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      ‘We’re on the edge of chaos’: families with trans kids fight for care as bans take hold

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      Aryn Kavanaugh was sitting in her living room in South Carolina when her 17-year-old daughter came into the room and said: “I’m really scared. I think people are gonna die.” Katherine, who is using her middle name for her protection, told Kavanaugh that she thought transgender youth may be the target of violence due to the hate generated by Donald Trump’s recent action.On 28 January, Trump issued an executive order to ban access to gender-affirming care for youth under 19 years old. It directed federal agencies to deny funding to institutions that offer gender-affirming medical care including hormones and puberty blockers.“She just felt like the world was crumbling around her. So we talked it out and tried to stay super positive,” said Kavanaugh, a parent of two trans children. “I think she really feels like we’re on the edge of chaos.”In a victory for trans kids and their families, a federal judge in Maryland blocked the ban on 4 March. The preliminary injunction extended a mid-February restraining order that blocked Trump’s directive and will remain in effect until further order from the US district court for the district of Maryland. In the meantime, the order prohibits the government from withholding federal funding to healthcare facilities that provide treatment to trans youth.Still, the executive order sent parents, children and medical providers into a tailspin as they deciphered its impacts. Some hospitals immediately canceled appointments and turned away new patients to adhere to the directive. In early February, Katherine was dropped as a patient at Virginia Commonwealth University, where she received gender-affirming care after South Carolina banned hormone therapy, surgery and puberty blockers for trans youth last year. Some parents say that their children’s mental health severely declined in the weeks following the executive order. And as a result, families have gone to great lengths to ensure that their trans kids continue to receive care, including considering moving abroad or stocking up on puberty suppressants.“We have seen dozens of families affected across the United States, in many, many states that have been left and abandoned without care that they need,” said Omar Gonzalez-Pagan, senior counsel and healthcare strategist at the LGBTQ+ civil rights organization Lambda Legal. “This is an unlawful executive order because it seeks to override the congressional mandate to condition federal financial assistance on non-discrimination, and this order seeks to require discrimination as a condition of federal funding.”The pause follows a lawsuit filed on 4 February by civil rights organizations including Lambda Legal and the American Civil Liberties Union (ACLU) on behalf of transgender youth. ACLU staff told the Guardian that they anticipated that the preliminary injunction would remain through the court proceedings.Some hospitals that stopped providing care to trans youth after the January directive, such as Children’s Hospital Los Angeles and Children’s Hospital of Richmond, lifted limits on surgeries or hormonal therapy in late February. Kavanaugh said she was “relieved and hopeful” about the preliminary injunction, though it does not roll back South Carolina’s ban on trans youth healthcare, which was signed into law last year.Her 18-year-old trans son Parker and Katherine received treatment at Medical University of South Carolina and then a private clinic in the state for several years until Henry McMaster, the governor of South Carolina, signed into law a ban on gender-affirming care for trans minors in May 2024. Parker is now old enough to receive his care in South Carolina, but the state ban means that the family has had to drive more than five hours each way to Virginia Commonwealth University for Katherine’s doctors’ appointments and medicine every few months.Being dropped as a patient due to the federal ban “puts us in a really tough spot because we’re already having to find care outside of South Carolina. And so that just limits our options,” Kavanaugh said. Katherine’s doctors connected her to a private medical practice in Fairfax, Virginia, that does not receive federal funding, so they were able to avoid a lapse in her care. While the change in providers did not cost more money, it stretched their commute to more than seven hours.In late February, Katherine’s puberty-blocker treatment at Virginia Commonwealth University resumed. In a statement, the hospital said that patients would continue medications, but that surgeries would remain suspended. Trans kids’ treatment remains in limbo as federal challenges wind through the court.‘A psychological toll’Studies have shown that gender-affirming medical care greatly improves trans people’s mental health and quality of life. A 2022 report published in the journal JAMA Network Open analyzed data from a study of 104 transgender and non-binary youth from ages 13 to 20 who received hormonal therapy or puberty blockers at the Seattle Children’s Gender Clinic for a year. Researchers found that 60% of participants reported lower rates of depression and 73% had less odds of suicidal ideation and self harm after receiving gender-affirming hormones and puberty blockers.Black transgender people, who experience the intersecting stigma of being gender diverse and racial minorities, are at even greater risk of poor mental health. A 2022 national survey of 33,993 LGBTQ+ young people by the Trevor Project, a non-profit, found that one in four Black transgender and nonbinary youth attempted suicide in the past year, more than double the rate of their cisgender counterparts.“It’s already difficult to access healthcare and treatment. It’s additionally difficult for folks who belong to other marginalized communities, especially families and children of color, as well as folks who are on various forms of state-funded insurance and may have difficulty selecting their providers to begin with,” Harper Seldin, a senior staff attorney at the ACLU, told the Guardian.“There is already a subset of gender clinics in this country who provide this care. When you lay over on top of that insurance and access based on family means, it’s particularly devastating for families who can’t just pick up and go somewhere else – to another city, state or other country – to get care.”While her trans daughter’s care hasn’t been directly affected by the executive order, Sarah, a Texas mother who asked that her last name not be used to protect her daughter’s privacy, said that her daughter Raven was devastated by the president’s directive. Raven, a 16-year-old Black trans girl in Texas who is using a pseudonym, dropped out of school last month due to her declining mental health, exacerbated by the federal ban. Sarah said that Raven had rarely got out of bed, and when she did, she would show her mom news reports of murdered Black trans girls and women.“She has told me that she’s afraid of being killed if she leaves the house,” Sarah said. “She really only will leave the house with me. But that’s very few and far between, because she’s just incredibly depressed.”Since dropping out of school, Sarah said that Raven’s depression and anxiety significantly decreased, and she plans to start GED test preparation classes over the summer.In November 2024, the LGBTQ+ non-profit Human Rights Campaign Foundation released a report that showed that half of the 36 transgender people killed in the last 12 months were Black trans women. That reality has made it terrifying for Raven to live as a Black trans girl, Sarah said.Raven’s medical providers have increased her antidepressants dosage, and she now checks in with her psychiatrist every three weeks. Since last year, Raven has had to fly to Colorado every six months to receive gender-affirming care due to a Texas ban on treatment for minors. She has received grants from the non-profit Campaign on Southern Equality to fund the travel for medical treatment, which has helped defer some of the exorbitant costs of seeking out-of-state care.Sarah said that she has researched living in other nations and would be willing to order medicine from Canada if Raven could no longer get medical treatment in Colorado. Gender-affirming care has drastically improved Raven’s life. “She feels more herself,” Sarah said. “If she didn’t have it, I don’t think she would choose to stay alive.”Navigating medical care restrictions has caused anxiety for parents who are shouldering the burden of the policies’ twists and turns for their children. A Georgia-based parent, Peter Isbister, said that he had chosen not to share the news of the executive order with his 11-year-old trans son Lev, who is using a pseudonym out of fear of harassment: “It’s taken a psychological toll on his parents, not on him.”An endocrinologist is currently monitoring Lev’s hormone levels to determine when he will be put on puberty blockers. Isbister, an attorney and founder of the peer support network Metro Atlanta TransParent, has to contend with the federal executive order and a looming ban on puberty blockers for minors in Georgia.“If the bill passes in Georgia, then we as a family are going to really have to study up more seriously on how it works to be an out-of-state person to get care in California, New Mexico, Massachusetts or wherever,” Isbister said. “And the more states that restrict access to care, the harder that’s going to be.”As a result of the federal and state policies, Isbister said that he has talked with an immigration attorney about acquiring Canadian citizenship for his son. But at least for now, Lev’s clinic continues to provide him care.While Isbister was “heartened” by the judge’s injunction on the executive order, he said that it is “wrenching and in my view unjust that my ability to provide my kid healthcare should be an issue for our federal courts”. More

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      The left needs its own version of techno-optimism | Amana Fontanella-Khan

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      Today we live in an era defined by crisis. Indeed, we are facing multiple overlapping threats at once: from accelerating climate breakdown to the rise of authoritarianism across the world, we are in a situation that the historian Adam Tooze calls “polycrisis”. It is no wonder that hope is scarce, pessimism is high and despair is pervasive. As one meme that captures the grim, morbid mood of our age reads: “My retirement plan is civilisational collapse.”But not everyone shares this gloomy outlook. On the extreme other end of public sentiment sit Silicon Valley billionaires: they are some of the most optimistic people on earth. Of course, it’s easy to be optimistic when you are sitting on enough money to sway national politics. And yet, the source of their optimism isn’t simply money. It is also a deep-seated faith in unfettered technological advances.The left is rightly skeptical of the rosy “techno-optimism” advanced by the likes of Elon Musk, far-right mega-donor Peter Thiel and hedge fund billionaire Marc Andreessen. To tech oligarchs, technological advancement is best delivered by unfettered free market capitalism. The democratic state is a hindrance to be opposed, dismantled and destroyed – a set of goals that they now enjoy the power to achieve. Their ideology ignores inequality and glosses over the material harms their companies wreak on workers and the environment. Silicon Valley’s billionaire techno-optimism is clearly incompatible with leftwing values and should be rejected.But can and should the left advance its own techno-optimism? Can it put forward a vision of a brighter future that can compete with the grand visions of space exploration presented by Musk? Can it make the case that science and technology ought to be harnessed to deliver breakthroughs, abundance, sustainability and flourishing of human potential? And what would a progressive, leftwing techno-optimism look like? A techno-optimism that the 99% could get on board with, especially communities of color, and Black people who have historically been excluded, or even harmed, by scientific and technological breakthroughs? These are some of the questions that this new series, Breakthrough, launched by the Guardian examines.The left used to embrace technology. Indeed, the most leftwing prophet of all, Karl Marx, was so pro-technology that he is often described as “Promethean”, a reference to the Greek god who stole fire to give to humans. And it was feminist Shulamith Firestone who in the 1970s envisioned a day where we might have artificial wombs and be liberated from housework, thanks to automation: a feminist utopia delivered by technology.Some of the most groundbreaking sci-fi imagery that we encounter in books and movies like the Matrix, such as people living virtual lives entirely untethered from their bodies, were first popularized by JD Bernal, the Marxist scientist and futurist who designed the so-called Bernal spheres, for permanent space settlement, in 1929. Writing of Bernal’s influential book, The World, the Flesh and the Devil: An Enquiry into the Future of the Three Enemies of the Rational Soul, Arthur C Clarke, considered one of the fathers of sci-fi, wrote that it was “perhaps the most remarkable attempt to predict the future of scientific possibility ever made, and certainly the most stimulating”. And it was all rooted in a firmly leftwing – and specifically, socialist – world view. And, of course, Star Trek, one of the most successful sci-fi series of all time, is widely considered to be depicting a socialist post-scarcity utopia.Today, however, the left is either fearful, agnostic or hostile towards technology. The green “degrowth” movement, for example, views industry and technology as the root of our climate crisis. For them, the solution to the climate crisis is not more technological growth and innovation, but less. As Kohei Saito, the author of the bestseller Slow Down: The Degrowth Manifesto, said in an interview: “I was initially more optimistic about the development of technology” but, after reading degrowth theories, “[I] abandoned the possibility of green growth.”Saito goes on to say: “If we want to have more, in today’s sense, it will simply bring about ecological catastrophe.” Reducing consumption and production – austerity and retreat, in other words – is the only path forward for the degrowth movement. But this ignores the fact that technology can help us replace fossil fuels with other sources of clean, affordable and scalable energy that would allow for continued growth and advancement, without harming the environment.Meanwhile, leftwing leaders such as Bernie Sanders and Alexandria Ocasio-Cortez are very good at the necessary and essential task of confronting tech monopolies and billionaires, who concentrate economic and political power in their hands. But what is often lacking is a positive, bold vision for what a science and technology agenda for the 99% would look like – how technology in the right hands might help provide abundance for all.This is a lost opportunity. For all the pessimism and decline that we are witnessing – declining rates of graduation, declining birth rates, declining rates of homeownership and a rise in deaths of despair and skyrocketing rents – we also may well be on the brink of unprecedented breakthroughs and advances that could create record levels of wealth to be enjoyed by all, if these breakthroughs are accompanied by a political system that favors the wellbeing of all over billionaires. It may be hard to imagine such a system at the moment, given that corporate interests have seized nearly all levers of power, but it is nonetheless critical to do so. Do we have a political vision of how tech and science might work for us all?In 2024, artificial intelligence (AI) was recognised with not one, but two, Nobel prizes. Google’s DeepMind discovered 2.2m entirely new materials – 800 years worth of science in a few months. Last year saw the first time that sickle cell disease, a disease that was hitherto incurable and predominantly affects people of African descent, was reversed in a novel Crispr gene-editing therapy. Cancer and heart disease vaccines could be ready within the next five years. And now, for the first time, AI is solving the intractable protein-folding problem – one of biology’s greatest challenges – and designing new proteins, which is essential for discovering new drugs and understanding why certain diseases occur.View image in fullscreenSo why is it that technology is almost never invoked by the left as a solution to polycrisis in general, or the climate crisis in particular? Why is it that the only people who offer bold, inspiring visions for the transformative role of technology are the likes of reactionaries like Musk?There are, of course, reasons for this. Technology alone is no panacea. Nor does technology guarantee progress. In fact, periods of technological advancement have almost always been accompanied by violence, dispossession and war. Many leftwing philosophers in the post-war period, having witnessed the ravages of fascism and Nazism, equated technology – and even the very idea of progress itself, with violence.As the Frankfurt school philosophers Theodor Adorno and Max Horkheimer – both of whom were Jewish intellectuals forced to flee Nazi Germany – argued in Dialectic of Enlightenment: “Technology … aims to produce neither concepts nor images, nor the joy of understanding, but method, exploitation of the labor of others, capital.”And Black artists such as Gil Scott-Heron, witnessing the advances of the space age, asked what benefit the Apollo mission might have for those struggling to make ends meet back on Earth. In Whitey on the Moon, Scott-Heron writes:“A rat done bit my sister Nell.(with Whitey on the Moon)Her face and arms began to swell.(and Whitey’s on the Moon)I can’t pay no doctor bill.(but Whitey’s on the Moon)Ten years from now I’ll be paying still.(while Whitey’s on the Moon)”Those critiques continue to resonate with many today. Especially as we witness one billionaire after another fly into space, as life on Earth grows more perilous by the day. And as billionaires push not simply the frontiers of space, but of the human body itself, it is right to remind ourselves of the legacy and history of eugenics. We can only benefit from warnings – such as those made by Timnit Gebru and Émile Torres – that the pursuit of longevity and eternal life, as well as transhumanist projects such as Neuralink, risk perpetuating eugenicist ideals in the 21st century.Perhaps, though, we would do well to adopt the position of the Frankfurt school philosopher, Herbert Marcuse, who accepted many of the critiques that his colleagues made of the Enlightenment, but who also left space for the possibility that it could go either way. In a 1941 essay on technology, he wrote: “[Technology] can promote authoritarianism as well as liberty, scarcity as well as abundance, the extension as well as the abolition of toil.”He envisioned a world in which technological progress might allow human flourishing and self-realization. In a world that is technologically advanced enough, “everyone could think and act by himself, speak his own language, have his own emotions and follow his own passions” once we are “no longer chained to competitive efficiency”.Perhaps the most important condition for us to flourish is to address our climate crisis. Today, to warm our homes and cook our meals, we still set fire to things. Those who cook on gas stoves heat their food over literal flames, as cavemen once did. If we are to move out of the fossil fuel era into a new, cleaner and sustainable era – while still maintaining our freedom to travel and fly and enjoy the material comforts that we do today – this will require a combination of political will and technology. Whether fusion energy, fission or a host of renewables, the path to a new era of energy production requires new technologies and breakthroughs. Right now, for example, Silicon Valley billionaires are investing billions in chasing the holy grail of limitless, clean fusion energy to power AI. Can and will the state match those efforts? And should the left make the case that it should?There is no inherent value in technology. It is neither good nor bad. It is up to us how machines are used. And indeed, who makes those machines, how, and to what ends are all political questions. While we push to change our political system and direct it towards a more equitable, inclusive and liberatory path, let us also, at the same time, push for technology to move in that direction, too.We live in dark, depressing and – frankly – terrifying times. Our planet’s fragile ecosystem is fast spiraling out of control. Our democracies are fracturing. And billionaires are seizing for themselves all of the spoils of the digital era. Technology might well be the thing that pushes us over the edge. But it could also, if we play our cards right, allow us to exit our era of polycrisis. But that won’t happen on its own. The path towards better technology – tech for the 99% – can only be achieved through a politics of the 99%. And it must start with a vision.It is time that the left deploy all of our energies and powers towards a political vision of abundance. Abundance that is delivered by a movement for the 99% that pushes for technological growth and development for the benefit of all.We hope this series might be a place for that political vision to be discussed, debated and laid out so that optimism about the future – in particular, techno-optimism – is no longer just something that the very rich in this world can have.

      Amana Fontanella-Khan is the Guardian US opinion editor More

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      The pink protest at Trump’s speech shows the Democrats aren’t coming to save us

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      Pretty (pathetic) in pinkHappy International Women’s Day (IWD), everyone! I’ve got some good news and some bad news to mark the occasion.The bad news is that a legally defined sexual predator is leading the most powerful country on earth and we’re seeing a global backlash against women’s rights. “[I]nstead of mainstreaming equal rights, we are seeing the mainstreaming of misogyny,” the UN secretary-general, António Guterres, said in his IWD message.The good news, for those of us in the US at least, is that the Democrats have a plan to deal with all this. Or rather, they have wardrobe concepts of a plan. On Tuesday night, Donald Trump addressed a joint session of Congress at the US Capitol. Some members from the Democratic Women’s Caucus (DWC), including Nancy Pelosi, decided to protest by … wait for it … wearing pink.“Pink is a color of power and protest,” the New Mexico representative Teresa Leger Fernández, chair of the DWC, told Time. “It’s time to rev up the opposition and come at Trump loud and clear.”The pink outfits may have been loud but the message the Democrats were sending was far from clear. They couldn’t even coordinate their colour-coordinating protest: some lawmakers turned up wearing pink while others wore blue and yellow to support Ukraine and others wore black because it was a somber occasion.Still, I’ll give the DWC their due: their embarrassing stunt seems to have garnered at least one – possibly two – fans. One MSNBC columnist, for example, wrote that the “embrace of such a traditionally feminine color [pink] by women with considerable political power makes a stunning example of subversive dressing”.For the most part, however, the general reaction appears to have been that this was yet another stunning example of how spineless and performative the Democrats are. Forget bringing a knife to a gunfight – these people are bringing pink blazers to a fight for democracy. To be fair, there were a few other attempts at protest beyond a pink palette: the Texas representative Al Green heckled the president (and was later censured by some of his colleagues for doing so) and a few Democrats left the room during Trump’s speech. Still, if this is the “opposition”, then we are all doomed.Not to mention: even the pink blazers seemed a little too extreme for certain factions of the Democratic party. House Democratic leadership reportedly urged members not to mount protests and to show restraint during Trump’s address. They also chose the Michigan senator Elissa Slotkin to give the Democratic response to Trump’s speech. While Slotkin tends to be described as a sensible centrist voice by a lot of the media, she’s very Trump-adjacent. Slotkin is one of the Democratic senators who has voted with Trump the most often and, last June, was one of the 42 Democrats to vote with the GOP to sanction the international criminal court (ICC) over its seeking of arrest warrants for Benjamin Netanyahu and other Israeli leaders for destroying Gaza. Human rights advocacy groups have warned that attacking the ICC like this undermines international law and the ability to prosecute or prevent human rights violations across the world. It speaks volumes about the US media and political class that a senator standing against international law can be called a centrist.This whole episode also speaks volumes about the Democrats’ plan for the future: it’s growing increasingly clear that, instead of actually growing a spine and fighting to improve people’s lives, the Democratic party seems to think the smartest thing to do is quietly move to the right and do nothing while the Trump administration implodes. I won’t caution against this strategy myself. Instead, I’ll let Harry Truman do it. Back in 1952, Truman said: “The people don’t want a phony Democrat. If it’s a choice between a genuine Republican, and a Republican in Democratic clothing, the people will choose the genuine article, every time.”Anyway, the upshot of all of this is that the Democrats are not coming to save us. We must save ourselves. That means organizing within our local communities and learning lessons from activists outside our communities. It means being careful not to normalize creeping authoritarianism and it means recognizing the urgency of the moment. The warning signs are flashing red: we need to respond with a hell of a lot more than a pink wardrobe.Make atomic bombings straight again!DEI Derangement Syndrome has reached such a fever-pitch in the US that a picture of the Enola Gay aircraft that dropped an atomic bomb on Japan has been flagged for deletion at the Pentagon. Apparently, it only got the job because it was Gay.Can a clitoris be trained to read braille?The Vagina Museum addressed this very important question on Bluesky.One in eight women killed by men in the UK are over 70A landmark report by the Femicide Census looks at the deaths of 2,000 women killed by men in the UK over the last 15 years and found that the abuse of older women hasn’t had as much attention as it should. “We have to ask why we see the use of sexual and sustained violence against elderly women who are unknown to the much younger men who kill them,” the co-founder of the Femicide Census told the Guardian. “The misogynistic intent in these killings is clear.”Bacterial vaginosis (BV) may be sexually transmitted, research findsWhile this new study is small, its findings are a big deal because BV is super common – affecting up to a third of reproductive-aged women – and has long been considered as a “woman’s issue”. Treating a male partner for it, however, may reduce its recurrence.How astronaut Amanda Nguyen survived rape to fight for other victimsAfter being assaulted at age 22, Nguyen got a hospital bill for $4,863.79 for her rape kit and all the tests and medication that went along with it. She was also informed that it was standard practice for her rape kit to be destroyed after six months. “The statute of limitations is 15 years because it recognises that trauma takes time to process,” Nguyen told the Guardian in an interview. “It allows a victim to revisit that justice. But destroying the rape kit after six months prevents a survivor from being able to access vital evidence.” After her traumatic experience, Nguyen successfully fought for the right not to have your rape kit destroyed until the statute of limitations has expired, and the right not to have to pay for it to be carried out.Female doctors outnumber male peers in UK for first timeIt’s a significant milestone in what has traditionally been a male-dominated profession.There’s an Israeli TikTok trend mocking the suffering of Palestinian childrenThis is one of those things that would be front page of the New York Times if it were directed at Israelis but is getting relatively little attention because of how normalized the dehumanization of Palestinians is. It’s also just the latest in a series of social media trends mocking Palestinian suffering.Florida opens criminal investigation into Tate brothers“These guys have themselves publicly admitted to participating in what very much appears to be soliciting, trafficking, preying upon women around the world,” the state attorney general said.The week in pawtriarchyJane Fonda, a committed activist, has always fought the good fight. But she’s also apparently fought wildlife. The actor’s son recently told a Netflix podcast that Fonda once “pushed a bear out of her bedroom”. While that phrase may mean different things to different people, in this instance it was quite literal. Fonda apparently scared off a bear who had entered her grandson’s room and was sniffing the crib. Too bad nobody was there to snap a photo of the escapade – it would have been a real Kodiak moment. More

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      View from the couch: therapists on sessions in new Trump era

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      In his conversations with trans clients, Will Williams, a therapist in Oakland, California, sees the psychic toll exacted by the fusillade of recent executive orders targeting transgender protections. Many of his patients are filled with fear – and for legitimate reasons.In the days after Donald Trump took office, the administration required passports to be marked with sex assigned at birth, banned trans people from serving in the military and cut funding for gender-affirming care. On some federal websites, the “T” was removed from “LGBT”.“There’s this literal embodied experience of ‘Oh I’m a target,’” said Williams, who is trans. “[We are] the 1% that is going to be targeted and blamed, and when it comes down from the theoretical into daily life – psychically there’s an experience of being erased.”When clients ask him “Do I even exist?”, Williams can at least offer some comfort. He asks: “How is it to be in a room with another trans person?” The question makes plain what is in front of them: yes, they both exist. “The medicine is in that,” Williams says. “Trump can say the moon doesn’t exist anymore, but the moon still shines, and it still waxes and wanes.”Williams is among the many therapists who are figuring out how to navigate a profession that has been plunged into uncharted territory during a tense second Trump term. It’s a new atmosphere, and therapists say they are “learning beside” their clients as they go.Many of those who spoke with the Guardian requested anonymity so they could speak freely about sensitive issues.Liberal therapists say they sometimes incorporate their political views into the healing process to provide support for clients distressed by Trump’s actions. “You’re taught in school that therapists aren’t supposed to be political, but it’s very political,” one liberal practitioner said. “Now, at least in my therapist friend group, we’re like, ‘Screw that, no, this is very political.’”Trump’s policies, such as deporting immigrants, go against therapists’ code of ethics that requires them to uphold client’s dignity and worth, she said. That hasn’t precluded her from working with Trump-supporting clients. Some don’t return “and that’s OK”, but she successfully works with a range of conservative patients.On the other end of the spectrum, some therapists say they are encountering liberal clients who are fearful of coming to therapy: “They want to know if their therapist voted against their human rights.” Providing assurance to anxious clients is an instance in which many are choosing to share their political views. “When appropriate, I want to let them know that it’s really safe,” one therapist said.Liberal therapists, conservative clientsThe relationship between liberal therapists and conservative clients has demanded a slight revision of therapeutic calculus. A few said they find themselves revolted by their clients’ beliefs but figure out how to work with them effectively despite the fraught dynamic.None of the therapists I interviewed said they try to change clients’ political views, but therapy is often about getting people to think about problems in their lives differently – and sometimes there’s overlap.One therapist I spoke with used the example of some of her clients’ fear and hatred of transgender people. She asks them where those fears stem from, because they are often passed on generationally.“What kind of things were you taught as a child? If you heard your parents talking about this – do all of your values align with your parents’ values? Have you ever broken from them? Will you feel rejected by your family or community if you think differently?” she asks.As therapy progresses, fears are often unlocked, and some of those questions are answered. “Even if the client isn’t focused on the political aspect, we can work on some of those themes, like fear, without getting into politics,” she said.Another liberal practitioner who took on a Trump-supporting client had doubts about their potential for growth in part because of the latter’s very religious, conservative beliefs. The client was upset with their church’s liberal positions on some issues, and that was causing a problem in their life.The therapist encouraged the client to talk with church leadership and to try to understand a different viewpoint. “I didn’t look at it as an opportunity or say, ‘Oh, I got a chance to try to win them over,’” she said. “It was, ‘Oh, you have this conflict, and maybe if you can see another perspective that would help you.’”Sometimes, the roles are reversed and fear is on the other foot. A practitioner who fears fascism and societal collapse, and has stocked up on supplies in case “the shit hits the fan”, said the money she makes taking on conservative clients is worth it.“You know, I’m billing $90 an hour, and I can listen to that bullshit for 50 minutes for $90,” she said. “I feel gross saying that because I do think my [Trump-supporting] clients are doing something awful, and are the personification of the problems I deal with.”A website, ConservativeCounselors.com, highlights the work of conservative therapists around the country. The Guardian sent emails to five of them, but only one responded in a brief email.“Conservative therapists have formed a pretty tight group, and many of us have shared that you’ve reached out for an interview,” the therapist, Maria Coppersmith, said. “The general consensus is that the Guardian is so ultra-liberal, that any conservative therapist that shares his or her viewpoint is likely to have their words twisted and will be highly misrepresented. You might get a naive newbie therapist that will agree to an interview, but I am respectfully declining.”‘Screw that, this is very political’To describe what’s occurring in the interplay between therapy and politics, Bill Doherty, co-founder of Braver Angels, a non-profit that works toward depolarization, borrowed a term from practitioners in destabilized Latin American countries: political stress. “It’s the anxiety and psychological preoccupation that stems from what’s happening in our political situation, how government officials are behaving and how we’re treating each other when we disagree,” Doherty said. “The challenge is therapists have their own viewpoints – they vote – this is not external to their lives. So the major challenge that’s now happening is therapists trying to keep their own political leanings from influencing clients.”Broadly speaking, therapists say the profound shock and sharp sense of fear that was almost universal among liberal clients after Trump’s first win has been replaced with variations of numbness, hopelessness and resignation.“After Trump won in 2016 everyone was like, ‘Oh my God what’s going to happen? What are we going to do?’ And during Covid they were like, ‘Oh my God, there are no adults in Washington! What are we going to do?’” a therapist said. Now his clients are much more despondent. “They’re like, ‘Fuck it, let it burn,’” he said.Williams said there was indeed less “fear and scrambling” in November 2024, but it has been more difficult for trans clients this time around. Many are running against the clock to make changes to identification cards, birth certificates, passports and other documents.Similarly, a therapist who works with federal employees says there is a broad sense of “whiplash”. The administration has also attacked minorities and women employed at federal agencies, claiming that they are unqualified and were only hired due to DEI initiatives. That takes a toll on some clients, who may end up questioning how people view their worth.And then there’s intra-family strife. One therapist certified to practice in Michigan and California said familial stress is greater in Michigan, a purple, more religious state. His clients feel a dissonance: “They say, ‘I love my parents, and they’re showing up for me, but then I also know that they voted for this person who’s completely appalling.’”Start honoring the numbnessEach therapist who spoke with the Guardian said anger and numbness over the second administration are initially appropriate responses. “Anger is a protective force,” Williams added.But to help his clients to settle their nervous systems, he directs them inward: “In the stillness they can access the greater wisdom – usually the message is there of what’s going to be supportive to them.” He also urges them to “go to nature and connect to systems older and larger than this moment, and put energy toward something life-affirming and creative”.Another therapist has clients accept this new reality. “Normalize that there is this threatening energy that is closing down certain civil liberties and trying to change social norms,” he said, adding that he also urges people to be curious about their numbness.This doesn’t mean embracing being inactive, however. “Find ways to start honoring the numbness, while starting to move energy, whether that’s physical movement, or getting out, seeing people and finding light in what feels like a dark time for some folks, whether that’s through art, music or nature,” he added.Doherty recommends what he calls “buffering”: limiting intake of news and conversations with friends and family about politics. That’s an especially helpful strategy for couples he counsels who have differing political viewpoints. Many still make it work, Doherty said.Most therapists tell their clients to focus on what they can control. Some suggest putting energy into mutual aid projects or partaking in local political action. One therapist is seeing her siblings more, making herself an ally to trans folks. She also likes to listen to the Moth story hour as a healthy escape from reality.However, another therapist pointed to a meme in which a person is lying in the road, about to get hit by a large truck. In the meme, a nearby therapist waves, shouting: “Just focus on the things you can control!” She finds the advice to be ludicrous. “I feel like an asshole as a therapist sometimes, so I try to not say shit like that.”Liberal therapists often face many of the same fears as their clients. Williams recounted how he worked with some of his youngest clients who were “heartbroken”, and how there was synergy in that process.“What I tried to do in those situations was reconnect them to: ‘We’re here, we’re alive, there’s a purpose,’” Williams said. “I actually left those sessions feeling more purposeful, and feeling more power from what I witnessed after reconnecting them with themselves.”Another therapist said she felt a similar energy by opening up about her political views and fears: “It feels more like we’re in this together,” she said. More

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      in UK Politics

      NHS dentistry facing ‘existential crisis’ with more practices going private amid tax hike

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      Your support helps us to tell the storyFrom reproductive rights to climate change to Big Tech, The Independent is on the ground when the story is developing. Whether it’s investigating the financials of Elon Musk’s pro-Trump PAC or producing our latest documentary, ‘The A Word’, which shines a light on the American women fighting for reproductive rights, we know how important it is to parse out the facts from the messaging.At such a critical moment in US history, we need reporters on the ground. Your donation allows us to keep sending journalists to speak to both sides of the story.The Independent is trusted by Americans across the entire political spectrum. And unlike many other quality news outlets, we choose not to lock Americans out of our reporting and analysis with paywalls. We believe quality journalism should be available to everyone, paid for by those who can afford it.Your support makes all the difference.Read moreEngland’s dentists warn that without a serious increase in government funding and an overhaul of contracts, NHS dentistry could cease to exist when the April tax hike forcing more practices to go private to make ends meet.Shiv Pabary, chair of the British Dental Association’s General Dental Practice Committee, said: “The future of NHS dentistry is in [Chancellor] Rachel Reeves’s hands”.Dr Pabary said dentists have been struggling for years to and cover rapidly rising costs with no substantial increase to NHS funding, and April’s increase to National Insurance contributions could force many more dentists to abandon NHS dentistry altogether.“It’s going to be horrendous for many practices,” he said. “And it’s a political choice, it really is, if they want NHS dentistry to exist. Because genuinely, I’ve been in this for 40 years, I think it faces an existential crisis.”It comes as the Liberal Democrats urged the government to exempt the health and social care sector from the National Insurance contribution increase coming in April, saying pharmacists, dentists and other health and care providers will face a combined £3 billion tax hike in the next financial year.The number of dentists providing NHS services is falling More

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      in US Politics

      The daylight savings debate misses the point: let’s make work hours flexible | Lynne Peeples

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      In a week, we will spring forward to daylight saving time. Donald Trump, Elon Musk and Vivek Ramaswamy all recently shared their desires to end the biannual flip-flopping of our clocks. The Republican senator Rick Scott recently reintroduced the Sunshine Protection Act, which would lock our clocks on daylight saving time. Scientists, meanwhile, urge us to adopt the opposite: permanent standard time.The DST debate is heating back up. But all this chatter is, once again, largely missing the point–an omission particularly glaring for an administration that claims to be seeking greater efficiency.The time displayed on our walls and wrists carries only the meaning we attach. If we want to rein in our nation’s spending, if we want to make America healthy again, then we should turn attention to our inner clocks. For starters, we should nudge companies and schools to relax or revise rigid schedules – rather than, for example, reverting to pre-pandemic in-office requirements.We are all born with inner clocks, better known as our circadian rhythms. These biological drumbeats sync with our planet’s patterns to drive our bodies to do the right things at the right times: fall asleep, digest food, and fight pathogens, to name a few vital functions. But our internal timekeepers don’t all tick the same. Your 7am might be my 2pm.The upshot: a lot of money could be saved, and illness avoided, if we dropped the traditional one-schedule-fits-all that gives the clock-on-the-wall so much sway.More circadian-friendly schedules mean more people can wake, work, and learn in closer alignment with their inner clocks. They get more sleep. They take fewer sick days. This is especially true for night owls, whose circadian rhythms are most incongruous with the long-established early bird-biased schedules. Sleep loss alone is estimated to cost the US economy upwards of $400bn a year due to absenteeism, accidents, and reduced productivity. That’s around 1.5% of the country’s GDP – and far more than the approximately 1% of the GDP that pays the salaries of all federal civilian employees, whose jobs have been under attack.Impacts on sleep and sickness aside, it also pays to allow people to work or study during their peak hours of productivity and performance. Alertness, cognition, and learning fluctuate across the day. So does our ability to think critically, communicate effectively, and act morally. Risks of costly lapses of attention and reaction ride these waves, too. And, again, the ebbs and flows are unique for every person.A business’s market value is now about 90 percent intangible – tied to assets like IP, relationships and reputation. In other words, companies are investing primarily in employees’ brainpower. A few have begun optimizing those investments by taking advantage of our biological diversity.Magne Skram Hegerberg, secretary general for the Norwegian Association of Lawyers, told me he uses a curious tool to utilize peak brainpower: an army of plush frogs. During their personal power hours, employees will place one of these brightly colored plush animals on their desk or the door to their office. This signals others to “frog off”. Starting times among his workers also now range from 6.30am to 2.30pm. Meetings are held midday, when early birds and night owls overlap. After making these changes, he said, productivity in some areas doubled and, more broadly, innovation, creativity, and problem-solving improved.View image in fullscreenCamilla Kring, founder of the Copenhagen-based B-Society, has advised Hegerberg and other companies including medical giants Medtronic and AbbVie. She has watched job satisfaction rise and sick days plummet. Her end goal, she said, is to create a “new time architecture” that helps everyone better live by their inner clocks. And that includes B-persons, her term for night owls, an often-stigmatized club to which Trump and Musk belong. “You are born with this rhythm,” said Kring. “It’s not something you choose.”Among the few good things to come out of the Covid pandemic was a glimpse into a more sun-synced life. Some studies found that people, especially night owls, tended to get more sleep and maintain healthier circadian rhythms as school and work schedules were relaxed. But much of that greater flexibility is now being reversed. The Trump administration has issued an executive order to end remote work for federal workers, a mandate pushed by Musk, who enforces strict in-office policies at Tesla, SpaceX, and X. Amazon, too, made the move in January. JP Morgan and Dell plan to do the same in March. Emerging policies that restrict where an employee works also tend to define when. And that can result in wasted resources.Sure, there are benefits to having employees in the office. It can reduce loneliness, encourage teamwork, and inspire creativity. But workplaces can still foster flexibility. Business leaders can spread out work hours and schedule meetings, lunches, and other events for the middle of the day. Those gatherings would probably be more pleasant and productive, anyway, with fewer sleep-deprived and circadian-disrupted participants. And who wouldn’t also appreciate a means to stem the recent rebound in traffic congestion?Some secondary schools in Europe similarly offer students the choice of earlier or later electives while concentrating core subjects to midday periods. And a growing number of middle and high schools in the US have delayed their first bell, acknowledging that traditionally early start times are biologically backwards. Rhythms don’t just vary between us; they also change within us, drifting significantly later during adolescence. But overall progress remains slow.The consequences of permanent DST would disproportionately impact teens and other night owls. When required to arrive at a strict time for work or school, DST effectively forces them up an hour earlier than their already-late preference. The later sunrise also means they get less of the morning light that their rhythms rely on to avoid drifting even later. Some early birds, on the other hand, might appreciate the additional evening light with DST. It can nudge their bodies to postpone pumping out melatonin and let them enjoy a night out with friends.But rather than arguing over whether or how to lock the clock, a more efficient use of regulatory resources is to steer society away from strict schedules, as well as non-essential shift work and illogically drawn time zones. (For the record, there is still one wrong answer: Permanent DST would steal an hour of morning light and tack it onto the evening, further blurring the day-night contrast our inner clocks crave.)Neither Trump nor Musk appear conscious of the value and vulnerability of their inner clocks. Trump regularly posts on social media in the early hours of the morning; Musk wore sunglasses throughout last week’s CPAC conference. Still, it is in their power to help themselves and the American people better live and work with–rather than against–their inner clocks, regardless of whether the clock on the wall reads DST or standard time. It is a matter of efficiency that they would be foolish not to embrace.

      Lynne Peeples is a science journalist and author of the new book The Inner Clock: Living in Sync with Our Circadian Rhythms More

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      in US Politics

      Medicaid recipients fear ‘buzzsaw cuts’ for Trump’s agenda: ‘We’re not going to be alive forever’

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      At the age of 62, Marya Parral knows that her, and her husband’s, years of being able to care for their two developmentally disabled sons are numbered, and so they have done everything they can to ensure their children can continue to live independently.For their oldest, Ian, that’s meant placing him in a program on an organic farm that caters to people diagnosed with autism. For Joey, their youngest, who has both autism and Down syndrome, Parral has found a caregiver who can help him deliver newspapers and run errands around their community of Ocean City, New Jersey.Parral said none of this would be affordable without help from Medicaid, the federal government’s insurance program for poor and disabled Americans. But this week, the Republican-controlled House of Representatives approved a budget framework that would make deep cuts to the program, and Parral worries her sons will lose what she has worked so hard to build.“We’re not going to be alive forever. We’re trying to set up a life for them, but that entire life that we’re working so hard to set up for them is dependent on Medicaid,” Parral said. “So it’s really devastating to think about cuts.”Producing a budget is the first step in the Republican-controlled Congress’s drive to enact legislation that will pay for Donald Trump’s priorities. House lawmakers will now spend weeks working to write and pass a bill that is expected to approve $4.5tn in extended tax cuts, as well as funding for Trump’s plan for mass deportations of undocumented immigrants.To pay for it, Republicans are considering a rollback of the federal social safety net, particularly Medicaid, which has nearly 80 million enrollees in all 50 states. The budget plan proposes an $880bn reduction in funding for the insurance over the next 10 years, an amount that experts warn would hollow out the program and have ripple effects across the entire American healthcare system.Megan Cole Brahim, a professor at Boston University School of Public Health and an expert on Medicaid, said the cut was the largest ever proposed, and if enacted would “have far-reaching impacts not just for those who rely on Medicaid, but for entire communities and economies”.“These changes mean millions of Americans – including the low-income, elderly, persons with disabilities, children – will lose health insurance coverage,” she said. “Others may see significant reductions in benefits or limited access to care. The impact on hospitals and health systems will be significant, particularly for safety-net and rural hospitals, which are already on the brink of closure. Patient revenues will fall, uncompensated care will rise. There will be staff layoffs and site closures.”John Driscoll, a healthcare executive and chair of the board of UConn Health in Connecticut, said: “The scale of the buzzsaw cuts to Medicaid would undermine every hospital’s ability to actually support its mission to care for the community, and would be a dangerous cut to the nursing-home infrastructure in the country.”Republican leaders backed the cuts to Medicaid, as well as to similar programs such as one that helps poor Americans afford food, as a way to mollify lawmakers in their party who want the US’s large budget deficit addressed. Still, not everyone is pleased. As the budget was being debated, eight Republican representatives, some of whom Democrats are keen to unseat in next year’s midterm elections, wrote to the House speaker, Mike Johnson, warning that their districts’ large Hispanic populations would be harmed.“Slashing Medicaid would have serious consequences, particularly in rural and predominantly Hispanic communities where hospitals and nursing homes are already struggling to keep their doors open,” they said.All eight ultimately voted for the resolution, but the dissent may be a warning sign for the budget’s prospects of enactment, particularly in the House, where the GOP has a mere three-seat majority. It also remains unclear whether Republicans will try to pass all of Trump’s priorities in one bill, or split them into two.The GOP has made clear they want to fully pay for the extension of Trump’s tax cuts, and Elyssa Schmier, vice-president of government relations for advocacy group MomsRising, said Medicaid and social safety programs are the party’s prime targets for cost savings.“If you’re not going to go after, say, the Pentagon budget, if they’re only going to go to some of these big mandatory spending programs, there’s only so many places that Republicans feel that they can go,” she said.In the days since the budget’s approval, Johnson and Trump have scrambled to downplay the possibility of slashing Medicaid, insisting they intend only to root out “fraud, waste and abuse.”“The president said over and over and over: ‘We’re not going to touch social security, Medicare or Medicaid.’ We’ve made the same commitment,” Johnson told CNN in an interview.Democrats have little leverage to stop the budget, which can be passed with simple majorities in both chambers. But the Democratic senator Ruben Gallego warned that gutting the social safety net to extend tax cuts that have mostly benefited the rich will alienate voters who sided with the GOP last November.“It will be on Donald Trump and Republicans, the fact that he’s going to side with the ultra-rich versus the working poor,” said Gallego, who won election to his seat in Arizona even as Trump captured the state’s electoral votes. “Families that are barely making a living, scratching a living, they’re now going to get kicked off healthcare to give tax cuts to the mega-rich.”The proposed cut to Medicaid would remove billions of dollars in funding from congressional districts nationwide that are represented by lawmakers from both parties, according to an analysis by the liberal Center for American Progress.In California’s San Joaquin valley, the Democratic representative Jim Costa’s district would lose the third-largest amount of funding, according to the data, and Medicaid coverage would be imperiled for more than 450,000 residents.“This reckless budget prioritizes the wealthy while devastating those who need help the most,” Costa said. “I voted no because this resolution is bad for our valley and a threat to the wellbeing of the people I represent.” More

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      in US Politics

      Trump cuts reach FDA workers focused on food safety and medical devices

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      The Trump administration’s effort to slash the size of the federal workforce reached the Food and Drug Administration this weekend, as recently hired employees who review the safety of food ingredients, medical devices and other products were fired.Probationary employees across the FDA received notices on Saturday evening that their jobs were being eliminated, according to three FDA staffers who spoke to the Associated Press on condition of anonymity because they were not authorized to speak publicly.The total number of positions eliminated was not clear on Sunday, but the firings appeared to focus on employees in the agency’s centers for food, medical devices and tobacco products – which includes oversight of electronic cigarettes. It was not clear whether FDA employees who review drugs were exempted.On Friday, the US Department of Health and Human Services announced plans to fire 5,200 probationary employees across its agencies, which include the National Institutes of Health, the FDA and the Centers for Disease Control and Prevention.People who spoke with the AP on condition of anonymity on Friday said the number of probationary employees to be laid off at the CDC would total nearly 1,300. But as of early Sunday afternoon, about 700 people had received notices, according to three people who spoke on condition on anonymity because they were not authorized to speak publicly. They said none of the CDC layoffs affected the doctors and researchers who track diseases in what’s known as the Epidemic Intelligence Service.The FDA is headquartered in the Maryland suburbs outside Washington DC and employs nearly 20,000 people. It’s long been a target of newly sworn-in health secretary Robert Kennedy Jr, who last year accused the agency of waging a “war on public health” for not approving unproven treatments such as psychedelics, stem cells and chelation therapy.Kennedy also has called for eliminating thousands of chemicals and colorings from US foods. But the cuts at FDA include staffers responsible for reviewing the safety of new food additives and ingredients, according to an FDA staffer familiar with the firings.An HHS spokesperson did not immediately respond to a request for comment on Sunday afternoon.Nearly half of the FDA’s $6.9bn budget comes from fees paid by companies the agency regulates, including drug and medical device makers, which allows the agency to hire extra scientists to swiftly review products. Eliminating those positions will not reduce government spending.A former FDA official said cutting recent hires could backfire, eliminating staffers who tend to be younger and have more up-to-date technical skills. The FDA’s workforce skews toward older workers who have spent one or two decades at the agency, and the Government Accountability Office noted in 2022 that the FDA “has historically faced challenges in recruiting and retaining” staff due to better money in the private sector.“You want to bring in new blood,” said Peter Pitts, a former FDA associate commissioner under George W Bush. “You want people with new ideas, greater enthusiasm and the latest thinking in terms of technology.”Mitch Zeller, former FDA director for tobacco, said the firings are a way to “demoralize and undermine the spirit of the federal workforce”.“The combined effect of what they’re trying to do is going to destroy the ability to recruit and retain talent,” Zeller said.The FDA’s inspection force has been particularly strained in recent years after a wave of departures during the Covid-19 pandemic, and many of the agency’s current inspectors are recent hires. It was not immediately clear whether those employees were exempted.FDA inspectors are responsible for overseeing thousands of food, drug, tobacco and medical device facilities worldwide, though the AP reported last year that the agency faced a backlog of roughly 2,000 uninspected drug facilities that hadn’t been visited since before the pandemic.The agency’s inspection force have also been criticized for not moving faster to catch recent problems involving infant formula, baby food and eyedrops. More