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      The Guardian view on Trump and reality: from promoting alternative facts to erasing truths | Editorial

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      What does the public need to know? The Trump White House boasts of being the most transparent administration in history – though commentators have suggested that the inadvertent leak of military plans to a journalist may have happened because senior figures were using messaging apps such as Signal to avoid oversight. Last week, it released thousands of pages of documents on John F Kennedy’s assassination. Donald Trump has declared that Kennedy’s family and the American people “deserve transparency and truth”.Strikingly, this stated commitment to sharing information comes as his administration defunds data collection and erases existing troves of knowledge from government websites. The main drivers appear to be the desire to remove “woke” content and global heating data, and the slashing of federal spending. Information resources are both the target and collateral damage. Other political factors may be affecting federal records too. Last month, Mr Trump sacked the head of the National Archives without explanation, after grumbling about the body’s involvement in the justice department’s investigation into his handling of classified documents.The impact is already painfully evident. Cuts at the National Oceanic and Atmospheric Administration have affected not only climate records but also an extreme weather risk tool. The purge’s results are absurd as well as damaging. A webpage on the Enola Gay, the aircraft that dropped the atomic bomb on Hiroshima, appears to have been marked for deletion because it was mistaken for a reference to LGBTQ+ issues.Yet the disparity between the data dump on the Kennedy assassination and the removal of other material is not a contradiction. It speaks volumes about the administration’s approach to truth and knowledge, which it regards as contingent and a matter of convenience. (Tellingly, it is also axing the body that provides most federal funding to libraries.)The 1963 presidential assassination is not only an event around which multiple theories circle but one that helped feed a broader culture of conspiracy theorising and distrust in authority. That has metastatised to the bizarre and extreme claims embraced and even promoted by Mr Trump or figures around him, including birtherism, Pizzagate and QAnon. These increasingly fantastical narratives have had real-world consequences. Facts, science and rationality itself are under attack.In his first term, Mr Trump’s aides shamelessly promoted “alternative facts” while decrying actual facts as “fake news”. The Washington Post tallied more than 30,000 false or misleading claims over those four years. This time round, his administration is removing existing sources of information. Websites, datasets and other information vanished from federal health websites – such as that for the Centers for Disease Control – last month, though some has since reappeared. One scientist called it “a digital book burning”. The Union of Concerned Scientists has warned that “critically important science conducted at many US agencies, institutions, and universities [is] under increasing assault”.Ad hoc preservation of essential national information and records is usually the work of those faced with the destructive force of foreign invasions, jihadist insurgencies or dictators. But as this bonfire blazes, a motley but committed array of individuals – “nerds who care”, in the words of one – are fighting back by preserving data before it is deleted. Their admirable effort to defend the truth deserves support.

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      ‘Trump derangement syndrome’ and the Goldwater rule for psychiatrists | Letter

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      A bill was recently introduced to the Minnesota legislature to categorise “Trump derangement syndrome” as a mental illness. The proposed bill defines the syndrome as characterised by “verbal expressions of intense hostility toward” Donald Trump and “overt acts of aggression and violence against anyone supporting [Trump] or anything that symbolises [Trump].”Such a bill obviously infringes on our constitutional right to freely criticise our elected leaders and can serve as a stepping stone towards labelling and punishing political opponents under the guise of utilising a variety of compulsory psychiatric interventions. However, this bill is reminiscent of anti-Trump mental health professionals who have opined that President Trump poses a great danger because of a severe personality disorder.Clearly, a psychiatric diagnosis can only be made by mental health professionals who are licensed to do so, and only after having examined a patient. It poses great danger to our society both when legislators use their political power to impose a psychiatric label on their political opponents and when mental health professionals misapply their expertise to give a psychiatric label to those whom they fear.In the 1960s, many psychiatrists opined on the mental health of the Republican presidential candidate Barry Goldwater. As a result of that controversy, in 1973 the American Psychiatric Association developed the “Goldwater rule”, which applies to public figures. It states that it is unethical for a psychiatrist to offer a proper authorisation for such a statement.This rule is still in effect, though much too often broken. Perhaps we need to develop a comparable national rule prohibiting political personnel, both elected and appointed, from creating psychiatric diagnoses as a tool against their political opponents.Leon Hoffman Psychiatrist, New York City, US More

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      ‘The goal is to disassemble public health’: experts warn against US turn to vaccine skepticism

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      As vaccine hesitancy increases in the US, isolated, tight-knit and religious communities have frequently been at the center of high-profile outbreaks.Such is the case in west Texas, where a rural community is the center of an expanding measles outbreak that has already claimed the lives of two Americans – the first deaths from the disease in nearly a decade.However, as the conspiracy theories of Maga conservatism marry the bugbears of the US health secretary and vaccine skeptic Robert F Kennedy Jr, the one-time fringe view of vaccines has become increasingly mainstream – with activists in right-leaning population centers taking lessons learned from the Covid-19 pandemic into the realm of childhood inoculations.One need look no further than Sarasota, Florida, for a full-throated political denunciation.“Generally, people are weak, lazy,” said Vic Mellor, an activist based near Sarasota, and a close ally of former Trump national security adviser Michael Flynn.Mellor owns the We the People Health and Wellness Center in nearby Venice. Mellor, in a shirt that shouts “VIOLENCE MIGHT BE THE ANSWER”, is a self-professed attendee of the January 6 insurrection at the US Capitol.“And that lazy part just makes them ignorant … Covid has proven that obviously this is true. I mean, all the facts are starting to come out on Covid now – that it was a hoax. That is just an extension of where this hoax began decades earlier with the vaccines, OK? This is all a money grab, this is all a power grab.”The pandemic was real, and it started Mellor down the road of questioning vaccines. Where he once opposed only the Covid-19 shots, he now opposes vaccines entirely – arguing they harm children despite experts on vaccines considering them one of mankind’s greatest medical achievements.“This is not an isolated, rural, religious community, which I think is what a lot of people associate with an anti-vaccine mentality,” said Kathryn Olivarius, the author of Necropolis: Disease, Power, and Capitalism in the Cotton Kingdom, and a historian of disease at Stanford University. “This is in the heart of everything.”Sarasota has become a proving ground for the Maga right. Among nail salons, mom-and-pop Cuban restaurants and roadside motels lining US 41, known locally as the Tamiami Trail, a visitor can find the gates of New College. This was once a public university prized for its progressive liberal arts education. Now it is part of the new conservative experiment in remaking higher education led by activists aligned with Donald Trump and the Republican Florida governor, Ron DeSantis.Along the same road is the Sarasota memorial hospital, an aberration in American healthcare – it is publicly owned with open board elections. The normally sleepy election became contentious when insurgent “health freedom” candidates, supported in part by Mellor, entered the race. Three won seats on the nine-member board in 2022.Even the name of this stretch of sun-bleached asphalt is up for debate. This year, a state Republican lawmaker – who has also introduced bills to limit vaccine requirements – briefly proposed changing its name to the “Gulf of America Trail” – a nod to Trump’s renaming of the Gulf of Mexico.Arguably the most salient artifact of this activism in Sarasota is the least visible: vaccination rates against measles.Measles vaccination rates for kindergarteners have plummeted over the last two decades – from 97% in 2004 to 84% in 2023, according to state health records. Sarasota is roughly on par with the vaccination rates in rural Gaines county, Texas – the center of the ongoing measles outbreak that sickened 279 people in in that state alone. Notably, both Gaines county and Sarasota have large home-schooling communities, meaning vaccination rates could in fact be lower.It is well known in research circles that right-leaning states across the US south and west have worse health metrics – from obesity to violence to diseases such as diabetes. That reality was supercharged during the pandemic; as vaccine mandates became a fixation on the right, Republican-leaning voters became more skeptical of vaccines. In turn, places with politically conservative leaders experienced more Covid-19 deaths and greater stress on hospitals.Measles is one of the most contagious diseases known to medicine. At least 95% of the population needs to be vaccinated to prevent outbreaks of the disease. But despite a supremely effective vaccine that eliminated the disease from the US in 2000, vaccine hesitancy has increasingly taken hold.skip past newsletter promotionafter newsletter promotionConservative activism alone can’t be blamed for declining measles vaccination rates. The measles vaccine in particular has been subject to a sustained firehose of misinformation stemming from a fraudulent paper linking the vaccine to autism in 1999. For years, this misinformation was largely nonpartisan. And Florida’s anti-vaccine movement was active even before the pandemic – with a vocal contingent of parents arguing against strengthening school vaccine standards in 2019.What appears new in Sarasota is how local conservative activists have brought opposition to vaccines into the heart of their philosophy. By Mellor’s telling, he and a loosely affiliated group of Maga activists began to adopt anti-vaccine beliefs as the pandemic wore on – helping organize major health protests in the area in recent years, such as mask mandate opt-outs and the “health freedom” campaign for hospital board seats.Mellor said his nearby property, the Hollow, was a gathering place during the pandemic (it is also a part-time gun range). He cites ivermectin, an anti-parasitic drug that became a fascination of the right, as the reason “we didn’t lose people at all” during the height of the pandemic. Available clinical evidence shows it is not effective against Covid-19.Kennedy has fit neatly into this realignment. He enjoys trust ratings among Republicans nearly as high as Trump, according to polling from the health-focused Kaiser Family Foundation. Kennedy has already spread dubious information about measles vaccines in public statements (notably: from a Steak ’n Shake in Florida) – a response one vaccine expert said “couldn’t be worse”.“While children are in the hospital suffering severe measles pneumonia, struggling to breathe, [Kennedy] stands up in front of the American public and says measles vaccines kill people every year and that it causes blindness and deafness,” said Dr Paul Offit, the director of the Vaccine Education Center and an attending physician in the division of infectious diseases at the Children’s Hospital of Philadelphia. Severe side effects from the vaccine are possible, but they are much rarer than disability and death from measles.“This is what happens when you have a virulent anti-vaccine activist, a science denialist, as the head of the most important public health agency in the United States,” said Offit. “He should either be quiet or stand down.”The same poll found trust in public health agencies has fallen precipitously amid Republican attacks. More than a quarter of Republican parents report delaying childhood vaccines, the poll found, a rate that has more than doubled since 2022. There is no analogous trend among Democratic parents. Despite how claims espoused by vaccine skeptics can be easily refuted, their power has not been undercut.“The anti-vaccine business is big business,” said Offit, pointing to the myriad unproven “treatments” offered by promoters of vaccine misinformation, some of which are offered at Mellor’s We the People health center. “We have been taken over by a foreign country, and the goal of that foreign country is to disassemble public health.”The misery of measles did not take long to appear in Texas – measles-induced pneumonia has already led pediatricians to intubate children, including at least one baby, according to the Associated Press. About one to three people out of 1,000 who are infected by measles die from the infection, and one in 1,000 suffer severe brain swelling called encephalitis, which can lead to blindness, deafness and developmental delays.“We actually don’t have the perspective people in the past had on these diseases,” Olivarius. “I have spent many, many, many years reading letters and missives from parents who are petrified of what’s going to happen to their children” if there are outbreaks of yellow fever, polio or measles, Olivarius said about diseases now largely confined to history – thanks to vaccines.“The lesson from history is these are not mild ailments,” she said. “These are diseases that have killed hundreds of millions of people – and quite horribly too.” More

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      ‘It’s back to drug rationing’: the end of HIV was in sight. Then came the cuts

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      This year the world should have been “talking about the virtual elimination of HIV” in the near future. “Within five years,” says Prof Sharon Lewin, a leading researcher in the field. “Now that’s all very uncertain.”Scientific advances had allowed doctors and campaigners to feel optimistic that the end of HIV as a public health threat was just around the corner.Then came the Trump administration’s abrupt cuts to US aid funding. Now the picture is one of a return to the drugs rationing of decades ago, and of rising infections and deaths.But experts are also talking about building a new approach that would make health services, particularly those in sub-Saharan Africa, less vulnerable to the whims of a foreign power.The US has cancelled 83% of its foreign aid contracts and dismantled USAid, the agency responsible for coordinating most of them.Many fell under the President’s Emergency Plan for Aids Relief (Pepfar) programme, which has been the backbone of global efforts to tackle HIV and Aids, investing more than $110bn (£85bn) since it was founded in 2003 and credited with saving 26 million lives and preventing millions more new infections. In some African countries it covered almost all HIV spending.View image in fullscreenThere is a risk, says Lewin, director of Melbourne University’s Institute for Infection and Immunity and past president of the International Aids Society, of “dramatic increases in infections, dramatic increases in death and a real loss of decades of advances”.There is no official public list of which contracts have been cancelled, and which remain. It appears that virtually no HIV-prevention programmes funded by the US are still in operation, save a handful principally providing drugs to stop pregnant women passing on the infection to their babies. Countries report disruption to the most basic measures, such as condom distribution.Some treatment programmes have been spared, but not those whose focus conflicted with the Trump administration’s war on “gender ideology” or diversity, equity and inclusion (DEI), such as those working with transgender communities. Doctors, nurses and other healthcare workers have been laid off, while worried patients are hoarding drugs or stretching supplies, according to UNAids surveillance. UNAids itself has lost more than half of its funding.Even programmes that have survived the cull have faced turmoil since February, with instructions to stop work rescinded but with no certainty that funding will continue.View image in fullscreenIn only one example, the Elizabeth Glaser Paediatric Aids Foundation says it has had to halt HIV treatment for 85,000 people in Eswatini, including more than 2,000 children, and tests for thousands of pregnant women and babies to prevent transmission and begin life-saving medication.Access to drugs represents an “immediate crisis”, Lewin says. “If people with HIV stop the medications, then not only do they get sick themselves, which is tragic, but they also then become infectious to others.”As clinics on the frontline of treating the disease scrabble to secure access to basic drugs, scientists at this month’s Conference on Retroviruses and Opportunistic Infections in San Francisco were hearing that HIV might soon be preventable with a once-a-year injection.The drug lenacapavir was already generating huge excitement in the field, after trial results showed that a six-monthly jab could prevent HIV. New results from the manufacturer Gilead suggest that a tweak to the formula and how it is given could see its protective effects last even longer.Nevertheless, Lewin says, the mood at the meeting, packed with many of the world’s leading HIV specialists, was “dire”.As well as programme cancellations, there are “huge concerns around science and what’s going to happen to the [US] National Institutes of Health, [whose] funding of science has been so significant on every level”, she says.Some scientists in receipt of US funding have been told to remove their names from DEI-linked research, she says, even though DEI is fundamental to the HIV response.View image in fullscreen“I don’t mean that in a sort of touchy-feely way, I mean that’s what we need to do: you need to actually get those treatments to these diverse communities.”In 2022, 55% of all new HIV infections were within “key populations”, such as gay men, other men who have sex with men, sex workers, transgender people, prisoners and people who inject drugs.Prof Linda-Gail Bekker, of South Africa’s Desmond Tutu Health Foundation, has seen US funding for three trials of potential HIV vaccines involving eight countries cancelled and only reinstated after an appeal to the US supreme court.“We’re running around like chickens without heads to at least get one going, because the vaccines are sitting in the fridge and will expire,” she says.She led the lenacapavir trial that showed it offered 100% protection to young women in sub-Saharan Africa, but now worries about HIV/Aids prevention “falling off the radar completely”.The global community had been making headway towards the United Nations’ goal of ending Aids by 2030, she says, with a five-year plan to use “amazing new innovative tools and scale them up”, which would have led to “less dependence on foreign aid and more self-reliance” as new infections fell and attention shifted to maintaining treatment for people with HIV.“All of that is hugely at risk now because, without these funds, our governments will have to step up but they will concentrate on treatment,” she says. “We know they will do that, because that is what we did for the first 30 years.”Efforts to control Aids were entering “the last mile”, which was always likely to be more expensive, she says. “The people who were happy to come into health facilities, they would have come into health facilities.”It would be difficult to rely on government funding to reach the remaining groups, she says, not only because of fewer resources but also because in some countries it means targeting groups whose existence is illegal and unrecognised, such as sex workers or sexual minorities, and young girls may be reluctant to use government clinics if they are not supposed to be sexually active.“I feel like the odds are very stacked against us,” says Bekker, adding: “We’re obviously going to have to re-programme ourselves [and] formulate a different plan.”Pepfar had pledged funding to the Global Fund to Fight Aids, Tuberculosis and Malaria, to deploy 10m doses of lenacapavir in low-income countries. While the Global Fund has promised to maintain its commitment, it might receive fewer than the planned number of doses, Bekker fears.“Six months ago, I was saying the best thing we can do with lenacapavir is offer it to everybody in a choice environment. [Now] I think we’re gonna have to say who needs [injectable] prep,” she says, “and the rest have to do the best they can.“How do we make that decision? And what does that look like? It is back to sort of rationing.“When we started ARVs [antiretroviral drugs] way back in 2000,” Bekker recalls, “you would go, ‘you get treatment; you don’t, you don’t, you don’t’.“It feels terrible … but you have to get over that. You have to say it will be infection-saving for some people. And we’ve got to make it count.”View image in fullscreenFor Beatriz Grinsztejn, president of the International Aids Society, the disruption is critical and threatens many vulnerable people. But, she adds, it could present “an important opportunity for ownership – otherwise we are always left in the hands of others”.She worries about the impact of cuts to funding on younger scientists, with their potential loss from the research field “a major threat for the next generation”. But, she adds, the HIV community is “powerful and very resilient”.There have already been calls for new ways of doing things. It is “time for African leadership”, members of the African-led HIV Control Working Group write in the Lancet Global Health. There are now plans for Nigeria to produce HIV drugs and tests domestically.Christine Stegling, deputy director of UNAids, says it began “a concerted effort” last year to develop plans with countries about how their HIV programmes could become more sustainable domestically “but with a longer timeframe … now we are trying to do some kind of fast-tracking”.Governments are determined, she says, but it will require fiscal changes either in taxation or by restructuring debt.The goal of ending Aids by 2030 is still achievable, Stegling believes. “I think we have a very short window of opportunity now, in the next two, three months, to continue telling people that we can do it.“I keep on reminding people, ‘look, we need to get back to that same energy that we had when people were telling us treatment can’t be available in the global south, right?’ And we didn’t accept it. We made it happen.“We have national governments now who are also very adamant, because they can see what can happen, and they want to make it happen for their own populations.” More

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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