’s envoy on religious freedoms was “accepting donations from organisations that use religious liberty as a way of denying others their human rights”. “The Christian nationalist movement is increasingly investing in the UK on a number of fronts, and all supporters of freedom and choice should take seriously the threat to human rights that this represents,” he said.ADF International UK said it was committed to protecting “liberties dear to the British people” including free speech and freedom of religion, and that its stance on abortion aimed to “protect the lives of both mother and baby in every pregnancy”. “Like much of the British public, we are concerned about political initiatives to further liberalise abortion law,” a spokesperson added.The charity, which has an office in Westminster, said it received funds from many countries, like “many UK charities on both sides of the abortion debate”; that claims it was not transparent about its funders were “baseless” and that it complied with all charity regulations. It did not comment on its link to the PM’s special envoy.View image in fullscreenJonathan Lord, co-chair of the British Society of Abortion Care Providers and a consultant gynaecologist, said: “We’ve known for some time that these extreme groups from America are infiltrating the UK, having been emboldened following the US supreme court’s actions removing women’s right to abortion there. However the scale of their spending and influence in the UK is disturbing, especially as we know they are actively lobbying MPs and want to restrict women’s reproductive rights, whether that is fertility treatment, contraception or access to abortion.”Other anti-abortion groups have also ramped up activity here in recent months. Right to Life, a leading UK anti-abortion charity, has been coordinating a lobbying campaign encouraging people to write to their MPs to tighten abortion laws, and spent £117,000 on Facebook ads in 2023, 10 times the amount in 2020.The charity – whose overall spending overall has risen from £200k in 2019 to £705k last year – also provides the secretariat to the Pro-Life all-party parliamentary group and aims to “deepen and expand relationships with parliamentarians”, according to its latest accounts. It is currently advertising vacancies for eight full-time staff and says in one ad that the role will include “producing briefings” for MPs and peers.The Centre for Bio-Ethical Reform UK – another anti-abortion group, which notoriously launched a billboard campaign featuring graphic images in pro-choice MP Stella Creasy’s constituency – has increased its staff numbers from four to 12 since 2017. Due to its status as a small company, it does not have to publish details of its income but said it was happy to engage in public debate about its “funding, growth and activities” and that its targeting of Creasy “does not equate to animosity towards her as a fellow human being”.MPs are due to vote in the coming weeks on proposed changes to abortion law that would see abortion decriminalised in England and Wales, as it is in Northern Ireland, Australia, France and New Zealand. Under a Victorian-era law that remains in place today, it is an offence to procure your own abortion. There are exemptions under the 1967 Abortion Act, which permits abortion in cases where two doctors agree that continuing the pregnancy would be risky for the physical or mental health of the woman. But the old law was never repealed and is still used today to prosecute and jail women for terminating pregnancies without sign-off from medics or after the 24-week limit.The proposal on decriminalisation from backbench Labour MP Diana Johnson has cross-party support and is expected to pass. However some in the Labour party fear it could be counterproductive and further embolden anti-abortion campaigning on related issues, such as the remote access to abortion that was introduced during the pandemic.A government spokesperson said abortion was an “extremely sensitive issue” with “strongly held views on all sides of the discussion”, and that MPs would have a free vote on the proposed law change. “By longstanding convention, any change to the law in this area would be a matter of conscience for individual MPs rather than the government,” a spokesperson said. More

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    Another Setback for Rishi Sunak in a Local Election

    Prime Minister Rishi Sunak’s Conservative Party is trailing the opposition Labour Party in opinion polls.Britain’s governing Conservative Party, which is trailing badly in the opinion polls, lost one of its safest parliamentary seats on Friday in a significant new setback for the prime minister, Rishi Sunak, who was also awaiting the result of another closely watched contest.Voting in the two Conservative strongholds of Tamworth and Mid Bedfordshire took place on Thursday to replace two of the party’s lawmakers — one of whom quit after an allegation of sexual assault — and came as Britain’s health care system faces acute strain and its economy stagnates amid high inflation.The first result, announced early Friday, from Tamworth, is a stinging blow to Mr. Sunak, who, since he became prime minister last year following the brief and disastrous leadership of Liz Truss, has failed to close a persistent double-digit deficit in the opinion polls against the opposition Labour Party. The stakes are high because Mr. Sunak must call a general election within the next 15 months.In Tamworth, northeast of Birmingham, the vote was to replace Chris Pincher, the former Conservative lawmaker who had represented the district. He resigned from Parliament after a drunken incident in which, it was alleged, he had groped two men. In the 2019 general election, Mr. Pincher won with a majority of 19,634. On Friday that was overturned when Sarah Edwards for Labour won 11,719 votes, and the Conservative candidate, Andrew Cooper, won 10,403.“Tonight the people of Tamworth have voted for Labour’s positive vision and a fresh start,” Ms. Edwards told her cheering supporters after the result. “They have sent a clear message to Rishi Sunak and the Conservatives that they have had enough of this failed government.”Keir Starmer, leader of the Labour Party, described the vote as “a phenomenal result that shows Labour is back in the service of working people and redrawing the political map.”In a statement, he added: “To those who have given us their trust, and those considering doing so, Labour will spend every day acting in your interests and focused on your priorities. Labour will give Britain its future back.”A result was also expected early Friday from the vote in Mid Bedfordshire, around 50 miles north of London, to replace Nadine Dorries, a former cabinet minister and prominent supporter of Boris Johnson, who quit as prime minister last year.Analysts caution against over-interpreting the results of these types of local contests — known as by-elections — where there is no prospect of the result changing the government, and voters often cast their ballots to register a protest against the governing party. Less than 36 percent of registered voters turned out to vote in Tamworth; in Mid Bedfordshire the number was higher, at 44 percent.Because the Conservatives won so convincingly at the last general election, in 2019, Labour still has an electoral mountain to climb if it is to win a clear majority the next time Britons are asked to decide who should govern them.Yet, the scale of the switch of votes does not bode well for Mr. Sunak, suggesting that even some of his Conservative Party’s more secure strongholds are no longer impregnable.Mr. Sunak was praised for restoring some measure of stability after Ms. Truss’s economic plans roiled the financial markets and she became the country’s shortest lived prime minister in history. But he has struggled to win over the British public after 13 years of Conservative government.In recent weeks, Mr. Sunak has tried to seize the political initiative with a series of eye-catching decision: scaling back climate change targets, canceling the second phase of a high-speed rail project, announcing new measures to phase out the sale of cigarettes to young people and proposing a shake-up the high school examination system.Little electoral reward appears to have flowed from these announcements, however, three of which were made at the Conservative Party’s annual conference in Manchester earlier this month.That meeting was distracted by a high-profile appearance by Ms. Truss, and by scarcely concealed jockeying from those who see themselves as contenders for the party leadership, should the Conservatives lose the general election.By contrast, Labour’s conference in Liverpool, the week after, presented a more unified and confident image of a party that sees itself as close to power.Friday’s results are the latest in a succession of election setbacks for Mr. Sunak. In July Labour won a by-election in Selby and Ainsty, in the north of England, overturning a Conservative majority of more than 20,000.Earlier this month, Labour unseated the Scottish National Party from the Rutherglen and Hamilton West district, in a result that underscored a revival of the main opposition party’s fortunes in Scotland. Success there during the next general election could significantly improve Labour’s prospects of forming the next government. More

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    How America Made James Bond ‘Woke’

    After so many decades fighting evil masterminds bent on Britannia’s destruction, the 21st-century version of James Bond has found a very 21st-century antagonist. In the newest Bond novel, “On His Majesty’s Secret Service,” 007 is charged with protecting King Charles III from a dastardly plot hatched by a supervillain whose nom de guerre is Athelstan of Wessex — in other words, a Little Englander, a Brexiteer, a right-wing populist, apparently the true and natural heir to Goldfinger and Blofeld.The novel’s Bond, who carries on a “situationship” with “a busy lawyer specializing in immigration law” (not to worry, he’s not taking advantage, “he wasn’t the only man she was seeing”), must travel to Viktor Orban’s Hungary to infiltrate the vast right-wing conspiracy and avert a terrorist attack at Charles’s coronation; along the way the secret agent muses on the superiority of the metric system and the deplorable dog whistles of populism.The book’s mere existence seems designed to agitate conservatives; I wouldn’t have read it without the spur of hostile reviews from right-of-center British scribblers. But the progressive Bond also usefully illustrates an interesting feature of contemporary politics in the English-speaking world. It isn’t just that American progressivism supplies an ideological lingua franca that extends across the Anglosphere, such that what we call “wokeness” naturally influences the fictional MI6 no less than the real C.I.A. It’s that forms of progressivism that originated in the United States, under specific American conditions, can seem more potent among our English-speaking friends and neighbors than they do in America itself.This is not a fully provable assertion, but it’s something that I felt strongly on recent visits to Canada and Britain. Politically, Canadian Conservatives and Britain’s Tories seem to be in very different positions. In Canada, the Conservative leader, Pierre Poilievre, looks poised for a major victory in the next election, which would end Justin Trudeau’s three-term reign as prime minister. In Britain, the Tories are poised for a drubbing in the next election, which would push them into the opposition for the first time since 2010.But in power or out of power, both groups seemed culturally beleaguered, resigned to progressive power and a touch envious of the position of American conservatives (if not of our political captivity to Donald Trump). In Canadian conversations there were laments for what was lost when Trudeau defeated Stephen Harper in 2015 — how elections have consequences, and the consequences in Canada were a sharp left-wing turn that no Conservative government is likely to reverse. In British conversations, the talk was all about how elections don’t have consequences, and how notional conservative rule has done nothing to halt the resilience of progressive biases in government and the advance of American-style wokeness in the culture.These complaints encompass a lot of different realities. In Canada, they cover the rapid advance of social liberalism in drug and euthanasia policy — with nationwide marijuana decriminalization followed by British Columbia’s new experiment in decriminalizing some harder drugs, while assisted suicide expands more rapidly than in even the most liberal U.S. state. In Britain, they cover the increasing enforcement of progressive speech codes against cultural conservatives — like the Tory councilor recently arrested by the police for retweeting a video criticizing how police officers dealt with a Christian street preacher.In both countries the complaints cover rising immigration rates — the conscious policy of the Trudeau government, which is presiding over an extraordinary surge in new Canadians, and the sleepwalking policy of the British Tories, who despite Brexit and repeated populist revolts find themselves presiding over record net migration rates. (By contrast, when America elected the immigration restrictionist Trump, immigration rates did actually decline.)And in both countries, conservatives feel that their national elites are desperately searching for their own versions of the “racial reckoning” that convulsed the United States in the summer of 2020, notwithstanding the absence of an American-style experience with either slavery or Jim Crow.Thus the spate of national apologies, canceled patriotic celebrations and church burnings in Canada in 2021, following claims about the discovery of a mass grave in British Columbia near one of the residential schools for Indigenous children that the Canadian government sponsored, often through religious institutions, in the 19th and 20th century. (The cruelty and neglect at these schools was real but the specific claims about graves at the B.C. school have outrun the so-far scanty evidence.) Or thus the attempted retcon of England’s deeply homogeneous history — well, since 1066, at least — into an American-style “nation of immigrants” narrative, and the sense, as the British writer Ed West wrote in 2020, that in English schools “America’s history is swallowing our own.”To the extent that these complaints capture an Anglosphere reality, I think you can identify several different points that might explain what Canadian and British conservatives are seeing.The first is a general tendency of provincial leaders to go overboard in establishing their solidarity and identification with the elites of the imperial core. Both Ottawa and London can feel like provincial capitals within the American imperium, so it’s not surprising that their leaders and tastemakers would sometimes rush to embrace ideas that seem to be in the American vanguard — behaving, as the British writer Aris Roussinos puts it, like “Gaulish or Dacian chieftains donning togas and trading clumsy Latin epithets” to establish their identification with Rome. By contrast in continental Europe, in countries that are under the American security umbrella but don’t share as much of our language and culture, the zeal for imitation feels a bit weaker, and “anti-woke” politics that double as anti-Americanism feel more influential.The second point is the role of secularization and de-Christianization, which are further advanced in the British Isles and Canada than in the United States. The new progressivism is not simply a new or semi-Christian substitute for the former Western faith, but the rhetoric of diversity-equity-inclusion and antiracism clearly fills part of the void left by Christianity’s and especially Protestantism’s retreat. So it would not be surprising for an ideology that originates in the post-Protestant precincts of the United States to carry all before it in post-Protestant Canada or Britain, while meeting more resistance in the more religious regions of America — and not just in the white-Christian Bible Belt but among the religious-conservative minorities whose rightward trend may be keeping the Republican coalition afloat.Then the third point is that smaller countries with smaller elites can find it easier to enforce ideological conformity than countries that are more sprawling and diverse. Once a set of ideas take hold among the cognoscenti — progressive ideas in this case, though it could apply to other worldviews as well — it’s more natural to conform, and more difficult to dissent, in the cozier precincts of Westminster or among Canada’s Laurentian elite than it is in the American meritocracy, which spins off more competing power centers and dissenting factions.An extreme example of this tendency is visible in Ireland, which shifted incredibly rapidly from being the West’s conservative-Catholic outlier to being close to uniformly progressive, a swing that the Irish writer Conor Fitzgerald attributes to a fundamental reality of small-island life: “Because of Ireland’s size, it is much more socially costly for an Irish person to appear to go against a consensus than it is for other people in other countries.”A recent essay by the Cardiff academic Thomas Prosser makes a related point about other small Celtic polities, noting that Scotland and Wales as well as Ireland have governments that are more progressive than their voters, a pattern he attributes to the way that ascendant ideologies (neoliberalism in the 1990s, or woke progressivism now) can sometimes achieve a kind of full elite “capture” more easily in smaller countries.Bucking consensus is presumably easier in Britain and in Canada. But not as easy, perhaps, as in the vast and teeming United States — which in its First Amendment-protected multitidinousness can be both the incubator of a potent new progressivism and also the place where resistance to that ideology runs strong, indeed stronger even than among 007 and other servants of His Majesty the King.The Times is committed to publishing a diversity of letters to the editor. We’d like to hear what you think about this or any of our articles. Here are some tips. And here’s our email: letters@nytimes.com.Follow The New York Times Opinion section on Facebook, Twitter (@NYTOpinion) and Instagram. More

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    Legacy of Boris Johnson Looms Over By-election to Replace Him

    The vote to pick a new member of Parliament in the ex-prime minister’s once-reliably Conservative district is just one of three by-elections on Thursday that will give a snapshot of Britain’s mood.When Boris Johnson paid a surprise visit last year to the Swallow pub and poured some pints, he seemed to leave the clientele more agreed on his skills as a barman than as a politician.“He asked me whether it was a decent pint — and it was,” said Tony O’Shea, 55, holding up a photo on his phone of the moment he was served a beer by Mr. Johnson, then the prime minister. Still a fan, Mr. O’Shea described Mr. Johnson as a “lovable rogue” whom he had voted for in 2019.On the other side of the pub, however, Jenny Moffatt, 73, had no complaints about the drinks she was served by Mr. Johnson. But she described him as “a buffoon,” with a tendency to “pontificate.”Love him or laugh at him, Mr. Johnson was an outsize presence both in British politics — and here in Uxbridge and South Ruislip, the district of outer London that he represented in Parliament. Now he is gone: He was forced out of Downing Street last summer and chose to resign his seat in Parliament last month after a ruling by senior lawmakers that he had lied to Parliament about lockdown-breaking parties.That leaves voters in his constituency to determine on Thursday what kind of post-Johnson future they prefer — to stick with the Conservatives or flip to Labour. Since the district was created in 2010, there have only been Tory representatives in Parliament but the party now trails badly in national opinion polls.Mr. O’Shea, who runs a cleaning company, said he was unsure for whom he will cast his ballot on Thursday. “There are a lot of people, irrespective of what has happened, who would still vote for Boris because of his character,” he said.It is partly thanks to Mr. Johnson’s tarnished legacy, however, that the current prime minister, Rishi Sunak, faces three unwelcome tests on Thursday in so-called by-elections — contests in local parliamentary districts — that fall at a time of roaring inflation and economic stagnation.As well as Mr. Johnson’s seat on the fringes London, there is a vacancy in Selby and Ainsty, in northern England, where one of Mr. Johnson’s allies, Nigel Adams, also quit. In both these contests, the Labour Party, the main opposition, detects the scent of success.A third contest was called when David Warburton, another Conservative, resigned after admitting he had used cocaine. In the race to succeed him in Somerton and Frome, in southwest England, the centrist Liberal Democrats are seen as the main challengers.Steve Tuckwell, second from left, the Conservative candidate running for a parliamentary seat in Boris Johnson’s former district, at a debate with other candidates this month. Susannah Ireland/Reuters“There is a sense that the by-elections are the end of the Boris Johnson era — this electoral test wouldn’t have happened but for him,” said Robert Hayward, a Conservative member of the House of Lords and a polling expert. He added that, because the three seats are being fought in three very different areas, they will give a rare snapshot of opinion across the country.“For the Conservatives, it will be a challenge and damaging if they lose all three,” said Mr. Hayward, while adding that “if they win even one it would substantially lift their spirits because expectations are so low.”Perhaps surprisingly, given their poor national poll ratings — trailing Labour by around 20 percentage points — the Conservatives are optimistic in Uxbridge and South Ruislip, where in the 2019 general election Mr. Johnson won by a relatively modest majority.However, the party is relying on local issues to buoy them, rather than counting on affection for Mr. Johnson. Indeed, the former prime minister has largely been airbrushed from the Tories’ campaign literature, has not been asked (or offered) to campaign for the new Tory challenger in his former district, Steve Tuckwell, and has had only a brief phone call with him.“Boris Johnson was a marmite politician” said David Simmonds, a Conservative lawmaker in the neighboring area of Ruislip, Northwood and Pinner, referring to a salty, yeasty paste that Britons tend to either love or hate.“There were people here who voted Conservative because they liked Boris Johnson and other people who stopped voting Conservative because they didn’t think he was the right person,” he added. “But that’s history, he’s not on the ballot paper at this election, I think people have moved on a while ago.”The résumé of Mr. Tuckwell is strikingly different from that of Mr. Johnson, who was educated at Eton College, Britain’s most famous private school, and Oxford University. By contrast Mr. Tuckwell stocked shelves at a supermarket as a part-time job when he was young, and then was employed as a postal worker. A protest against plans to extend an ultra low emission zone for vehicles, known as ULEZ, across all London boroughs, in London, in April.Maja Smiejkowska/ReutersMr. Tuckwell’s campaign stresses his local credentials in part because his main rival, the Labour Party’s Danny Beales, is now an elected councilor in Camden, an inner London municipality. (Mr. Beales was born and raised in the Uxbridge and South Ruislip district.)The Conservatives also have a pressing local issue because the mayor of London, Sadiq Khan, a Labour member, plans to extend an ultra low emission zone across all of London’s boroughs, including Uxbridge, effectively levying a fee on drivers of older, more polluting, cars.The plan, known as ULEZ, already operates in central London and aims to improve the quality of the city’s air, which has been found to have contributed to the death of one girl in the city.The threatened new cost has alarmed many drivers in Uxbridge and South Ruislip, and Mr. Tuckwell has likened the scheme to the tactics of a famed highwayman, Dick Turpin, an 18th century figure whose exploits were romanticized after his execution and who, according to legend, may have once lived locally.“After all, Turpin asked for a few shillings — not four-and-a-half grand a year,” Mr. Tuckwell wrote, totaling the cost of using a noncompliant car every day of the year to more than £4,500, or about $5,870.Mr. Beales has been under pressure on the issue and recently said that now is “not the right time” to extend ULEZ because of the squeeze it puts on incomes.But that is not enough to satisfy some. Outside his home, Neil Wingerath said the new rules would cost him £12.50 each time he drove his 13 year-old Land Rover SUV.“I’m not a Conservative but I am persuaded to vote Conservative because of ULEZ,” said Mr. Wingerath, 67, a retired accountant, who added that the resale value of his car had halved since the announcement of the ULEZ expansion to the area. “They are unsellable locally.”Even on this most local of issues, however, there is no escaping the legacy of Mr. Johnson who, in a newspaper article, recently condemned the “sheer bone-headed cruelty,” of the extension of ULEZ to outer London.His critics point out that the policy was introduced in inner London, by none other than Mr. Johnson himself when he served as the city’s mayor. More

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    With Local Elections in Much of the U.K., Here’s What’s at Stake

    Municipalities across England will face voters, including in areas that could sway the next national election. Here’s a guide to the ballots and how to interpret them.Votes will be cast across England on Thursday in local elections that will be a test of the popularity of Prime Minister Rishi Sunak, who has stabilized Britain’s politics but whose government remains unpopular in the face of surging inflation, sluggish economic growth and labor unrest.These votes will not affect the national Parliament that gives Mr. Sunak his power: Members of Parliament face the public every five years or so in a general election. The date is flexible but one isn’t expected until next year.But Thursday’s voting could offer important clues about whether Mr. Sunak, whose Conservative Party trails the opposition Labour Party in opinion polls, can turn things around.At stake are seats for around 8,000 representatives in lower tiers of government: municipalities that control services like garbage collection and construction permitting and raise taxes, within strict constraints, on residential property.It’s not an infallible guide to national sentiment. Turnout will be far lower than at a general election and parochial issues like planned housing developments could sway some races.Still, this may be the largest public vote between now and the next general election, and it’s fought across most of the areas likely to determine the next British government, with national issues often prominent in campaigning.What’s the state of play nationally?Recent surveys show Mr. Sunak cutting into Labour’s lead, though it remains in double digits. So he retains hopes of snatching an unlikely fifth consecutive general election victory for the Conservatives.Keir Starmer, Labour’s leader, needs a decent result to sustain his hopes of becoming the next prime minister. Despite moving his party close to power, he has failed to excite voters.The Labour leader Keir Starmer on the eve of local elections in Gillingham, England, on Tuesday.Gareth Fuller, via Associated PressThe local elections will indicate how Labour’s polling lead and Mr. Sunak’s polling progress translate into real votes.Who’s voting and where?The elections on Thursday take place across much — but not all — of England. Scotland and Wales aren’t voting, and Northern Ireland has local elections on May 18.Up for grabs are seats for representatives in 230 municipalities. The last time these seats were contested was in 2019, when Parliament was gridlocked over Brexit and the two main parties were about equally unpopular. Many big cities are voting (London excepted) but so are more rural areas.Both main parties hold a lot of these seats, but the Conservatives are defending the most — around 3,500 — and polling suggests they will lose plenty.How many is the key question: The parties traditionally seek to massage expectations. Greg Hands, the chair of the Conservatives, has talked of estimates that his party could lose 1,000 seats — a high number that some analysts think he inflated in an effort to portray lower losses as a triumph.Which are the results to watch?Some the most closely watched votes will be in so-called red wall areas in northern England and the Midlands. These deindustrialized regions used to be heartlands of the Labour Party. Mr. Sunak’s predecessor but one, Boris Johnson, fought a pro-Brexit general election campaign in late 2019 that won many of them for the Conservatives.With support dwindling both for the Conservatives and for Brexit, Labour hopes to regain some former strongholds, for example in northeastern England in areas like Middlesborough and Hartlepool.In the south, analysts will watch how the Conservatives perform in their traditional strongholds, prosperous towns like Windsor and Maidenhead, now sometimes known as blue wall areas. Here, Mr. Johnson alienated anti-Brexit Conservative voters, allowing independent candidates and a centrist party, the Liberal Democrats, to make gains. Mr. Sunak hopes his more technocratic style has arrested that slide.Prime Minister Rishi Sunak in London in April. The local elections will indicate how Labour’s polling lead and Mr. Sunak’s polling progress translate into real votes.Neil Hall/EPA, via ShutterstockSome results should emerge overnight — the northern city of Sunderland, for instance, prides itself on having all its votes counted just hours after the polls close, at 10 p.m. local time — but many places start counting the next day. There won’t be a reliable picture of votes across England until later on Friday.What’s the likely impact on British politics?Earlier this year, when Mr. Sunak’s leadership looked shaky, these elections seemed like a potential trigger for a leadership crisis and a comeback opportunity for Mr. Johnson, whose own fall was accelerated by local election losses last year.Since then, Mr. Sunak has struck a post-Brexit deal with the European Union on Northern Ireland, and stabilized the economy after upheavals under Liz Truss, Mr. Johnson’s short-lived successor. By contrast, Mr. Johnson is embroiled in an inquiry into whether he lied to Parliament about lockdown-busting parties during the pandemic.So Mr. Sunak’s position looks secure for now. But a bad result could demoralize party workers, shake confidence in his prospects, embolden his critics and confirm expectations that he will postpone calling a general election until late next year (it must take place by January 2025). A better-than-expected result for the Conservatives would strengthen Mr. Sunak and increase pressure on Mr. Starmer.If the Conservatives do suffer, the prime minister has one big thing going for him: timing. On Saturday, all the British media’s attention will shift to the pomp and pageantry of the coronation of King Charles III. More