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CDC chief ‘targeted’ for refusing to ‘rubber-stamp unscientific, reckless directives’, lawyers say – as it happened

by Evelyn Reynolds 28 August 2025, 02:18

Susan Monarez was removed from her position as director of the Centers for Disease Control and Prevention on Wednesday without being told why she was fired, her lawyers said in a statement.“First it was independent advisory committees and career experts. Then it was the dismissal of seasoned scientists. Now, Secretary Kennedy and HHS have set their sights on weaponizing public health for political gain and putting millions of American lives at risk”, her lawyers, Mark Zaid and Abbe David Lowell, said in a statement posted on social media.“When CDC Director Susan Monarez refused to rubber-stamp unscientific, reckless directives and fire dedicated health experts, she chose protecting the public over serving a political agenda. For that, she has been targeted. Dr. Monarez has neither resigned nor received notification from the White House that she has been fired, and as a person of integrity and devoted to science, she will not resign.”“This is not about one official,” the lawyers added. “It is about the systematic dismantling of public health institutions, the silencing of experts, and the dangerous politicization of science. The attack on Dr. Monarez is a warning to every American: our evidence-based systems are being undermined from within.”The Department of Health and Human Services offered no explanation when it announced in an unsigned social media post that Monarez, who was confirmed by the Senate as CDC director and sworn in by Kennedy just last month, was no longer in charge of the public health agency.Sources “who spoke anonymously for fear of retribution”, told the New York Times reports that Monarez had objected to sweeping changes to the panel of experts who advise the agency on vaccine policy made by Donald Trump’s anti-vaccine health secretary Robert F Kennedy Jr.An administration official also told the Times that Kennedy had summoned Monarez to his office on Monday and demanded that she resign. After she refused to do so, she called Dr Bill Cassidy, the Republican chairman of the Senate health committee. Kennedy then accused Monarez of “being a leaker” and said that she would be fired.Hours before Monarez left the agency, Kennedy hailed decisions by the Food and Drug Administration on Wednesday revoking the emergency use authorization for the Covid-19 vaccines manufactured by Pfizer, Moderna and Novavax that CDC experts estimate saved 3.2 million lives in the United States.Vaccines from the three manufacturers are now authorized by the FDA only for people who are 65 and older, or younger people with an underlying medical condition that puts them at risk for severe disease.Even those that qualify for the vaccines will only be able to get them in the US if the advisory panel, reshaped by Kennedy to include Covid vaccine opponents, votes to approve them.This concludes our live coverage of the second Trump administration for the day, but we will be back at it on Thursday morning. Here are the latest developments:

The leadership of the US Centers for Disease Control and Prevention was thrown into chaos after the health department announced the Senate-confirmed CDC director, Susan Monarez, was no longer in charge, but her lawyers said she refused to resign and had not been fired.

First it was independent advisory committees and career experts. Then it was the dismissal of seasoned scientists. Now, Robert F Kennedy Jr and HHS have set their sights on “weaponizing public health for political gain” and “putting millions of American lives at risk”, lawyers for Monarez said in a statement. “When CDC Director Susan Monarez refused to rubber-stamp unscientific, reckless directives and fire dedicated health experts, she chose protecting the public over serving a political agenda. For that, she has been targeted. Dr. Monarez has neither resigned nor received notification from the White House that she has been fired, and as a person of integrity and devoted to science, she will not resign.”

At least three CDC senior officials resigned after Monarez was ousted. One squarely blamed Robert F Kennedy Jr’s leadership.

“I am not able to serve in this role any longer because of the ongoing weaponization of public health,” Dr Demetre Daskalakis, who resigned as director of the National Center for Immunization and Respiratory Diseases told colleagues.

Public health experts are sounding the alarm about the chaos at the CDC, as at least three senior leaders resigned following the ouster of the apparent ouster of the CDC director.

As a Senate-confirmed official, only the president has the authority to fire her, and, for once, Donald Trump has been strangely silent as this drams unfolded. But the White House press office issued a statement saying that Monarez had been removed, not by Trump but by “the White House”.
While differences over vaccines appear to have been central to the rift between the ousted CDC director, Susan Monarez, and Robert F Kennedy Jr, the health secretary, Monarez also stood out from her bosses by mourning for the officer who died defending the agency’s campus in Atlanta from a gunman who was driven by misinformation about the Covid-19 vaccine.While Monarez publicly mourned David Rose, who, as our colleague George Chidi wrote, was murdered by a lie, others in the CDC were distressed that Kennedy said little, and Trump nothing about the attack on their campus.The confusion over whether or not Susan Monarez is still the director of the Centers for Disease Control and Prevention, after the health department said she was not, and her lawyers said she has not resigned or been fired, partly stems from the fact that Monarez was confirmed by the Senate last month.As a Senate-confirmed official, only the president has the authority to fire her, and, for once, Donald Trump has been strangely silent as this drama unfolded on Wednesday night.But the White House press office has just issued a statement saying that Monarez has been removed, not by Trump but by “the White House”.“As her attorney’s statement makes abundantly clear, Susan Monarez is not aligned with the President’s agenda of Making America Healthy Again” the White House deputy press secretary, Kush Desai, said in a statement to the Guardian. “Since Susan Monarez refused to resign despite informing HHS leadership of her intent to do so, the White House has terminated Monarez from her position with the CDC.”As Aaron Fritschner, an aide to Don Beyer, a Democratic congressman, observed: “Don’t think ‘the White House’ has the power to terminate the Director of the CDC. The President does, but they didn’t say that he did, which is curious.”Public health experts are sounding the alarm about the chaos at the CDC, as at least three senior leaders resigned following the apparent ouster of the CDC director.“What’s happening at the CDC should frighten every American Regardless of whether you are MAGA, MAHA, neither, or don’t give a damn about labels or politics. It’s unclear whether the CDC director—confirmed just weeks ago—has been fired or not. Absolute shitshow,” Dr Craig Spencer, an emergency medicine doctor and professor at Brown University School of Public Health posted. “And incredible career professionals resigned tonight, sounding a massive alarm,” he added. “This is pure chaos that leaves the country unprepared. Imagine cases of Ebola in the U.S. right now? We would be an absolute mess.”“RFK, Jr is increasingly becoming a liability for the White House,” Dr Jonathan Reiner, a cardiologist and professor of medicine at George Washington University, observed. “I doubt the president feels good about RFK’s incessant attack on his COVID vaccine triumph and he’s likely not going to be pleased that the HHS Sec is usurping the role of the President in hiring/firing senate confirmed officials.”“There is a wholesale destruction of leadership at the CDC. The newly confirmed Director is out,” Dr Ashish Jha, the Biden administration’s coronavirus response coordinator, wrote. “Most of the top leaders who run key centers have resigned en masse. Total implosion. All because of [Secretary Kennedy’s] leadership. What a complete disaster.”Dr Demetre Daskalakis, who resigned on Wednesday from his position as the director of the National Center for Immunization and Respiratory Diseases at the CDC, just posted his full, blistering resignation letter on Instagram.In the letter, the veteran public health official blames the views and erratic leadership of Robert F Kennedy Jr, the health secretary, for making it impossible for him to continue.“I am unable to serve in an environment that treats CDC as a tool to generate policies and materials that do not reflect scientific reality and are designed to hurt rather than to improve the public’s health. The recent change in the adult and children’s immunization schedule threaten the lives of the youngest Americans and pregnant people,” Daskalakis wrote, in reference to the decision in May, for the CDC to remove its recommendation of the Covid-19 vaccine for healthy children and pregnant women.He added that the data to support this change was never shared with the CDC and that a public information sheet on the change, “written to support the Secretary’s directive” was circulated by the health department “without input from CDC subject matter experts”.Daskalakis also called out Kennedy’s fondness for “social media posts announcing major policy changes” without consulting CDC experts in advance. “Having to retrofit analyses and policy actions to match inadequately thought-out announcements in poorly scripted videos or page long X posts should not be how organizations responsible for the health of people should function,” he wrote.“The intentional eroding of trust in low-risk vaccines favoring natural infection and unproven remedies will bring us to a pre-vaccine era where only the strong will survive and many if not all will suffer,” he added. “I believe in nutrition and exercise. I believe in making our food supply healthier, and I also believe in using vaccines to prevent death and disability. Eugenics plays prominently in the rhetoric being generated and is derivative of a legacy that good medicine and science should continue to shun.”“The recent shooting at CDC is not why I am resigning,” Daskalakis wrote, drawing attention to the gunman who fired hundreds of rounds into CDC buildings who was motivated by unfounded theories about injuries from the Covid-19 vaccine that Kennedy has promoted.“My grandfather, who I am named after, stood up to fascist forces in Greece and lost his life doing so. I am resigning to make him and his legacy proud. I am resigning because of the cowardice of a leader that cannot admit that HIS and his minions’ words over decades created an environment where violence like this can occur. I reject his and his colleagues’ thoughts and prayers, and advise they direct those to people that they have not actively harmed,” Daskalakis wrote.“For decades, I have been a trusted voice for the LGBTQ community when it comes to critical health topics,” the doctor, who formerly led HIV/AIDS prevention at the CDC, and once dressed in drag to administer meningitis vaccines, added. “I must also cite the recklessness of the administration in their efforts to erase transgender populations, cease critical domestic and international HIV programming, and terminate key research to support equity as part of my decision.”Susan Monarez was removed from her position as director of the Centers for Disease Control and Prevention on Wednesday without being told why she was fired, her lawyers said in a statement.“First it was independent advisory committees and career experts. Then it was the dismissal of seasoned scientists. Now, Secretary Kennedy and HHS have set their sights on weaponizing public health for political gain and putting millions of American lives at risk”, her lawyers, Mark Zaid and Abbe David Lowell, said in a statement posted on social media.“When CDC Director Susan Monarez refused to rubber-stamp unscientific, reckless directives and fire dedicated health experts, she chose protecting the public over serving a political agenda. For that, she has been targeted. Dr. Monarez has neither resigned nor received notification from the White House that she has been fired, and as a person of integrity and devoted to science, she will not resign.”“This is not about one official,” the lawyers added. “It is about the systematic dismantling of public health institutions, the silencing of experts, and the dangerous politicization of science. The attack on Dr. Monarez is a warning to every American: our evidence-based systems are being undermined from within.”The Department of Health and Human Services offered no explanation when it announced in an unsigned social media post that Monarez, who was confirmed by the Senate as CDC director and sworn in by Kennedy just last month, was no longer in charge of the public health agency.Sources “who spoke anonymously for fear of retribution”, told the New York Times reports that Monarez had objected to sweeping changes to the panel of experts who advise the agency on vaccine policy made by Donald Trump’s anti-vaccine health secretary Robert F Kennedy Jr.An administration official also told the Times that Kennedy had summoned Monarez to his office on Monday and demanded that she resign. After she refused to do so, she called Dr Bill Cassidy, the Republican chairman of the Senate health committee. Kennedy then accused Monarez of “being a leaker” and said that she would be fired.Hours before Monarez left the agency, Kennedy hailed decisions by the Food and Drug Administration on Wednesday revoking the emergency use authorization for the Covid-19 vaccines manufactured by Pfizer, Moderna and Novavax that CDC experts estimate saved 3.2 million lives in the United States.Vaccines from the three manufacturers are now authorized by the FDA only for people who are 65 and older, or younger people with an underlying medical condition that puts them at risk for severe disease.Even those that qualify for the vaccines will only be able to get them in the US if the advisory panel, reshaped by Kennedy to include Covid vaccine opponents, votes to approve them.Inside Medicine, a newsletter written by Jeremy Faust, a public health researcher and emergency medicine physician, just published the full text of email statements three CDC leaders who resigned on Wednesday sent to their colleagues to explain their reasons for leaving the US public health agency after its new director abruptly departed.The most explosive charge came from Dr Demetre Daskalakis, who stepped down as the director of the National Center for Immunization and Respiratory Diseases. “I am not able to serve in this role any longer because of the ongoing weaponizing of public health. You are the best team I have ever worked with, and you continue to shine despite this dark cloud over the agency and our profession,” Daskalakis wrote. “Please take care of yourself and your teams and make the right decisions for yourselves.”“For the good of the nation and the world, the science at CDC should never be censored or subject to political pauses or interpretations,” Dr Deb Houry, the agency’s chief medical officer, wrote. “Vaccines save lives – this is an indisputable, well-established, scientific fact. Informed consent and shared decision-making must focus not only on the risks but also on the true, life-saving benefits that vaccines provide to individuals and communities. It is, of course, important to question, analyze, and review research and surveillance, but this must be done by experts with the right skills and experience, without bias, and considering the full weight of scientific evidence. Recently, the overstating of risks and the rise of misinformation have cost lives, as demonstrated by the highest number of US measles cases in 30 years and the violent attack on our agency.”Houry’s statement seemed like a clear response to recent statements and actions to limit access to vaccines by the anti-vaccine health secretary, Robert F Kennedy Jr.Dr Daniel Jernigan, who resigned as director of the premiere US center for the study of emerging and zoonotic infectious diseases, told colleagues: “I believe strongly in the mission of public health and the leadership that CDC has given for almost 80 years; however, given the current context in the Department, I feel it is best for me to offer my resignation.”Jernigan, whose center included the CDC’s Immunization Safety Office, testified to Congress last year that the CDC estimates that the vaccination of children born between 1994 and 2021 “will prevent 472 million illnesses and 29.8 million hospitalizations, help avoid 1,052,000 deaths, and save nearly $2.2 trillion in total societal costs”.He also pointed to research that, as of November 2022, Covid-19 vaccines had “saved more than 3.2 million lives in the United States, prevented more than 18.5 million hospitalizations, and averted over $1.15 trillion in healthcare costs”.“I am not able to serve in this role any longer because of the ongoing weaponization of public health,” Dr Demetre Daskalakis, who resigned on Wednesday from his position as the director of the National Center for Immunization and Respiratory Diseases at the CDC told colleagues in an email obtained by STAT, a health news site.Those concerns were echoed by another departing CDC leader, Dr Deb Houry, the chief medical officer, who wrote that “ongoing changes prevent me from continuing in my job as a leader of the agency” adding that science should “never be censored or subject to political interpretations”.The two CDC leaders, and their colleague Daniel Jernigan, who ran the Center for Emerging Zoonotic Infectious Diseases, quit the agency after the abrupt departure of Susan Monarez, the Senate-confirmed director of the CDC.US officials announced on Wednesday the departure of the director of the nation’s top public health agency, after less than one month in the job.“Susan Monarez is no longer director of the Centers for Disease Control and Prevention. We thank her for her dedicated service to the American people,” the US Department of Health and Human Services wrote in a statement posted on social media.HHS officials did not explain why Monarez is no longer with the agency. Before the announcement was made, Monarez told the Associated Press: “I can’t comment.”Three senior officials at the Centers for Disease Control and Prevention resigned on Wednesday after the new CDC director Susan Monarez, abruptly left the agency.Shortly after the US Department of Health and Human Services, HHS, announced on social media that Monarez “is no longer director of the Centers for Disease Control and Prevention”, at least three CDC leaders resigned: Dr Debra Houry, the chief medical officer; Dr Daniel Jernigan, the director of the National Center for Emerging and Zoonotic Infectious Diseases; and Dr Demetre Daskalakis, director of the National Center for Immunization and Respiratory Diseases.There was no immediate explanation for why any of the senior leaders have left the top US public health agency. Monarez was sworn in just four weeks ago. More

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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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How Baltimore’s violent crime rate hit an all-time low: ‘This is not magic. It’s hard work’
by Evelyn Reynolds 16 August 2025, 11:00
The end of violence in Baltimore is a litany of stories that weren’t told in 90-second clips on the evening news, about shootings that didn’t happen.The untold stories sound different, said Sean Wees: “The guys had guns pointed at each other. We got in between.”One summer afternoon, two years ago, two men emerged from a corner store at Patapsco Avenue and Fifth Street, steps from Wees’s office at Safe Streets, in Baltimore’s Brooklyn neighborhood.“They had a little face-off in the store,” Wees said. “Words were exchanged when they stepped out the store.”A woman in the neighborhood saw what was about to go down and banged on the door of Safe Streets, a longstanding city-run violence-prevention program and a fixture in Baltimore. Wees knows his community, and knew one of the men well – a guy with a high potential for violence. A shooter. The other guy was new, Wees said.The neighborhood was still reeling from a mass shooting that June. Safe Streets had de-escalated five fights at a Brooklyn Day block party, but weren’t on the scene when a gunfight started there late that night. Two people died, 28 were injured and Wees was on edge.He and his co-worker Corey Winfield rushed outside to find both men shouting at each other with guns drawn.View image in fullscreen“We stood in between,” Wees said. “Corey was talking to one, and I was talking to a guy that was from the community.” Wees and Winfield carefully talked them back from the cliff.“That’s why having that rapport and being very active in your community is real important with this work,” Wees said. “Because if you don’t have that rapport, you’re not going to get them to put away those guns, because you don’t know what this man is thinking. You don’t know if he had that respect for you, enough to not blow your brains out along with the next man.”Violent crime in America’s big cities has been receding from pandemic highs for about two years. But even in comparison, Baltimore’s improvement is breathtaking: fewer people have been killed in the city over the last seven months than in any similar period in the last 50 years.As of 15 August, the running 365-day total for murders in Baltimore stood at 165 dead. Assuming the city remains on that pace, its murder rate would finish below 30 per 100,000 residents for the first time since 1986. If it remains on the pace set since 1 January, it would finish 2025 at 143 murders, a rate of about 25 per 100,000, last seen in Baltimore in 1978.It confounds Baltimore’s bloody legacy. An army of social workers, violence interventionists, prosecutors, community leaders, and even cops all pulling in the same direction for once has made David Simon’s stories from The Wire or Donald Trump’s exasperating trash talk less relevant.But this metropolitan renaissance is born of agony.Before Ahmaud Arbery or Breonna Taylor or George Floyd, there was Freddie Gray, rattled to death in the back of a Baltimore police department van.“We had, if you will, a head start with our uprising in 2015,” said Dr Lawrence Brown, a Baltimore historian and health equity researcher.View image in fullscreenGray’s death in April 2015 of spinal injuries set off an earthquake of protests against police brutality across the country, with none as consequential or long-lasting as those at the epicenter. Protests in Baltimore turned into riots.“Since 2015, there’s been here in Baltimore this acknowledgement that equity needs to be a priority,” Brown said. The riots were as much about the conditions of poverty that led to Gray’s death – people losing their homes in foreclosure to water bills, for example – as they were about police brutality, Brown noted.But the heavy-handed response by cops to the protests and failures to hold police accountable for misconduct eviscerated the relationship between the Baltimore police and the public. Baltimore’s state attorney Marilyn Mosby laid murder charges on the officers involved, and Baltimore’s police union closed ranks in response, eviscerating the relationship between police and politicians. And a series of scandals at city hall and the state attorney’s office – and the failure of Mosby’s charges to result in convictions – eviscerated the relationship between politicians and the public.Violence skyrocketed.Three months after Gray’s death, Baltimore’s homicide count set a 42-year record high. Baltimore’s mayor canned the police chief, then abandoned her re-election bid. In the previous year, 211 people had been killed in Baltimore, about 33.8 per 100,000 residents. That was high at the time relative to other large US cities, but reflected incremental improvement by Baltimore’s historical standards. After Freddie Gray’s death turned the city upside down, the count rose to 344 in 2015 – a 63% increase and a multi-decade high – bucking a long national trend of declining violent crime. The rate at which police made arrests in homicide cases cratered.View image in fullscreenThe gun trace taskforce (GTTF) scandal in 2017 exacerbated problems.Baltimore’s police culture revolved around statistics-driven measures of productivity, which Baltimore street cops often achieved by busting whoever happened to be convenient without concern about the quality of an arrest or the real criminality of a suspect, according to an internal report in the wake of the scandal.The GTTF had a reputation for aggressively pursuing arrests and putting up big numbers, insulating it from internal scrutiny. But a federal investigation revealed that the taskforce had long abandoned its mission to track down the source of illegal guns and had instead become a criminal gang prowling the street to rob drug dealers. Its officers planted guns and drugs on suspects and fabricated testimony to cover their tracks. More than a dozen police officers went to federal prison.Baltimore had tried more than one way to attack violent crime, from zero-tolerance “broken windows” policing to relying on neighborhood crime statistics to motivate police officers into making more arrests. Efforts to get guns off the street backfired spectacularly from political interference, incompetence and, with the GTTF, corruption.The scandal destroyed whatever public faith in Baltimore’s police department remained. By 2017, Baltimore’s homicide rate had risen to the highest of any large city in the US.“We had a police unit that was committing crimes. They were contributing to the crime,” Brown said. This history makes it hard to attribute the city’s current gains to police work, he added: “Who do I give credit to? Police are the lowest on my scales. It may be 5%. In some cases, at least with that gun trace taskforce, it’s negative.”Snake-bitten, adrift and in a state of profound civic despair, Baltimore’s leaders came to a fundamental consensus: reducing violence had to take priority over everything else. It was defining the city and was the only thing voters cared about.The first time Brandon Scott saw someone get shot in Park Heights, he wasn’t quite seven years old.Scott, a former city council member, had long been a keen observer of violence-prevention strategy before becoming mayor in 2020. An academic consensus looking at research done in Chicago and elsewhere about violence had long suggested that a dollar spent on policing reduced violence less than a dollar spent on intervention. But political leaders find it hard to justify cuts to police budgets under the best of circumstances. And Baltimore in 2021 did not have the best of circumstances.Scott had been mayor of Baltimore for about three months when the American Rescue Plan Act (Arpa) passed in Congress, giving him an option to supercharge his violence-prevention strategy without a massive political battle. The $1.9tn economic stimulus package passed in March 2021, sending $1,400 checks to taxpayers, paying unemployment benefits at a higher rate and granting money to cities to recover from the pandemic however they saw fit. Using Arpa money, the city could fund the new data-driven project without using the police budget, sidestepping the thorny “defund the police” rhetoric that had hamstrung previous efforts around the country.“When we said we were going to reduce violence by 15% from one year to the next, folks laughed at me,” Scott said. “Folks said that we couldn’t do it this way. The only way that we could do it is we went back to zero-tolerance policing, which actually didn’t do it in the first place.”Against a Baltimore police budget topping half a billion dollars – the largest police budget per capita of any large city in the US – Baltimore’s political establishment gave its new millennial mayor room to experiment with $50m in Washington’s money.View image in fullscreenTrust was in short supply after years of scandal. The first step was to get everyone on board – the cops, the hospitals, the jails, the schools, the social services teams, the state government and the feds. Scott appointed Richard Worley as the city’s new police commissioner in June 2023; Worley was a life-long Baltimore officer picked in part to bring the rank and file in line with Scott’s antiviolence program. Scott emphasizes partnerships as an important part of the plan’s successes.Other federal grants, from the Bipartisan Safer Communities Act, emerged in 2022 to help support the network of non-profits needed for the plan. The funding came from the first federal gun-control legislation enacted in 28 years, with the support of 15 Senate Republicans and $250m over five years for community violence-intervention programs under the Department of Justice.Baltimore’s approach is tailored and personalized. The social worker who knocks on someone’s door carries a letter written for that person from the mayor, with an offer of help – and a threat.“We focus on the individuals and groups that are most likely to be a victim or perpetrator of that gun violence, and we go to them,” Scott said. “They actually get a letter from me. And if they don’t do that – if they don’t take us up on that help to operate their lives in a different way, to not put themselves at risk of being a victim or perpetrator or get involved in illegal and violent activity, then we remove them through our law enforcement partnership with the police department that obviously works at my direction, or with our attorney general, our state’s attorney and our federal law enforcement partners, and we’re holding people accountable.”Crime charts start showing the decline in September 2022, when the comprehensive plan had been up and running for about a year, Scott said. About three out of four people offered services by the program accepted them, and the city today has less violence than at any point in his life, he said.“Of the folks that we’ve been able to work with through our partners … 95.7% of them have not been re-victimized, and 97.7% of them have not recidivated,” Scott said. “You’re talking about, in any city, a very relatively small group of people who are at the highest risk. For us to be intensely focusing on them, and to have that few of them become victims again, or recidivate into their previous life, is very impressive.”No one got killed in Baltimore last week. Also, the local paper’s reporters are quitting in droves. Surely, this is a coincidence.Summers bleed Baltimore. School is out. People congregate. Tempers flare. But between 27 July and 2 August, the homicide line of the Baltimore police department’s weekly crime report posted a shutout.Baltimore’s strategy revolves around focused deterrence. Take the kind of targeting advertisers use to put an ad up on your phone for mouthwash on a day you forgot to brush your teeth, and apply it to murder. Only, instead of an ad, someone at high risk for violence gets a case worker knocking on their door.“We’re talking about young people at elevated risk,” said Kurtis Palermo, who runs the youth violence-prevention non-profit Roca in Baltimore. “We’re not talking about the young person who says F-you to his teacher, or tells Mom, Dad, Grandma they don’t want to do XYZ. We’re talking about kids who literally have probably two tracks: jail and death.”Palermo knocks on doors while a cop is carrying the mayor’s letter. As often as not, he has to knock on a door a dozen times before he finds his charge.The process often begins after a shooting. Case workers at local hospitals treating gunshot victims will take note of a patient’s history and their friends and family. The data is combined with school records, police records, social services records and whatever else might be relevant; then the violence-prevention team will have a quick meeting. When they determine someone has enough risk factors, they intervene.View image in fullscreen“It could be anything from information that is gleaned on jail calls, video evidence, you know, whatever it is, and then the connections to other people,” said Terence Nash, chief of the group violence-reduction strategy (GVRS) in the mayor’s office of neighborhood safety and engagement.About 570,000 people live in Baltimore. If 200 people are murdered in the city in a year, the average person’s risk would be about one in 2,850. But almost all the violence is concentrated among a tiny, impoverished and identifiable subset of that 570,000: 2% or less of the city, Nash said. If 80% of 200 murders are in this cluster, then most people are facing a murder risk of a bit less than 14,000 to one, while the high-risk cluster’s odds are about one in 71.There’s no single factor that is perfectly predictive, Nash said. But as connections accumulate with other people at risk for violence, a threshold is crossed. The process is epidemiological, treating violence like an infection to track.Two types of people are most vulnerable, Nash said: people in their early 20s who are feuding over trivial matters, “someone looked at somebody wrong, somebody bumped into somebody”; and older people in the drug game, “more around violence that has to do with their criminal enterprise, and so it’s much more calculated”.Critically, it’s not every young person with an Instagram beef, and not every Sandtown neighborhood street dealer that rises to their attention. The risk factors create a reasonable, articulable – and legally defensible – basis for contact. The team looks at each person individually, and crafts an approach for each one, Nash said.“This is not magic. It’s hard work,” Nash said. “It takes attention to detail.”Jaylen was in a hospital bed recovering from a gunshot wound when a life coach with Youth Advocate Programs (YAP) approached him. Jaylen had, he said, been in the wrong part of West Baltimore at the wrong time. He wasn’t especially receptive at first to a life coach, of all things, he said.“I thought there was a catch,” the 20-year-old said. “I thought I’d have to pay them back in the future.”Jaylen couldn’t say much about his life or where he was: people might still want to hurt him. But it took a couple of months of outreach for the offer of help from Teshombae Harvell, Jaylen’s life coach, to look real. It took consistency.“It’s about the follow-up,” Harvell said. “Today they might say get the F out of here. Tomorrow, they could be wanting services, because something tragic happened where they need change.”When someone gets shot, Jaylen expects someone to retaliate, he said: “Back and forth, back and forth. It’s never-ending.”What Harvell offered – what no one had offered in a credible way before – was a plan for the future, and perhaps the realization that he had a future. Jaylen had thought about killing someone before, he said. He felt as if the prospect of surviving long enough to have a legit life wasn’t worth considering.Now he has a driver’s license and wants to become a plumber. Helping fix some of Baltimore’s stubborn oversupply of abandoned houses would be a living, and ironically would be paying back the city for its help.“The only way programs like YAP or GVRS are going to be successful is for people to buy in,” said Harvell. “They can’t be spectators on the outside, looking in, wondering if it’s going to be a success or a failure.”Brandon Scott’s approach offers benefits to get people out of the street and off a violent path: housing, victim assistance, drug treatment, mental health services, job training.“There’s the carrot and stick,” said Ivan Bates. “We’re the stick.”Bates had a pretty good track record of getting drug dealers off the hook before winning election as Baltimore’s state’s attorney – what most places call the district attorney and chief prosecutor. Baltimore’s history of light prosecutions for handgun cases is a legacy of questionable policing practices – weakly supported cases landing in court – and a negative view of mass incarceration by prosecutors.“I was the one who was beating the brakes off the state,” Bates said. “Look, my law partner and I went 25, 26 straight jury trials against Baltimore city prosecutors representing some pretty rough people, you know. And when I come and say that the street – the criminal elements – do not respect that approach, I’m not saying it because I read in a book. I’m saying it because I lived it.”After defeating Mosby and assuming office in January 2023, Bates immediately reversed her policy of non-prosecution for low-level offenses like drug possession, prostitution and trespassing. He successfully lobbied the Maryland legislature to increase the penalty for illegal gun possession from three years to five years. And he started putting people in prison.View image in fullscreenIn Mosby’s last two years in office, 2,186 people faced felony gun charges. Mosby dismissed about 34% and another 30% received plea bargains, mostly without imprisonment. In Bates’s first two years, the number of cases increased a bit, to 2,443. Bates only dismissed 19% of the cases, and only 10% received plea agreements. The rest were convicted – an increase of about 1,000 people sent to prison – which includes a 70% increase in homicide convictions.“Everybody has a plan. The mayor had his plan. The police department, they have their plan,” Bates said. “And when I came and I ran for office, I had my plan. The plans have to work together as one.”Bates is quick to attribute the city’s reduction in violence to a team effort. For example, without victim assistance – which is supported by a federal grant – prosecutions that would have fallen apart in previous years concluded in convictions because witnesses could be found to appear in court. Police now are actually focused on removing illegal guns from the street, he said.It also requires people to have an out. Without a path off the street, people on the edge in Baltimore will do what they must to survive, he said.He rejects the suggestion that his approach is a return to mass incarceration. Prosecution is not zero tolerance and it is not indifferent to a defendant’s conditions.“We have focused on violent repeat offenders, not the first-time kid,” Bates said. “Remember, 5,000-6,000 individuals are doing this type of behavior. So, we’re not here to go back to mass incarceration.”But he’s sensitive to how this approach plays out in five years.“My No 1 worry is, when individuals come home, we have to have something for them,” he said. “Did we actually prepare them to come home? … Look, I believe everybody pays a debt to society. We move on, and then we as a society put them in a place that they can win. And if we didn’t, then we’re going to see these numbers bounce back up.”Sean Wees from Safe Streets said stopping a shooting might come down to noticing that a kid on a street corner has holes in his shoes.“So we asked the little kid, are you hungry?” Wees said. “That could lead to a conversation where you find out this kid is not eating. But we have the resources, or if we don’t have them at that time, we find the resources to help this family out. And now that key individual, that target individual, is the father of that child … We fed his child now, we’ve started to build a rapport with this guy, because he’s going to be appreciative of the work that we just did. That’s how this works.”View image in fullscreenOne might think that the thing that prevents expanding the work is personnel. Very few people have the street credibility, the devotion and the nerve to be successful. But Wees said the constraint is actually money.“I love this work, because I’m always trying to save an individual life,” he said. “I’m good with this work. The time and the money don’t match right now, but guess what? I still do this work … You get more money, people will put in more time.”For the first time in forever, Charm City’s leaders are all pulling in the same direction, and crime is falling through the floor. They’ve placated violence in inventive and predictable ways. They are, of course, justifiably concerned that Donald Trump will undo their successes on Republican “screw cities” general principles.Trump closed the White House office of gun violence prevention on the first day he took office. Three months later, the Department of Justice cut the $300m allocated to community violence-intervention grants in half, including many in Baltimore. The cuts were part of a larger $811m culling across the office of justice programs, Reuters reported. Funding for gun-violence victims’ services, conflict mediation, social workers, hospital-based programs: gone.Scott blasted the cuts to the program’s partners as dangerous and reckless.“You’re talking about an administration who has said for years that they want to drive down crime in these cities,” he said. “The truth is no one cares if the mayor is a Republican or Democrat in any city when it comes to gun violence.”The youth antiviolence organization Roca had three grants terminated, one in Baltimore with about $1m left unspent. The termination letter said the grant did not align with its priorities including “directly supporting certain law enforcement operations, combating violent crime, protecting American children, and supporting American victims of trafficking and sexual assault”.As applied to Roca, the rationale is absurd. But they could see it coming, said Dwight Robson, a Roca executive.“Initially, it was a huge blow. We were estimating that we were going to serve roughly 60 fewer young people a year,” Robson said. After an outcry, funders outside the federal government, including the city itself, started to step in, who “made it clear that they don’t want to lose momentum” in Baltimore.Support in other places, like Boston, is fleeting, in part because they’ve done their job too well, Robson said: “Boston is the safest big city in America. And you know, the homicides and crime just aren’t on people’s radars to the degree that it is in Baltimore.”Roca has appealed the decision to cut their grant, and a coalition of non-profits is suing the Trump administration, arguing that the cuts were made unlawfully.The real threat posed by the cuts is continuity, said Stefanie Mavronis, director of the mayor’s office of neighborhood safety and engagement (Monse). The violence-intervention plan has worked in part because it has been consistent. People are so used to the presence of Monse staffers around crime scenes and in high-violence neighborhoods that some people have come to expect a knock on the door after a shooting.View image in fullscreenIf Monse’s partners start disappearing, and if they can’t back up promises of help made to victims – or shooters – then things may fall apart, she said.“We’ve got to make the investment in the service side of things,” Mavronis said. “We can’t just make empty promises to folks who we are telling we have the services for you to change your life.”Baltimore’s leaders, both in city hall and in the streets, have been putting their reputations and capital on the line, in some cases risking their lives.Budget cuts while they’re winning makes it look like they want Baltimore to lose. The exasperation is plain.“We have the lowest amount of violence that we’ve seen in my lifetime, and I’m 41 years old,” Scott said. “If everyone says that they agree that this is the top issue, that we have to make sure that more people are not becoming a victim of these things, why change it? Why disrupt the apple cart, if the apple cart is producing the best results that we’ve seen in a generation?” More
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Why the US is burning $10m worth of birth control | Moira Donegan
by Evelyn Reynolds 1 August 2025, 12:00
There are few better metaphors for the receding status of American women than one offered up by the Trump administration at a medical waste disposal facility outside Paris this week: rather than distribute nearly $10m worth of birth control, which had been purchased by USAID and was destined to be given to women in low-income countries, primarily in Africa, the Americans decided to burn it.The incinerated contraceptives included 900,000 birth control implants, 2m doses of injectable long-acting birth control, 2m packs of contraceptive pills and 50,000 IUDs. The medicine is just the latest in the far-reaching fallout from cuts made by the so-called “department of government efficiency,” or Doge, a project in which Elon Musk and a group of his very young, overwhelmingly male acolytes unilaterally slashed congressionally appropriated funding to government programs they did not like. The cuts have been devastating for non-profits that work to improve women’s health and safety worldwide. Sarah Shaw, an associate director at the global family planning group MSI Reproductive Choices, says that the cuts will put women at risk as they strain their health with unplanned pregnancies and seek out illegal abortions; other women who are denied access to birth control will lose out on the opportunities for education, professional development or remunerative work that can help them escape abuse, rise out of poverty, pursue their talents and ambitions and better provide for the children they already have.When MSI attempted to buy the contraceptives, the administration would only accept full price, which the organization couldn’t afford, she said. Several non-profits, including MSI, had offered to pay to ship and repackage the supplies, according to another representative. But the Trump administration refused, partially due to federal rules the prohibit the US from providing such goods to groups that perform, provide referrals for or offer education about abortions. In addition to the cost of purchasing the contraceptives, American taxpayers will now be on the hook for about $167,000 for the cost of burning them.It’s just the latest in a series of signs that the Trump administration is turning against the provision of birth control, particularly the safe, effective and woman-controlled hormonal methods that have been a cornerstone of healthcare policy for decades and which were a precondition of women’s advancement in work and education over the past 60 years.In April, the Trump administration abruptly announced that it was suspending a large swath of the domestic service grants distributed under Title X, the program meant to help low-income Americans access birth control, STD treatment and other sexual and reproductive healthcare. Of the 86 Title X grants awarded for fiscal year 2024, nearly 25% were “temporarily withheld”, mostly based on highly suspect allegations that the grant-receiving institutions – including 13 Planned Parenthood affiliates – had failed to comply with Trump executive orders banning things like DEI programs. Eight states now receive zero Title X dollars: California, Hawaii, Maine, Missouri, Mississippi, Montana, Tennessee and Utah. Alaska, Minnesota and Pennsylvania have also lost most of their contraception funding.The domestic cuts – along with the exclusion of Planned Parenthood clinics from Medicaid reimbursements – mean that American women, too, are now facing dramatically greater obstacles to accessing birth control. Clinics that relied on Title X funding are now set to close: 11 Planned Parenthood clinics already have, including in Democratically controlled states like California. Planned Parenthood says that cumulatively, the cuts could lead the organization to close about 200 of its 600 clinics nationwide – a devastating cut to abortion providers in particular that will make a wide range of reproductive services inaccessible to women regardless of where they live.But the Trump administration is not merely forcing these programs for women’s health and dignity go up in flames. They are redirecting them to better suit their preferred cultural outcome: one in which women’s lives, ambitions and talents are all subordinated to the task of childbearing. The New York Times reported last month that the White House is redirecting Title X funds that once went to birth control to instead fund an “infertility training center” and programs in something called “restorative reproductive medicine”. If Title X’s original aim was to help American women control their fertility so as to build healthier families and to enable them to pursue other aims – like learning or work – in the new administration’s version, the program exists mainly to encourage women to have more children. But the switch should not be seen as a genuine investment in infertility, an often devastating condition with which many Americans struggle. Because the new Title X priorities do not, by and large, direct more money to IVF. Trump promised, on the campaign trail, to make IVF free. But the procedure, which has opponents on the Christian right, is not included in the administration’s new priority of “restorative” reproductive medicine, a practice that avoids controversial fertility treatments; instead, doctors seek the “root cause” of a woman’s infertility, which may involve telling them they can conceive with proper diet and exercise.In government, money allocation is a statement of values. With its dramatic cuts to contraceptive funding at home and abroad, the Trump administration is making its values clear. It does not value women’s health; it does not value their dignity, their control over their own lives, their aspirations, their earning potential, their desire to be freed from ignorance, or poverty, or the abuse they suffer under the hands of husbands and fathers. It does not value their ability to control their own bodies, and by extension, it does not value their ability to enter the public sphere. It does not value their dreams, their gifts, their hard work or invention or aspiration to anything other than making babies. American women, like women everywhere, depend on birth control to live lives of freedom and to pursue their dreams. But because of the Trump administration, those dreams are going up in smoke.
Moira Donegan is a Guardian US columnist More
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Top medical body concerned over RFK Jr’s reported plans to cut preventive health panel
by Evelyn Reynolds 27 July 2025, 18:41
A top US medical body has expressed “deep concern” to Robert F Kennedy Jr over news reports that the health secretary plans to overhaul a panel that determines which preventive health measures including cancer screenings should be covered by insurance companies.The letter from the the American Medical Association comes after the Wall Street Journal reported on Friday that Kennedy plans to overhaul the 40-year old US Preventive Services Task Force because he regards them as too “woke”, according to sources familiar with the matter.During his second term, Donald Trump has frequently raged against organizations and government departments that he considers too liberal – often without any evidence. The US president, and his cabinet members such as Kennedy, have also overseen huge cuts and job losses across the US government.The taskforce is made up of a 16-member panel appointed by health and human services secretaries to serve four-year terms. In addition to cancer screenings, the taskforce issues recommendations for a variety of other screenings including osteoporosis, intimate partner violence, HIV prevention, as well as depression in children.Writing in its letter to Kennedy on Sunday, the AMA defended the panel, saying: “As you know, USPSTF plays a critical, non-partisan role in guiding physicians’ efforts to prevent disease and improve the health of patients by helping to ensure access to evidence-based clinical preventive services.”“As such, we urge you to retain the previously appointed members of the USPSTF and commit to the long-standing process of regular meetings to ensure their important work can be continued without disruption,” it added.Citing Kennedy’s own slogan of “Making America healthy again,” the AMA went on to say: “USPSTF members have been selected through an open, public nomination process and are nationally recognized experts in primary care, prevention and evidence-based medicine. They serve on a volunteer basis, dedicating their time to help reduce disease and improve the health of all Americans – a mission well-aligned with the Make America Healthy Again initiative.”According to the Affordable Care Act, public and private insurance companies must cover any services recommended by the Preventive Services Task Force without cost sharing.In a statement to MedPage Today, Department of Health and Human Services spokesperson Andrew Nixon did not confirm the reports, instead saying: “No final decision has been made on how the USPSTF can better support HHS’ mandate to Make America Healthy Again.”Reports of Kennedy’s alleged decision to overhaul the taskforce come after the American Conservative published an essay earlier this month that described the taskforce as advocating for “leftwing ideological orthodoxy”.It went on to accuse the panel of being “packed with Biden administration appointees devoted to the ideological capture of medicine”, warning that the “continued occupation of an important advisory body in HHS – one that has the capacity to force private health insurers to cover services and procedures – by leftwing activists would be a grave oversight by the Trump administration”.In response to the essay, 104 health organizations, including the American Medical Association, issued a separate letter to multiple congressional health committees in which they urged the committees to “protect the integrity” of the taskforce.“The loss of trustworthiness in the rigorous and nonpartisan work of the Task Force would devastate patients, hospital systems, and payers as misinformation creates barriers to accessing lifesaving and cost effective care,” the organizations said.In June, Kennedy removed all 17 members of a US Centers for Disease Control and Prevention panel of vaccine experts. Writing in a Wall Street Journal op-ed, he accused the committee of having too many conflicts of interest.Kennedy’s decision to overhaul the immunization panel was met with widespread criticism from health experts, with the American Public Health Association executive director Georges Benjamin calling the ouster “a coup”.“It’s not how democracies work. It’s not good for the health of the nation,” Benjamin said. More
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Trump cracks down on homelessness with executive order enabling local governments
by Evelyn Reynolds 24 July 2025, 20:59
The federal government is seeking to crack down on homelessness in the US, with Donald Trump issuing an executive order to push local governments to remove unhoused people from the streets.The order the US president signed on Thursday will seek the “reversal of federal or state judicial precedents and the termination of consent decrees” that restrict local governments’ ability to respond to the crisis, and redirect funds to support rehabilitation and treatment. The order aims to “restore public order”, saying “endemic vagrancy, disorderly behavior, sudden confrontations, and violent attacks have made our cities unsafe”, according to the order.The action comes as the homelessness crisis in the US has significantly worsened in recent years driven by a widespread shortage of affordable housing. Last year, a single-day count, which is a rough estimate, recorded more than 770,000 people experiencing homelessness across the country, the highest figure ever documented.Cities and states have adopted an increasingly punitive approach to homelessness, seeking to push people out of parks and city streets, even when there is no shelter available. The supreme court ruled last year that cities can impose fines and even jail time for unhoused people for sleeping outside after local governments argued some protections for unhoused people prevented them from taking action to reduce homelessness.Karoline Leavitt, the White House press secretary, told USA Today, which first reported on the executive order, that the president was “delivering on his commitment to Make America Safe Again” and end homelessness.“By removing vagrant criminals from our streets and redirecting resources toward substance abuse programs, the Trump Administration will ensure that Americans feel safe in their own communities and that individuals suffering from addiction or mental health struggles are able to get the help they need,” she said.The president’s order comes after last year’s US supreme court ruling, which was one of the most consequential legal decisions on homelessness in decades in the US.That ruling held that it is not “cruel and unusual punishment” to criminalize camping when there is no shelter available. The case originated in Grants Pass, Oregon, a city that was defending its efforts to prosecute people for sleeping in public.Unhoused people in the US have long faced crackdowns and sweeps, with policies and police practices that result in law enforcement harassment, tickets or jail time. But the ruling supercharged those kinds of aggressive responses, emboldening cities and states to punish encampment residents who have no other options for shelter.In a report last month, the American Civil Liberties Union found that cities across the US have introduced more than 320 bills criminalizing unhoused people, the majority of which have passed. The crackdowns have taken place in Democratic- and Republican-run states alike.Advocates for unhoused people’s rights have long argued that criminalization only exacerbates the housing crisis, shuffling people in and out of jail or from one neighborhood to the next, as they lose their belongings and connections to providers, fall further into debt and wind up in increasingly unsafe conditions.During his campaign last year, Trump used dark rhetoric to talk about the humanitarian crisis, threatening to force people into “tent cities”, raising fears that some of the poorest, most vulnerable Americans could end up in remote locations in settings that resemble concentration camps. More
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Consent decrees force schools to desegregate. The Trump administration is striking them down
by Evelyn Reynolds 24 July 2025, 11:00
In late April, the Department of Justice announced that it was ending a decades-long consent decree in Plaquemines parish, Louisiana, in a school district that has been under a desegregation order since the Johnson administration in the 1960s.The Plaquemines parish desegregation order, one of more than 130 such orders nationwide, was in place to ensure that the school district, which initially refused to integrate, followed the law. Many consent decrees of the era are still in existence because school districts are not in compliance with the law.Some experts, including former justice department employees, say the change in direction for the department could be worrying.These orders “provide students with really important protections against discrimination”, said Shaheena Simons, who was the chief of the educational opportunities section of the civil rights division at the justice department for nearly a decade. “They require school districts to continue to actively work to eliminate all the remaining vestiges of the state-mandated segregation system. That means that students have protections in terms of what schools they’re assigned to, in terms of the facilities and equipment in the schools that they attend. They have protection from discrimination in terms of barriers to accessing advanced programs, gifted programs. And it means that a court is there to protect them and to enforce their rights when they’re violated and to ensure that school districts are continuing to actively desegregate.”The justice department ended the Plaquemines parish desegregation order in an unusual process, one that some fear will be replicated elsewhere. The case was dismissed through a “joint stipulated dismissal”. Previously, courts have followed a specific process for ending similar cases, one in which school districts prove that they are complying with the court orders. That did not happen this time. Instead, the Louisiana state attorney general’s office worked with the justice department in reaching the dismissal.“I’m not aware of anyone, any case, that has [ended] that way before,” said Deuel Ross, the deputy director of litigation of the Legal Defense Fund (LDF); the LDF was not specifically involved with the Plaquemines parish case. “The government as a plaintiff who represents the American people, the people of that parish, has an obligation to make sure that the district has done everything that it’s supposed to have done to comply with the federal court order in the case before it gets released, and the court itself has its own independent obligation to confirm that there’s no vestiges of discrimination left in the school district that are traceable to either present or past discrimination.”Despite the district not proving that it is compliant with the order, the justice department has celebrated the end of the consent decree.“No longer will the Plaquemines Parish School Board have to devote precious local resources over an integration issue that ended two generations ago,” Harmeet K Dhillon, assistant attorney general of the justice department’s civil rights division, said in a statement announcing the decision. “This is a prime example of neglect by past administrations, and we’re now getting America refocused on our bright future.”But focusing on the age of the case implies that it was obsolete, according to Simons, who is now the senior adviser of programs and strategist at the Lawyers’ Committee for Civil Rights Under Law. “The administration is trying to paint these cases as ancient history and no longer relevant.”In 1966, the Johnson administration sued school districts across the country, particularly in the south, that refused to comply with desegregation demands. At the time, Plaquemines parish was led by Leander Perez, a staunch segregationist and white supremacist.Perez had played a large role in trying to keep nearby New Orleans from desegregating, and once that effort failed, he invited 1,000 white students from the Ninth Ward to enroll in Plaquemines parish schools. By 1960, nearly 600 had accepted the offer. Perez was excommunicated by Archbishop Joseph Francis Rummel for ignoring his warning to stop trying to prevent schools run by the archdiocese of New Orleans from integrating.Perez attempted to close the public schools in Plaquemines parish, and instead open all-white private academies, or, segregation academies, which became a feature of the post-integration south. An estimated 300 segregation academies, which, as private schools, are not governed by the same rules and regulations as public schools, are still in operation and majority white.Students and teachers working in school districts today might be decades removed from the people who led the push for desegregation in their districts, but they still benefit from the protections that were long ago put in place. Without court oversight, school districts that were already begrudgingly complying might have no incentive to continue to do so.According to the Century Foundation, as of 2020, 185 districts and charters consider race and/or socioeconomic status in their student assignment or admissions policies, while 722 districts and charters are subject to a legal desegregation order or voluntary agreement. The justice department currently has about 135 desegregation cases on its docket, the majority of which are in Louisiana, Mississippi, Alabama and Georgia.skip past newsletter promotionafter newsletter promotion“Separate but equal doesn’t work,” said Johnathan Smith, former deputy assistant attorney general in the civil rights division at the justice department. “The reality is that students of color do better when they are in integrated classrooms … We know that the amount of resources that are devoted to schools are greater when there are a higher number of white students. So to have students attend majority-minority school districts means that they’re going to be shut out, whether that’s from AP classes, whether that’s from extracurricular activities. All the activities that make it possible for students to fully achieve occur when you have more integrated classrooms.”“Public education isn’t just about education for the sake of education,” he added. “It’s about preparing people to be citizens of our democracy and to be fully engaged in our democratic institutions. When you have students that are being shut out from quality public education, the impact is not just on those communities. It’s on our democracy writ large.”Smith, the current chief of staff and general counsel for the National Center for Youth Law, said that the decision “signals utter contempt for communities of color by the administration, and a lack of awareness of the history of segregation that has plagued our nation’s schools”.“Even though we are 71 years after the Brown v Board [of Education] decision, schools of this country remain more segregated today than they were back in 1954,” he said. “The fact that the administration is kind of wholeheartedly ending these types of consent decrees is troubling, particularly when they’re not doing the research and investigation to determine whether or not these decrees really should be ended at this point.”Smith said that the decision in the Plaquemines parish case may be a “slippery slope” in which other school districts begin reaching out to the Trump administration.“The impact they can have across the country and particularly across the south is pretty huge,” he said. “I worry that we’re going to see more and more of these decrees falling and more and more of these districts remaining segregated without any real opportunity to address that.” More
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Should we ban opinion polls?
by Evelyn Reynolds 20 July 2025, 15:00
Ahead of the 2016 US presidential election, opinion polls predicted a win for Hillary Clinton. She lost, and the polling industry went through one of its regular spasms of self-criticism and supposed reform. Alas, it did not vote itself entirely out of existence. France and Spain ban the publication of opinion polls in the days leading up to an election, but we should go one better and ban their publication at any time.No doubt it adds much to the gaiety of the British nation to see the Conservative party slip to third or fourth in the polls, but any poll asking who you would vote for if there were a Westminster election tomorrow, held at a time when there almost certainly will not be an election for another four years, is meaningless as a guide to the makeup of the next Parliament.If polls were simply useless that would be no reason to ban them, though. A better reason is that they are actively harmful: a species of misinformation that pollutes the public sphere.One fundamental problem, recognised long ago, is that there is no such thing as “the public”, thought of as a hive mind with a single homogeneous view. To report the results of any poll as “the British public thinks…” is simply a falsehood, except perhaps in the unlikely circumstance that fully 100% of respondents agree on some point. There is, for the same reason, no such thing as “the will of the British people”, a spectre conjured into being only when something very dubious is being proposed.So what is it exactly that opinion polls measure? A random sample, hopefully statistically reliable, of differing and irreconcilable opinions. Not informed opinions exclusively, of course, but also the opinions of conspiracy theorists, the news-phobic and the merely deranged. By such a scientific operation we may uncover the valuable truths that a third of Conservative voters would prefer to see Nigel Farage as prime minister, while 7% of American men believe they could beat a grizzly bear in unarmed combat.A deeper question is whether polls actually create, in whole or in part, what they purport to be revealing. Does everyone go around with settled, reasoned views on every hot-button issue of the day, just waiting to be revealed by a questioning pollster? The answer was clear to the American journalist Walter Lippmann in his 1922 book Public Opinion. It is unrealistic, he argued, to expect people to be able to form “sound public opinions on the whole business of government”, and they shouldn’t actually have to. “It is extremely doubtful whether many of us would … take the time to form an opinion on ‘any and every form of social action’ which affects us.”The act of asking a question, though, heightens the importance of the subject in the mind of the questionee, creating an urge to have one’s say where there might previously have been neither urge nor say at all. As Walter Bagehot, the 19th-century political theorist and editor of the Economist, once observed: “It has been said that if you can only get a middle-class Englishman to think whether there are ‘snails in Sirius’, he will soon have an opinion on it.” As though to prove him right, in 1980 a third of American respondents helpfully offered their view on whether the “1975 Public Affairs Act” should be repealed, even though that legislation did not actually exist.The way you ask the question, moreover, can profoundly influence the outcome. A 1989 study by the American social scientist Kenneth A Rasinski found that varying verbal framings of political issues changed the outcome: “More support was found for halting crime than for law enforcement, for dealing with drug addiction than for drug rehabilitation, and for assistance to the poor than for welfare.” Other such experiments have shown that the order of questioning also matters, that Americans express more support for government surveillance if terrorism is mentioned in the question, and that nearly twice as many people think that the government “should not forbid speeches against democracy” than it “should allow speeches against democracy”, though the options are exactly equivalent.Modern opinion polls, then, are part of the machinery behind the “manufacture of consent”, a phrase originally coined by Lippmann to describe the propaganda operations of politicians and the press. It is no accident, after all, that George Gallup had been an advertising man, with the Madison Avenue firm Young & Rubicam, before he helped to pioneer the methods of systematic opinion polling by borrowing from market research and PR. In 1936, Gallup and his colleagues correctly predicted the election of Franklin D Roosevelt, proving the old-fashioned forecasting methods outdated. Using the “new instrument” of polling, he declared happily in 1938, “the will of the majority of citizens can be ascertained at all times”. This was, of course, partly by way of advertising his own commercial interest as founder, in 1935, of the American Institute of Public Opinion (Gallup Poll). His fellow pollster Elmo Roper described their nascent industry as “a veritable goldmine”.Profitable it may be, but the constant drizzle of polling also incentivises short-term, knee-jerk decision-making by governments. A leader may make a hasty policy change merely in response to a poll, and then if the polling improves, take that as proof that the new policy is correct. Keir Starmer was no doubt cheered when, following his Enoch Powell-adjacent speech on immigration in May, polling found that “more Britons [now] believe that the government wants to reduce net migration”. But a policy designed to massage approval ratings over the course of weeks is not always going to be the same as a good policy that will last years.It would be invidious after all this not to mention one consideration that strongly favours opinion polls, which is that they provide a steady stream of pseudo-news to the media. If each day did not bring a new revelation about the imaginary public’s confected opinion on one or another issue, there would be much less for news programmes to report on. And what would we all do then?Further readingPublic Opinion by Walter Lippmann (Wilder, £7.49)Manufacturing Consent by Edward S Herman and Noam Chomsky (Vintage, £12.99)Lies, Damn Lies, and Statistics by Michael Wheeler (WW Norton & Company, £13.99) More
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Trump administration to destroy nearly $10m of contraceptives for women overseas
by Evelyn Reynolds 18 July 2025, 18:01
The Trump administration has decided to destroy $9.7m worth of contraceptives rather than send them abroad to women in need.A state department spokesperson confirmed that the decision had been made – a move that will cost US taxpayers $167,000. The contraceptives are primarily long-acting, such as IUDs and birth control implants, and were almost certainly intended for women in Africa, according to two senior congressional aides, one of whom visited a warehouse in Belgium that housed the contraceptives. It is not clear to the aides whether the destruction has already been carried out, but said they had been told that it was set to occur by the end of July.“It is unacceptable that the State Department would move forward with the destruction of more than $9m in taxpayer-funded family planning commodities purchased to support women in crisis settings, including war zones and refugee camps,” Jeanne Shaheen, a Democratic senator from New Hampshire, said in a statement. Shaheen and Brian Schatz, a Democratic senator from Hawaii, have introduced legislation to stop the destruction.“This is a waste of US taxpayer dollars and an abdication of US global leadership in preventing unintended pregnancies, unsafe abortions and maternal deaths,” added Shaheen, who in June sent a letter to the secretary of state, Marco Rubio, about the matter.The department decided to destroy the contraceptives because it could not sell them to any “eligible buyers”, in part because of US laws and rules that prohibit sending US aid to organizations that provide abortion services, counsel people about the procedure or advocate for the right to it overseas, according to the state department spokesperson.Most of the contraceptives have less than 70% of their shelf life left before they expire, the spokesperson said, and rebranding and selling the contraceptives could cost several million dollars. However, the aide who visited the warehouse said that the earliest expiration date they saw on the contraceptives was 2027, and that two-thirds of the contraceptives did not have any USAID labels that would need to be rebranded.The eradication of the contraceptives is part of the Trump administration’s months-long demolition of the Agency for International Development (USAID), the largest funding agency for humanitarian and development aid in the world. After the unofficial “department of government efficiency” (Doge) erased 83% of USAID’s programs, Rubio announced in June that USAID’s entire international workforce would be abolished and its foreign assistance programs would be moved to the state department. The agency will be replaced by an organization called America First.In total, the funding cuts to USAID could lead to more than 14m additional deaths by 2030, according to a recent study published in the journal the Lancet. A third of those deaths could be children.“If you have an unintended pregnancy and you end up having to seek unsafe abortion, it’s quite likely that you will die,” said Sarah Shaw, the associate director of advocacy at MSI Reproductive Choices, a global family planning organization that works in nearly 40 countries. “If you’re not given the means to space or limit your births, you’re putting your life at risk or your child’s life at risk.”MSI tried to purchase the contraceptives from the US government, Shaw said. But the government would only accept full price – which Shaw said the agency could not afford, given that MSI would also have to shoulder the expense of transportingthe contraceptives and the fact that they are inching closer to their expiration date, which could affect MSI’s ability to distribute them.The state department spokesperson did not specifically respond to a request for comment on Shaw’s allegation, but MSI does provide abortions as part of its global work, which may have led the department to rule it out as an “eligible buyer”.In an internal survey, MSI programs in 10 countries reported that, within the next month, they expect to be out of stock or be on the brink of being out of stock of at least one contraceptive method. The countries include Burkina Faso, the Democratic Republic of Congo, Mali, Ethiopia, Nigeria, Tanzania, Timor-Leste, Senegal, Kenya and Sierra Leone.Shaw expects the stock to be incinerated. “The fact that the contraceptives are going to be burned when there’s so much need – it’s just egregious,” she said. “It’s disgusting.” The Department of State spokesperson did not respond to a request for information on the planned method of destruction.The destruction of the contraceptives is, to Shaw, emblematic of the overall destruction of a system that once provided worldwide help to women and families. USAID funding is threaded through so much of the global supply chain of family planning aid that, without its money, the chain has come apart. In Mali, Shaw said, USAID helped pay for the gas used by the vehicles that transport contraceptives from a warehouse. Without the gas money, the vehicles were stuck – and so were the contraceptives.“I’ve worked in this sector for over 20 years and I’ve never seen anything on this scale,” Shaw said. “The speed at which they’ve managed to dismantle excellent work and really great progress – I mean, it’s just vanished in weeks.”Other kinds of assistance are also reportedly being wasted. This week, the Atlantic reported that almost 500 metric tons of emergency food were expiring and would be incinerated, rather than being used to feed about 1.5 million children in Afghanistan and Pakistan. Meanwhile, almost 800,000 Mpox vaccines that were supposed to be sent to Africa are now unusable because they are too close to their expiration date, according to Politico.The cuts to foreign aid are slated to deepen. Early on Friday morning, Congress passed a bill to claw back roughly $8bn that had been earmarked for foreign assistance.“It’s not just about an empty shelf,” Shaw said. “It’s about unfulfilled potential. It’s about a girl having to drop out of school. It’s about someone having to seek an unsafe abortion and risking their lives. That’s what it’s really about.” More

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