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    Trump moves to push employers on IVF coverage and lower fertility drug costs

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    The Trump administration announced Thursday that it is urging US employers to create new fertility benefit options to cover in vitro fertilization and other infertility treatments.In an announcement from the Oval Office, Donald Trump also said his administration had cut a deal with the drug manufacturer EMD Serono to lower the cost of one of its fertility drugs and list the drug on the government website TrumpRx.These moves, Trump said, would lead to “many more beautiful American children”.“In the Trump administration, we want to make it easier for all couple to have babies, raise children and have the families they’ve always dreamed about,” Trump said.Employers are encouraged to offer the fertility benefit option separately from their medical coverage, similar to how dental and vision coverage is usually offered to employees. The labor department, the treasury and the health department will on Thursday also release guidance on how employers can legally create the option.However, Republicans who spoke at Trump’s announcement framed the benefit as a “recommendation”, indicating that employers will not be required to offer the coverage nor receive government subsidies for doing so. They also stressed that the benefit will be structured to give employers immense flexibility to determine what will or will not be covered.Without new incentives to offer IVF coverage, it is unclear how many employers will ultimately support it.Trump, who has called himself the “fertilization president”, made support for infertility treatments a major part of his re-election campaign, especially after the nation erupted in outrage when the Alabama supreme court deemed embryos “extrauterine children”. Because IVF can lead to the creation of unused or discarded embryos, that decision temporarily forced many Alabama IVF providers to stop working.Yet in the months since taking office, the Trump administration has remained quiet on the issue. In February, he signed an executive order directing the administration’s domestic policy council to make recommendations to “aggressively” reduce the price tag of IVF, which often costs tens of thousands of dollars and is frequently not covered by insurance.A detailed report on the recommendations was supposed to be made public by May. No report ever emerged.While IVF is extremely popular among Americans, the GOP’s deep ties to the anti-abortion movement have made it something of a political landmine among elected Republicans. The movement has long opposed IVF, as advocates believe that embryos are people.White House officials have in recent months discussed the possibility of supporting restorative reproductive medicine (RRM), a constellation of therapies that purport to restore people’s “natural” fertility.Although RRM is popular among anti-abortion advocates and adherents of the “make America healthy again” movement, several major medical organizations say there is little quality evidence that RRM is more effective at helping people have babies than mainstream fertility medicine.Trump did not mention RRM in his Thursday address. When a reporter asked if he had any thoughts on anti-abortion activists’ opposition to IVF, Trump said: “I think this is very pro-life.”Pronatalist rhetoric, which holds that having children is important to a county’s wellbeing and that the state should incentivize people to procreate, dominated the press conference that followed Trump’s address. Robert F Kennedy, the health and human services secretary, highlighted the falling US birthrate, while Mehmet Oz, the administrator for the Centers for Medicare and Medicaid Services, claimed that Kennedy and Trump are “great leaders” because they have big families.People who want more children but can’t have them, Oz added, are “under-babied”.“There’s gonna be a lot of Trump babies,” Oz said. “It turns out the fundamental creative force in society is about making babies.” More

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      Maha is backing this ‘natural’ infertility treatment. Is it the right’s path to limiting IVF?

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      View image in fullscreenFor Erica L and her husband, in-vitro fertilization was the “nuclear option”.After two years of trying to conceive, Erica and her husband had no idea why they could not have a baby. Doctors said only that they had “unexplained infertility”, a non-diagnosis of a diagnosis that is given to an estimated 15% of people trying to conceive. Erica was not ideologically opposed to trying IVF, but felt daunted by the price and unpredictability.Then Erica stumbled across a clinic that specialized in “restorative reproductive medicine”, or RRM. The clinic did bloodwork on Erica and her husband and urged them to eat well-balanced foods and take supplements, as well as prioritize exercise and sleep. Erica also started tracking her temperature and menstrual cycle in intense detail.“We wanted to do everything that we could to try to have a baby as naturally as possible,” said Erica, who asked that her full last name not be published. “There’s a lot of invasive things that I just wasn’t comfortable with.”Restorative reproductive medicine is a decades-old name for a constellation of therapies that are meant to revive the “natural” fertility of people trying to conceive. Often, RRM entails prescriptions for hormones, supplements and lifestyle changes – such as adopting a better diet – as well as closely analyzing one’s menstrual cycle. Its practitioners also sometimes use aggressive surgeries to root out endometriosis, a common and chronic condition that occurs when tissue that is similar to uterine tissue grows outside of the uterus. And, critically, RRM practitioners avoid the use of assisted reproductive technology such as IVF.Top Republicans, rightwing organizations and even White House officials have recently begun to rally behind RRM, seizing on its promise to enhance fertility without resorting to IVF. Many anti-abortion conservatives revile IVF because it can create unused embryos – a practice they see as unethical, if not murderous, as they believe life begins at conception.Yet IVF remains staggeringly popular, to the point that Donald Trump pledged to make it free in the wake of a 2024 Alabama supreme court decision that imperiled the procedure. Now, conservatives are trying to pare back that commitment – and some fertility doctors, including ones who offer RRM, worry that the right is co-opting RRM as a Trojan horse in order to sell a fertility agenda to voters while undermining IVF.Backed by several high-profile anti-abortion groups, Republicans in Congress have repeatedly introduced legislation to bolster government-funded research and education on RRM. In March, the Heritage Foundation – the influential thinktank behind the notorious Project 2025 – released a 63-page report that endorsed RRM and slammed IVF.Then, in July, the Department of Health and Human Services posted a notice soliciting applications for a $1.5m grant to fund an “infertility training center” that would expand access to resources for “holistic infertility treatments” rather than assisted reproductive technology. In August, the Washington Post reported that the Trump administration is backing away from the president’s campaign promises about IVF, although a White House spokesperson rebutted that claim.View image in fullscreenDr Kaylen Silverberg is a reproductive endocrinologist who has advised administration officials, including Trump’s chief of staff Susie Wiles, about IVF. During his discussions with officials, Silverberg said he was asked about RRM.“I’ve been doing this for 31 years, and I’d never even heard the term,” said Silverberg, who is also advisory board chair of the advocacy group Americans for IVF. “So I started doing research about it. I realized that restorative reproductive medicine is just a pseudonym for a basic infertility evaluation.”Silverberg’s view is shared by many mainstream fertility doctors and organizations, who say that the difference between their work and RRM is less scientific than ideological. In their view, RRM is a rebranded version of everyday fertility medicine, minus IVF.RRM, with its focus on optimizing the body’s “natural” rhythms, is tapping into a growing interest in holistic health and wellness – one that is being increasingly politicized and expertly leveraged by the “Make America Healthy Again” (Maha) movement.But support for RRM alone, Silverberg said, cannot fulfill Trump’s campaign promises. “The problem is going to be if – and this is a big if – anybody tries to limit expansion of fertility access and care and coverage to restorative reproductive medicine.”‘There is another option’RRM is not a monolith. Some of its leading organizations and adherents take no position on IVF and reject the idea that RRM is ideologically driven or a new name for old medicine. Instead, they are drawn to RRM’s stance that infertility is not itself a disease but a symptom of something else that has gone wrong.Established in 2000, the International Institute for Restorative Reproductive Medicine (IIRRM), the preeminent group championing RRM, maintains a registry of RRM clinicians and collects data about its techniques’ efficacy.Dr Monica Minjeur, who was trained in family medicine and serves as the US director of communications and development for the International Institute for Restorative Reproductive Medicine, said RRM is “not an anti-IVF movement”. As far as Minjeur knows, no one in Congress has approached the institute to discuss RRM.“We will never say: ‘IVF should go away.’ We just mostly want people to realize: ‘Hey, there is another option,’ because so many couples are told IVF is your only option,” said Minjeur, who added that she is a Democrat.View image in fullscreenSome RRM advocates and groups do oppose IVF and have long aligned themselves with conservative causes such as the anti-abortion movement. One of the most well-known RRM techniques is NaPro Technology, which usually involves such tactics as cervical mucus tracking and has been pioneered by the anti-abortion Saint Paul VI Institute since the 1980s, when the Vatican condemned IVF. The institute’s website presents NaPro Technology as an alternative to IVF, which it calls “a highly abortive technology that often forces women to make abortion-related decisions”.In June, a new thinktank, the Maha Institute, held a roundtable discussion about women’s health and fertility. In her introduction to the discussion, Maureen Ferguson, a commissioner for the US Commission on International Religious Freedom with longstanding ties to the anti-abortion movement, sang RRM’s praises.“Traditional women’s health and fertility care has relied heavily on big pharma bandaids and workarounds that circumvent a women’s reproductive system,” Ferguson said. “Women of all political stripes appreciate healthcare that works in harmony with their body and restores health.”IIRRM wants to harness Maha advocates’ enthusiasm but is wary of being equated with the movement, according to Minjeur and Dr Tracey Parnell, the institute’s global director of communications and development. They described RRM and Maha as two sides of a Venn diagram.“We want to bring increased health to women and men and families,” Minjeur said of Maha. “Beyond that, there are definitely a fair amount of differences.”Parnell added: “We really truly are open to quite broad collaboration without being co-opted.”The rise of wellness cultureThe Make America Healthy Again movement is perhaps the best illustration of a broader push within American conservatism to incorporate the historically leftwing language of holistic health and “natural” treatments – in short, “wellness” – to advocate for traditionally rightwing aims, such as convincing women to have big families.This push started to gain steam in the years after the Covid pandemic, as trust in mainstream medicine started to falter: a survey of nearly half a million US adults found that trust in physicians and hospitals declined from roughly 72% to just 40% between April 2020 – the month after the pandemic broke out – and January 2024. As trust eroded, the wellness industry exploded. Between 2019 and 2023, it grew from $5.3tn to $6.32tn, according to the Global Wellness Institute, which defines wellness as the ongoing and individual pursuit of “optimal holistic health and wellbeing”.“Wellness” can encapsulate a wide range of activities, from undeniably healthy behaviors (such as exercising and eating nutritious foods) to practices that may be dangerous (such as drinking raw milk). These activities are yoked together by a deceptively simple ethos, according to Amy Larocca, author of the book How to Be Well: Navigating Our Self-Care Epidemic, One Dubious Cure at a Time.“In wellness, things that are natural are superior to things that are not,” Larocca explained.Wellness’s sales pitch can be particularly appealing to Americans, given the astronomical costs of traditional healthcare in the US. A single IVF cycle can run tens of thousands of dollars and most states do not require insurers to cover it. By contrast, countries such as Denmark and Sweden cover vast swathes of fertility treatments, including IVF.RRM treatments tend to cost far less than IVF, and may soon get even cheaper. In June, Arkansas’s Republican-dominated state legislature became the first in the country to pass a law requiring state insurance to cover RRM therapies.But critics say there is little quality evidence that RRM is more effective at helping people have babies than mainstream fertility medicine. The American Society for Reproductive Medicine, the American College of Obstetricians and Gynecologists, the Society for Maternal-Fetal Medicine and the Society of Gynecologic Surgeons are worried that other states may follow Arkansas’s lead; last week, the medical organizations sent a letter to urging the National Governors Association to reject pro-RRM legislation.Women’s health and infertility are especially ripe breeding groups for wellness because mainstream medicine routinely fails to take either seriously. Between 2013 and 2023, just 8.8% of research funded by the National Institutes of Health focused on women’s health. Women are also more likely to have their medical concerns dismissed. When women and people of color show up at emergency rooms with signs of chest pain, they usually wait longer; women are also less likely to be admitted.‘Many sobbing women’A year after Erica started working with the restorative reproductive medicine clinic, the clinic told her: “We’re really concerned that you’re not pregnant yet. You should be pregnant.”The RRM specialists suggested that Erica might have endometriosis, which affects about one in 10 women and girls worldwide and is believed to be a leading cause of infertility.It is also profoundly understudied. In 2023, a mere 0.06% of the NIH’s $47bn budget was earmarked for endometriosis research. Because many doctors dismiss the symptoms of endometriosis or lack the expertise to recognize it, it generally takes between five and 11 years to get a diagnosis.Erica went ahead with a surgery to diagnose and remove endometriosis tissue. RRM practitioners have suggested that the condition can be treated by a “one-and-done surgery” – as one RRM surgeon put it in the Heritage Foundation report – that aggressively excises endometriosis tissue.A month later, Erica got pregnant. Erica estimated that she and her husband spent, in total, about $2,500 on RRM.“We definitely wouldn’t have our daughter without them,” she said of RRM specialists.View image in fullscreenMany of RRM’s prescriptions are common sense: if you are trying to get pregnant, it can be helpful to take a holistic view of your health and know as much about your menstrual cycle as possible. But mainstream reproductive endocrinologists are skeptical of RRM’s position that infertility itself is not a disease, which runs counter to the World Health Organization’s definition of infertility. They also suspect that RRM may over-rely on surgery to treat endometriosis. One recent review of infertility treatments published in the New England Journal of Medicine found that while surgery can help mild cases of endometriosis, doctors should use IVF when it is severe. When treated with IVF, almost 40% of women under 35 who have endometriosis get pregnant within a single cycle, the review found.“We do a lot of surgery and other treatment options that can optimize a woman’s fertility. But in the end, there are many diagnoses that cannot be solved with those elements alone and need a very effective tool like IVF,” said Dr Rachel Weinerman, a reproductive endocrinologist and associate professor at Case Western Reserve University’s school of medicine. “You need to have a whole toolbox available to decide what is the right tool for that specific patient.”Dr Eve Feinberg, a reproductive endocrinologist at Northwestern University’s Feinberg school of medicine, first heard of RRM when she started treating patients who had tried it. If patients stick with RRM and defer the use of assisted reproductive technology for too long, Feinberg warned, some may become so old that they lose their chance to have biological children.“I’ve had many sobbing women in my office who really missed out on their fertility window by trying endless numbers of years of this method, who weren’t given the truth and weren’t given a chance to explore other methods because they were misled and they were told that this would work for them,” she said. “I counsel my patients that IVF has limitations. It doesn’t work for every patient. I didn’t feel like these women were adequately counseled in that way.”In an extensive memo it shared with the Guardian, IIRRM rejected many of the critiques of RRM as unfounded, including the idea that it over-relies on surgery. Physicians who provide IVF too often default to it, the institute contended, adding that it would welcome more research comparing RRM to conventional medicine.As someone who eats a mostly plant-based diet, runs religiously and avoids makeup, Feinberg considers herself to be more “natural” than most. She understands the appeal of the wellness-style language that surrounds RRM.“It’s being marketed as being holistic. It’s being marketed as being natural and ethical,” Feinberg said. But, she continued: “I think RRM plays into this fallacy that we can understand everything and we can fix everything. 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      Trump administration eviscerates maternal and child health programs

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      Multiple maternal and child health programs have been eliminated or hollowed out as part of the Department of Health and Human Services (HHS) layoffs, prompting alarm and disbelief among advocates working to make Americans healthier.The fear and anxiety come as a full accounting of the cuts remains elusive. Federal health officials have released only broad descriptions of changes to be made, rather than a detailed accounting of the programs and departments being eviscerated.“Pediatricians, myself included, are losing sleep at night – worried about the health of the nation’s children,” said Dr Sue Kressly, president of the American Academy of Pediatrics.“The one that stands out to me is the Maternal and Child Health Bureau. There is no way to make our country healthier by eliminating expertise where it all starts, and it all starts at maternal and child health.”The health secretary, Robert F Kennedy Jr, announced HHS would eliminate 10,000 jobs as part of a restructuring plan. Together with cuts already made by Elon Musk’s unofficial “department of government efficiency”, HHS is likely to lose 20,000 workers – roughly one-quarter of its workforce.“We aren’t just reducing bureaucratic sprawl,” Kennedy said. “We are realigning the organization with its core mission and our new priorities in reversing the chronic disease epidemic.”Piecemeal and crowd-sourced information, which has filled the vacuum left by a lack of information from the health department, appears to show maternal health programs slated for elimination, many without an indication of whether they will be reassigned. The Guardian asked HHS to comment on the cuts but did not receive a response.The picture of cuts was further muddied on Thursday when Kennedy told reporters, according to Politico: “We’re going to do 80% cuts, but 20% of those are going to have to be reinstalled, because we’ll make mistakes.”In the aftermath of the height of the Covid-19 pandemic, there’s been much conservative criticism of public health agencies, particularly the Centers for Disease Control and Prevention (CDC). Pandemic policy continues to be an animating force within the Republican party, whose supporters are cynical about the value of federal public health programs following federal vaccine mandates.The cuts to maternal health programs may serve a second purpose for Republicans.Such programs have come under fire in some conservative states, in part because the experts involved investigate deaths that could have been prevented with abortion services – now illegal or severely restricted in nearly two dozen conservative states.As part of the restructuring, the administration announced 28 divisions would be folded into 15, including the creation of a new division, called the “Administration for a Healthy America”, or “AHA”.The administration argued the “centralization” would “improve coordination of health resources for low-income Americans and will focus on areas including, primary care, maternal and child Health, mental health, environmental health, HIV/Aids and workforce development”.Meanwhile, experts in HIV/Aids, worker health and safety, healthcare for society’s most vulnerable, and experts in maternal and child health have received “reduction in force” notices, a federal term for layoffs, or have been placed on administrative leave with the expectation of being eliminated.“It certainly appears there was a particular focus on parts of HHS that dealt with women’s or reproductive health,” said Sean Tipton, chief policy officer at the American Society for Reproductive Medicine, about the cuts.He added: “How in the world you can justify the CDC eliminating the division of maternal mortality is beyond me.”Among the divisions hard-hit was the Health Resources and Services Administration (HRSA), an operating division of HHS like the CDC, which housed the the Maternal and Child Health Bureau. HRSA lost as many as 600 workers.The CDC’s division of reproductive health, which studies maternal health, appeared to have been nearly eliminated, according to multiple reports, with some of the division’s portfolio also expected to be folded into AHA.skip past newsletter promotionafter newsletter promotionThe entire staff of a gold-standard maternal mortality survey, a program that was called the Pregnancy Risk Assessment Monitoring System, was also put on leave, Stat reported. The epidemiologist in charge of the CDC survey, Jennifer Bombard, wrote to colleagues on Tuesday: “[T]he entire CDC PRAMS team, including myself, has received the Reduction in Force (RIF) notice from HHS today.”A HRSA hotline that had fielded calls from new moms seeking mental health support was also cut, Stat reported. Layoffs at the Administration for Children and Families have jolted providers of federally backed high-quality childcare for low-income families, a program called Head Start.The CDC’s only experts on infertility were laid off, just days after Trump described himself as the “fertilization president” at an event marking Women’s History Month. The team had collected congressionally mandated statistics on fertility clinics’ success rates. Without the workers, it is unclear who at the department will help fertility clinics comply with the law.“I’m astounded, sad, perplexed,” said Barbara Collura, president of Resolve: The National Infertility Association. “Infertility impacts one in six people globally, and now we don’t have anybody at the CDC who knows anything about infertility and IVF?”A division of the CDC called the National Center for HIV, Viral Hepatitis, STD, and Tuberculosis Prevention also appeared to be gutted, with the director Jonathan Mermin placed on administrative leave. Among the center’s many tasks, it worked to curb the spread of congenital syphilis, a debilitating disease that is on the rise in the US.The March of Dimes, an influential non-profit whose mission is to improve the health of mothers and babies, said the cuts “raise serious concerns” at a time when maternal mortality rates remain “alarmingly high”.“As an OB-GYN and public health leader, I can’t overstate the value these resources and programs – and our partners across CDC, HRSA, and NIH – have brought to families and frontline providers,” said Dr Amanda Williams, the interim chief medical Officer at the March of Dimes.“We rely on the data, research, clinical tools and partnerships built by the Division of Reproductive Health (DRH) and HRSA to protect maternal and infant health – especially in communities hit hardest.”Heads of National Institutes of Health (NIH) centers were also forced out – and, apparently, offered reassignment to the Indian Health Service to be stationed in Alaska, Montana or Oklahoma, the journal Nature reported. Such large-scale reassignments are unprecedented, according to Stat.Among those to be placed on leave was one of the federal government’s pre-eminent leaders of research, the director of the National Institute of Allergy and Infectious Diseases (NIAID) Dr Jeanne Marrazzo. Marrazzo had expertise in sexually transmitted infections and women’s reproductive tract infections – a background that gave health advocates hope of curbing the US’s sky-high STD rates. Dr Diana Bianchi, director of the Eunice Kennedy Shriver National Institute of Child Health and Human Development, was also forced out.“These cuts are significant,” Kressly said. “And the policy and program changes that are made because the cuts impact real people in real communities, and I’m not just talking about the people who lost their jobs.” More

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      Trump signs executive order expanding access to IVF, says White House

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      Donald Trump has signed an executive order to expand access to in vitro fertilization, White House press secretary Karoline Leavitt said on Tuesday.“The Order directs policy recommendations to protect IVF access and aggressively reduce out-of-pocket and health plan costs for such treatments,” Leavitt said in a post on Twitter/X.More details soon … More

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      Mass production of genetically selected humans: inside a Pennsylvania pronatalist candidate’s fantasy city-state

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      When Simone Collins, a Republican running for a seat in Pennsylvania’s state legislature, and her husband, Malcolm, were privately asked last year about their ideas for the model “pronatalist” city-state, they sensed an opportunity.With their own YouTube channel, online education platform and foundation, the couple are among the most high-profile and outspoken proponents of the pronatalist cause, which is centered on the belief that the developed world is facing a demographic collapse and that birthrates must rise to stave off disaster.The couple, who have four children, were approached last year by an individual posing as a wealthy donor willing to finance their work. In response to his request, they created a 15-page slide deck entitled The Next Empire: Leveraging a Changing World to Save Civilization. It contained ideas that seem plucked out of a dystopian science fiction movie. According to their presentation, the city-state they envisaged would become a magnet for “no-holds-barred” medical research, which in turn would open the door to the “mass production of genetically selected humans”.The voting rights of citizens of the city-state would be linked to their value to society, according to the Collinses’ presentation. The proposed city-state government would have “incentive systems that grant more voting power to creators of economically productive agents” and would be run by a single “executor” – which the proposal also called a “dictator” – with full control of the government’s laws and operational structure. The executor would be replaced every four years by three “wards”, according to the slide deck. Wards would be elected by previous executors.It may appear that the Collinses’ views are so far outside the mainstream that one could shrug off pronouncements as eccentric and alarmist. But the Collinses are part of a movement they call the “new right”, which rejects some aspects of traditional conservatism and bills itself as pragmatic, family-oriented and anti-bureaucratic. They staunchly support the Republican ticket, Donald Trump and JD Vance, and billionaire Elon Musk.Last year, Malcolm Collins said he thought the Isle of Man would be the best place to begin.“I actually think that’s the most viable place to do it. You’re near the center of Europe, you’re in a rapidly depopulating area, you can tell them look, this will obviously bring a lot of technology and investment to your country. But the great thing about a proposal like this is even if they turn it down, you can take it to other countries,” Malcolm told the man purporting to be an investor at the time.The funding never materialized and the proposal was never pitched to the Isle of Man, a British crown dependency located in the Irish Sea, because the man who claimed to be a wealthy investor was actually an undercover researcher with Hope Not Hate, a UK-based anti-racism group. It shared video recordings of the encounters with the Collinses – and a copy of their presentation – with the Guardian.Asked about the slide deck in an interview with the Guardian last week in their home in Audubon, Pennsylvania, Simone and Malcolm, who work together and appear rarely to be apart, acknowledged that their proposal “wasn’t supposed to be public”. But Simone Collins nevertheless said she stood by its core tenets “100%”, including the idea of mass-producing embryos, and of giving people who they deem to be less productive members of society less voting power.“If you are draining resources, you should have less influence,” she said.Asked about how it felt to be the subject of undercover research, Malcolm Collins said: “The experience was quite validating for both us and our movement.” He added: “Now I think it is pretty clear that despite us not socially isolating people with toxic views, the worst views we actually have are being slightly elitist and weird eccentrics (which isn’t exactly surprising to anyone).”The couple say their ideas were meant to be experimental and fit for a city-state, not a democracy such as the US. But the views are not dissimilar to ones expressed by one of Simone and Malcolm’s political heroes, the Republican vice-presidential nominee, JD Vance. In a July 2021 speech, Vance said parents should be given “an advantage” and “more power” in the voting process than those who don’t have children.Simone Collins previously worked as managing director of Dialog, which she describes as an exclusive secret society, co-founded by Peter Thiel. Thiel, the PayPal founder, helped launch and fund Vance’s political career, and has supported the rightwing blogger Curtis Yarvin, who in 2012 said he believed the US should install a monarchy and “get over their dictator phobia”.‘We do target the elites’The Collinses often describe their pronatalist agenda in humanitarian terms – part of a wider bid to save the developed world from impending social and economic catastrophe. Their website outlines their desire to work with “any person or organization that shares our goal to preserve as much of civilization and as many cultures as possible”.But in the recordings made by Hope Not Hate, Malcolm describes their pronatalist agenda as being principally designed to transform the current socioeconomic elite into a future biological elite.“It’s easy to forget how small the population of people in the world who actually impacts anything or matters is,” he said. “When we do our campaigns we work really aggressively on how do we spread ideas within that narrow network, because also they are the people we want having kids and we want in the future.”View image in fullscreen“When we talk to reporters we’re very ‘Oh, this isn’t just for the elites’, but, in truth, we do target the elites – ha ha – unfortunately.”Malcolm said he and his wife are working to create a network of other pronatalist families, with whom their children can go to summer camp, grow up alongside “knowing this isn’t weird, what we’re doing” and, ultimately, marry. But this goes beyond the average desire to find family friends with shared values and be part of a community. “What I’m really trying to do is ensure that my kids have an isolated and differential breeding network,” he said.The so-called “elites” appear to be a central preoccupation for the Collinses and it is a theme they return to repeatedly and unprompted. “The very few families – and I think we might be talking about a hundred, 500 families in the world today – who are high fertility and really technologically engaged and economically engaged … own the future of our species,” Malcolm said.When the Guardian asked the Collinses about the remarks, Malcolm said they were “not incongruent with our other messaging”, and that they were better off “convincing Taylor Swift to have kids than John Doe on the street if we want to create ripple effects society-wide leading to more kids”.Race for the statehouseSimone Collins’s run to represent Pennsylvania’s 150th district in the state’s house of representatives was born, she said, out of frustration with traditional political campaigns. She acknowledges that her odds of success are low and that she has eschewed traditional local campaign tactics, like investing in ads or mailers.skip past newsletter promotionafter newsletter promotionBut she is a big supporter of Donald Trump’s run for the presidency and has sought through her own candidacy, which has mostly been self-funded by what she calls the family’s “what the hell” savings account, to encourage so-called low propensity voters in her Pennsylvania district to boost the former president’s chances.“We are very interested in tipping the election [in Trump’s favor] and one of the most meaningful ways I can do so is as a Republican candidate running in a key, key swing spot,” she said. The Collinses have done this, she said, by printing out “hundreds and hundreds” of mail-in ballot applications, filling them out, and sending them to potential Republican voters to sign and send back so that they can be sent mail-in ballots. She said it is part of an effort to examine whether there are “low-cost and highly effective ways” to sway election results, even in Democratic-leaning districts like hers, where incumbent Democrat Joe Webster was first elected in 2018. Records show Webster has spent about $80,000 on his campaign, while Collins has spent just under $5,000.“I didn’t have enough money to send mail-in ballot applications to every low-propensity voter, but we’ll look after the election of what percent of those people voted,” she said.Asked whether there are aspects of Trump’s candidacy that trouble her – from his criminal convictions to being found liable for sexual assault – Collins said she is no more troubled by the Republican nominee’s record than that of Kamala Harris, the vice-president and Democratic nominee.“Nobody elects a president. You elect a team,” she said. “So many smart people I know are tapped into who his team is going to be.”She is most excited about billionaire Elon Musk’s high-profile involvement in the Trump campaign, and the Republican nominee’s promise that Musk would lead a cost cutting and “efficiency” drive in government spending. Musk has admitted it would lead to “temporary hardship” for Americans.Musk is reportedly a father of “at least” 11 children, according to a recent New York Times report that detailed the Tesla co-founder’s effort to fill a compound full of his own children and their mothers. Although he has been open about his pronatalist views, the New York Times reported that Musk likes to keep details about his own growing family a secret.It is the emergence of Silicon Valley as key partners in “the new right” that has the couple most excited about Republicans today. The Skype co-founder and Estonian billionaire Jaan Tallinn (a father of five) donated just under half a million dollars to the Collinses’ pronatalist foundation in 2022.The issues“I’m very pro-gun. If you walk around this house you’ll find guns all over the place,” Simone Collins said, pointing to an old musket that is mounted on the wall. She said the guns are locked up and not loaded, and that ammunition is kept in proximity. While others might not like the constant sound of gunfire from a nearby gun club and shooting range, Collins said she loved the sound.Child protective services (CPS), the state agency people can call if they fear a child is being abused or neglected, has visited the Collinses at home on two occasions. Asked what prompted the first visit, Malcolm told the Guardian in a written statement that it “was supposedly because our kids were wearing used clothing, played outside in our fenced-in yard (with us watching from inside), and got sick frequently (this was before we took them out of preschool and during a time when sickness in preschools post-pandemic was brutal as kids returned from isolation)”.The second visit by CPS, Simone Collins said, followed the publication of the last Guardian article about the couple, published in May, which included a description of how Malcolm had slapped their then two-year-old on the face for nearly knocking over a table in a restaurant. Slapping a child is legal in Pennsylvania if it doesn’t cause serious pain or injury.View image in fullscreen“After the Guardian piece came out, CPS was here again. They walked through every room of this house because the internet decided that we were abusive, terrible people. They came again. I feel bad wasting their time. They’re like, ‘Please don’t beat your infants, or whatever. But no, you’re obviously fine,’” she said.Some voters in her district have called her directly to ask about her stance on issues, including abortion. Abortion is legal in Pennsylvania up until 24 weeks, though there are some restrictions in place. Simone Collins said she would support what in effect would amount to an abortion ban in the state after 12 to 15 weeks, with exceptions if a woman’s life was in danger or the fetus had an anomaly. Any abortion performed after 15 weeks, she said, would have to include giving the fetus pain medication.Collins is, however, an unabashed advocate for IVF, which is opposed by many conservative and anti-abortion Republicans. Simone and Malcolm have used IVF themselves and plan to continue having more children. They also are “huge early supporters” of embryo selection based on a “polygenic score” related to intelligence. In other words, selecting embryos based on IQ.Collins is planning for her next embryo transfer in January. More

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      Senate Republicans block bill to ensure IVF access for second time

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      Senate Republicans voted on Tuesday afternoon to block a bill that would have ensured access to in vitro fertilization nationwide.Every Republican, except Susan Collins of Maine and Lisa Murkowski of Alaska, voted against the measure. Though a majority of 51 voted in favor, the bill needed 60 votes to pass. Democrats had brought the measure back to the floor after Republicans previously blocked it from advancing in June.Democrats have been pushing the issue this year after Alabama’s supreme court ruled that frozen embryos could be considered children under state law, leading several clinics in the state to suspend IVF treatment.Republicans, including Donald Trump, have scrambled to counter what could be a deeply unpopular stance against IVF.“Senate Republicans put politics first and families last again today by blocking the Right to IVF Act for the second time since June,” said Emilia Rowland, national press secretary for the Democratic National Committee.The vote marked Democrats’ latest election-year attempt to force Republicans into a defensive stance on women’s health issues.The bill had little chance of passing, but Democrats are hoping to use the do-over vote to put pressure on Republican congressional candidates and lay out a contrast between Kamala Harris and Trump in the presidential race, especially as the former president has called himself a “leader on IVF”.Rowland warned that Donald Trump would jeopardize access to fertility treatments if he wins in November.“Voters know the difference between words and actions,” she said. “And between now and November, they will turn out against Republicans from the top to bottom of the ballot.”The push started earlier this year after the Alabama supreme court ruled that frozen embryos can be considered children under state law. Several clinics in the state suspended IVF treatments until the Republican-led legislature rushed to enact a law to provide legal protections for the clinics.Democrats quickly capitalized, holding a vote in June on the congressional bill from the Illinois senator Tammy Duckworth and warning that the US supreme court could go after the procedure next after it overturned the right to an abortion in 2022. The legislation would also increase access to the procedure and lower costs.The Senate majority leader, Chuck Schumer, said on the floor on Tuesday morning that the vote was a “second chance” for Republicans.“Americans are watching, families back home are watching, and couples who want to become parents are watching, too,” Schumer said.Meanwhile, Republicans have scrambled to counter Democrats on the issue, with many making clear that they support IVF treatments. Trump last month announced plans, without additional details, to require health insurance companies or the federal government to pay for the fertility treatment.In his debate with Harris earlier this month, Trump said he was a “leader” on the issue and talked about the “very negative” decision by the Alabama court that was later reversed by the legislature.But the issue has threatened to become a vulnerability for Republicans as some state laws passed by their party grant legal personhood not only to fetuses but to any embryos that are destroyed in the IVF process. Before its convention this summer, the Republican party adopted a policy platform that supports states establishing fetal personhood through the constitution’s 14th amendment, which grants equal protection under the law to all US citizens. The platform also encourages supporting IVF but does not explain how the party plans to do so.Democrats say that if Trump wants to improve access to the procedure, then Republicans should vote for their legislation.Duckworth, a military veteran who has used the fertility treatment to have her two children, has led the Senate effort on the legislation. “How dare you,” she said in comments directed toward her Republican colleagues after the first vote blocking the bill.Republicans have tried to push alternatives on the issue, including legislation that would discourage states from enacting explicit bans on the treatment, but those bills have been blocked by Democrats who say they are not enough.The Associated Press contributed reporting More

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      Democrats unite to center reproductive rights as Republicans flail on abortion

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      As Kamala Harris and Donald Trump prepare to meet on the debate stage in Philadelphia, the battle over abortion rights has vaulted to the center of the 2024 presidential election campaign, the first since the supreme court’s decision overturning Roe v Wade.At the party’s convention last month, Democrats spotlighted the harrowing stories of women placed in medical peril as a result of post-Roe abortion bans in their states. Last week, the Harris campaign launched a 50-stop “reproductive freedom” bus tour across several battleground states, kicking off in Trump’s “back yard”, miles from the former president’s Mar-a-Lago residence in south Florida.And this weekend, days before the first – and perhaps only – primetime presidential debate, where the issue is likely to be raised, the Harris campaign debuted three new TV ads reminding voters that Trump has repeatedly taking credit for his role in ending the 50-year-old constitutional right to an abortion. The message is blunt: because of Trump, one in three women of reproductive age now live in states where abortion is banned or significantly restricted. And it could get worse, they warn, if Trump is given a second term.“Donald Trump is a fundamental threat to reproductive freedom – and you don’t have to take our word for it – Trump said it himself,” Lauren Hitt, a spokesperson for the Harris-Walz campaign, said in a statement. “Vice-President Harris and Governor Walz are fighting to restore reproductive freedom in all 50 states because they trust women to make the right decisions for their families.”In the bitterly contested race for the White House, abortion remains a glaring vulnerability for the Republican nominee.“You know it’s an important issue because Trump is trying to change his position,” said Celinda Lake, a veteran Democratic pollster.As a candidate, Trump has held conflicting positions on abortion, alternately boasting that he appointed three of the nine supreme court justices whose votes were decisive in overturning Roe, while complaining that Republican extremism on the issue has cost his party at the ballot box.​He recently appeared to endorse a ballot measure to expand abortion rights in his adopted home state of Florida, only to announce one day later – after sparking backlash among prominent conservative groups – that he would vote against it. He has also previously hinted at support for a 15-week federal ban only to insist that the issue should be left to the states. His campaign has said Trump would not sign a national abortion ban as president.While the economy remains the top election issue for voters this November, a New York Times/Siena College poll released in August showed that a growing share of battleground state voters, particularly women, say abortion will be central to their decision. Among women younger than 45, abortion has eclipsed the economy as their single most important issue.In the final months of the campaign, Democrats are aiming to harness the unabated anger over the loss of federal abortion protections, especially among women and young people, and unifying around a platform that seeks to protect what remains of abortion access and the availability of reproductive healthcare, including contraception and fertility treatments such as in vitro fertilization (IVF).In polling and focus groups, Lake said abortion rights remains an especially salient issue for women and the issue was helping to fuel a widening gender gap between Harris and Trump. Harris’s vocal support for abortion rights has not only energized young voters, a core Democratic constituency, but is also helping to persuade independent women and, as Lake put it, “older women who remember when abortion was illegal, and don’t think the idea of jailing doctors, investigating miscarriages, [and] eliminating birth control and IVF is a good idea”.View image in fullscreenIn recent weeks, Trump, who has long worried that Republican-led efforts to outlaw abortion and restrict access to reproductive care could imperil his White House bid, has sought recast his approach to the issue. During a town hall even in battleground Wisconsin, he endorsed a plan to make the government or insurance companies cover the cost of IVF – a type of fertility assistance that can cost tens of thousands of dollars and that some in the anti-abortion movement want to see limited.“We wanna produce babies in this country, right?” Trump said.Democrats assailed the proposal as insincere, pointing to the Republican’s record and the positions of his running mate, JD Vance.Trump has had “more positions on reproductive rights than he has had wives”, Ana Navarro, a TV personality and anti-Trump Republican, said last week, at the Florida launch of the Harris campaign’s bus tour.Democrats have leveraged the abortion issue to secure key victories in the 2022 midterms, when mobilization efforts around abortion rights drove strong turnout and enthusiasm, helping the party keep control of the Senate and limiting Republican gains in the House. In Michigan, Democrats secured a governing trifecta as voters in the state overwhelmingly turned out to back a ballot initiative enshrining abortion rights in the state’s constitution.“Bringing the message to the people, talking with women and healthcare providers and our families, that’s how we had such a historic outcome in our ’22 election here in Michigan,” the state’s governor, Gretchen Whitmer, a co-chair of Harris’s campaign, said in an MSNBC interview this week. “But it’s important, even for Michiganders and New Yorkers and Floridians, to know what’s at stake if we have a second Trump presidency.”Some Republicans have argued that the potency of abortion rights would wane in a noisy presidential election. But Lake believes the opposite could be true.skip past newsletter promotionafter newsletter promotionAbortion rights are a priority for young voters who are more likely to turn out in a presidential election year. Constitutional amendments seeking to guarantee abortion rights are on the ballot in 10 states this fall, including battleground states like Arizona and Nevada as well as Florida, once a presidential bellwether that has trended Republican in recent cycles.“We are the belly of the beast here in the state of Florida,” said Nikki Fried, the chair of the Florida Democratic party. “We are the state that has drastically moved on abortion from two years ago having full access to now being one of the most extreme abortion bans in the country.”Florida Democrats are hopeful the ballot initiative will help boost the former representative Debbie Mucarsel-Powell’s underdog campaign against the Republican incumbent senator Rick Scott. Elsewhere in the battle for control of the Senate, vulnerable Democratic incumbents Jon Tester of Montana and Jacky Rosen of Nevada will appear on the ballot alongside measures to protect abortion rights.Fried, who joined the Harris campaign kick-off in Palm Beach county last week, said the referendum had helped draw attention to the state – and was mobilizing voters of all political stripes.“If they can take away access to reproductive healthcare, what else is next?” she said. “What other types of rights have we moved the needle on that would be going backwards if Trump is re-elected?”The state’s referendum would overturn the state’s unpopular six-week ban, guaranteeing the right to abortion “before viability”, usually around 24 weeks of pregnancy. A poll released in mid-August found that 56% of Sunshine state voters support the proposed amendment, just shy of the 60% threshold needed to become law. Yet it drew more support than Trump, who led Harris 51% to 47% in the state, according to the survey.Abortion remains Harris’s strongest issue. She holds a 15-percentage-point advantage over Trump in a national poll of likely voters by The New York Times and Siena College. Yet there were also signs that Trump’s mixed signals have muddied the waters on the issue. According to the survey, released Sunday, nearly half of independent voters say they did not think the former president would sign into law a national abortion ban.Still, the Republican nominee must contend with his base, particularly evangelicals and other conservative Christians, who expect Trump to further restrict access to abortion as president.Kristan Hawkins, president of the prominent anti-abortion group Students for Life of America, recently told the Guardian that young conservatives were “shocked and saddened to see someone who they thought was pro-life, or who had always reaffirmed pro-life values, walking back on that”.Tuesday’s presidential debate in Philadelphia offers one of the highest-profile opportunities for Harris to draw a sharp contrast with Trump on abortion. Reproductive rights supporters anticipate Harris will challenge the former president over his attempts to shift positions on the issue.“I hope that Vice-President Harris makes it crystal clear for the tens of millions of people who are watching that leaving it to the states is not a moderate position – that it is extreme,” said Rob Davidson, a Michigan-based emergency physician and executive director of the Committee to Protect Health Care, a left-leaning coalition of physicians and medical professionals that recently endorsed Harris.Davidson said voters will also want to hear Harris articulate her vision for expanding access to reproductive healthcare.“We know what Trump did,” he said. “What are we going to do going forward?” More

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      JD Vance endorsed anti-IVF report that contradicts Trump’s new stance

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      A rightwing thinktank report proposing sweeping restrictions to abortions and fertility treatments was endorsed by JD Vance years before he became a fervent backer of Donald Trump and – eventually – his vice-presidential running mate known for his derisive views on childless women.In 2017, months into Trump’s presidency, Vance wrote the foreword to the Index of Culture and Opportunity, a collection of essays by conservative authors for the Heritage Foundation that included ideas for encouraging women to have children earlier and promoting a resurgence of “traditional” family structure.The essays lauded the increase in state laws restricting abortion rights and included arguments that the practice should become “unthinkable” in the US, a hardline posture the Democrats now say is the agenda of Trump and Vance, who they accuse of harbouring the intent to impose a national ban following a 2022 supreme court ruling overturning Roe V Wade and annulling the federal right to abort a pregnancy.The report also includes an essay lamenting the spread of in vitro fertilisation (IVF) and other fertility treatments, with the author attributing them as reasons for women delaying having children and prioritising higher education rather than starting families.IVF has emerged as an issue in November’s presidential race after Trump said last week that he favoured it being covered by government funding or private health insurance companies – a stance seeming at odds with many Republicans, including Vance, who was one of 47 GOP senators to vote against a bill in June intended to expand access to the treatment.The report’s contents provide fresh insights into the philosophy informing some of Vance’s inflammatory later public statements, which have included saying that America is run by “childless cat ladies” and that he is disturbed by the idea of teachers who do not have children.He has also suggested that people without children are likely to become “more sociopathic”.The 2017 report was released a year after the publication of Vance’s bestselling memoir, Hillbilly Elegy, and also after he had made a series of statements denouncing Trump, whom the US senator called “cultural heroin” and speculated could become “America’s Hitler”. He also described himself as “a never Trump guy”.However, its foreword contains hints that Vance’s thoughts on the then president were already evolving.“We all seem to be waking up to the fact that things are not quite what they used to be,” he wrote. “When president Trump has spoken of the country as trapped in a losing game of international trade or decried the carnage on so many American streets, he has earned criticism for painting an overly pessimistic view of his own country. Yet that pessimism struck a chord with many Americans.skip past newsletter promotionafter newsletter promotion“The question for those concerned about the future of the country is not whether negativity is justified, but why negativity inspired so many at the polls.”Vance’s views ultimately went full circle, and Trump endorsed his successful election campaign for the US Senate in Ohio in 2022.The foreword to the 2017 report also seems to be one of Vance’s first known links to the Heritage Foundation, a thinktank responsible for producing Project 2025, a controversial and radical blueprint for remaking US government and society in a conservative image. Trump has disowned the 922-page document. But the campaign of Kamala Harris, the Democratic presidential nominee, has depicted it as an assault on basic freedoms and typical of what lies in store under a second Trump presidency. More

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      Donald Trump is backing free IVF? You can practically smell the desperation | Arwa Mahdawi

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      Would you like to do your bit to curb population decline in the west? Fancy a home full of babies with very high IQs and extremely blond hair? Well, let me introduce you to the Donald J Trump Insemination Institute. On a sprawling ranch in New Mexico, women can be impregnated, free of charge, with Trump’s sperm, ensuring that future generations, on Earth and Mars, are blessed with a steady supply of very stable geniuses.Sorry if I turned your stomach there, but I’m afraid I’m only half-joking. It was actually Jeffrey Epstein – who used to party with Trump – who was besotted with the idea of a ranch where 20 women at a time would be impregnated, in order to seed the human race with his DNA. Elon Musk, who is obsessed with babies and Trump, may harbour similar fantasies. Earlier this year the New York Times reported that Musk has “volunteered his sperm” to help seed a colony on Mars. (Musk has denied these claims.)While Trump hasn’t announced plans for a baby ranch of his own yet, he is suddenly a big fan of artificial insemination. Last week the former president announced that he would support free in vitro fertilisation (IVF) treatments if elected again. “We wanna produce babies in this country, right?” Trump said during a town hall campaign event in Wisconsin. He didn’t provide many details about how this would work other than saying that either the government or insurance companies would pay for everything.Another fuzzy detail? How government-sponsored IVF would coexist with the Republican party’s 2024 platform, which supports states’ rights to pass foetal personhood laws. It is impossible to support widespread access to IVF while also supporting the idea of foetal personhood, which holds that an embryo is a person and destroying one is homicide. I am fairly sure that Trump has no idea how IVF actually works, so here is a little explainer: you typically fertilise multiple eggs because you have no idea how many of them will develop into viable embryos. You could fertilise 20 eggs and end up with no viable embryos or end up with 20. The only way to control how many embryos you create is to harvest a single egg at a time, which is hugely expensive, inefficient and emotionally exhausting. In short: Trump seems to be running on a platform where IVF would be free but also effectively illegal.While it may be half-baked, Trump’s free IVF policy makes it clear that he is desperate to woo female voters. Women have registered and voted at higher rates than men in every US presidential election since 1980 and now – for obvious reasons – they are leaning heavily towards Kamala Harris. I’m not sure a last-minute IVF policy is going to cancel out the fact that abortion rights are a key issue in this election and Trump has boasted about being the guy who overturned Roe v Wade. Nor will it cancel out the fact that Trump is a legally defined sexual predator who can’t stop himself from saying every misogynistic thought that creeps into his little head. During a recent rally in Pennsylvania, for example, Trump praised his male supporters for “allowing” their wives to attend his campaign rallies without them.While Trump is clearly trying to appeal to women with his IVF policy, you also have to wonder whether his buddy Musk – one of the most influential voices in the US’s growing pro-natalist movement – has a hand in this. If the billionaire did get a position in a Trump administration (a possibility that has been repeatedly floated) one imagines Musk would encourage the US to emulate Hungary’s pro-natalist policies, which stem from a racist desire to encourage births and repopulate the country with the “right” (AKA white) kind of children. “We want Hungarian children,” Viktor Orbán said in 2019. “Migration for us is surrender.”Free IVF may sound like a progressive policy on the surface but, for many on the right, it is linked to a belief that women are nothing more than baby-making machines designed to pass on the legacy of men. A future Donald J Trump Insemination Institute may not be as far-fetched as it sounds. Arwa Mahdawi is a Guardian columnistDo you have an opinion on the issues raised in this article? If you would like to submit a response of up to 300 words by email to be considered for publication in our letters section, please click here. More