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      ‘A scary time to be a scientist’: how medical research cuts will hurt the maternal mortality crisis

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      On Tuesday, a few days after the Trump administration announced its plan to slash billions of dollars in funding for biomedical and behavioral research, an investigator at a maternal health research center in Pennsylvania told Dr Meghan Lane-Fall that the cuts may lead her to leave academia altogether.Lane-Fall urged her not to make any sudden moves. “It’s not like nothing has happened. No one’s threatened her job,” said Lane-Fall, a professor at the University of Pennsylvania. “But if she looks six months down the line, it looks uncertain.”She did advise her colleague to update her resume.Among the many fields of research threatened by the funding cuts is the growing effort to curb the US maternal mortality rate, which is far worse than in other rich nations. Not only could the cuts delay vital breakthroughs but women’s health experts warn they could also push promising young scientists out of the field.“Above and beyond the stalling of progress, we’re going to see this hollowing out of the workforce that’s been working on this research,” Lane-Fall said. “That will reverberate for years, if not decades.”Late last week, the Trump administration declared that the National Institutes of Health (NIH) would only reimburse 15% of researchers’ “indirect costs”, which can pay for expenses such as staff and laboratory maintenance. Normally, such costs hover at around 50% for elite universities. If indirect costs are capped at such a low percentage, scientists and the institutions where they work say they will not be able to carry out research.A court ordered that the Trump administration suspend the policy earlier this week, but this change – which was reportedly the work of the Elon Musk-run “department of government efficiency” (Doge) – casts into doubt the future of the NIH, the planet’s premier public funder of biomedical research. In 2023, the NIH spent more than $35bn on grants. If implemented, the new policy would endanger at least $4bn worth of funding, but its impact could go much further, imperiling the ability of research institutions – especially smaller ones – to do their work at all. The US maternal mortality rate almost doubled between 2018 and 2022, with rates of deaths among Black and Indigenous expecting or new mothers increasing at a disproportionally fast clip. States that Donald Trump won may be hit especially hard by NIH cuts: they are home to some of the country’s worst maternal mortality rates.To address this crisis, the NIH in 2023 launched a seven-year, $168m initiative to set up more than a dozen research centers to investigate and improve maternal health outcomes, as well as help train new maternal health researchers. The future of these centers – one of which is co-led by Lane-Fall – are now in question.“We’re working with agencies across 20 Michigan counties – that have more than 7 million people in them – to be able to improve services so that moms don’t get sick and die,” said Dr Jennifer E Johnson, a Michigan State University public health professor who helps run one of the research centers in Flint, Michigan. “To do that, we need offices. We need electricity. We need lights, heat, IT, infrastructure, people to create and sell the contracts. All of the support for that would be cut dramatically.”Normally, Johnson said, NIH reimburses about 57% of the indirect costs for Michigan State University’s grants, including hers. It’s not feasible, she said, for the university to cover those costs on its own or for her center to lower its indirect costs so substantially.“If we can’t turn on the lights and we can’t pay the rent and we can’t get people hired – I don’t know what we would do,” Johnson said. “The research is the car. All the infrastructure costs are the road. You can go a little while, but if there’s no maintenance on that, it’s a problem.”Several of the institutions that host the maternal health centers – which tend to focus on improving maternal mortality among people of color and rural communities – are set to lose millions over the NIH cuts. Stanford University officials have said the school, whose center aims to reduce the risk of dangerous postpartum hemorrhages, would take a $160m loss. The University of Utah, which studies how drug addiction impacts pregnancy, would lose $45m.The Guardian reached out to dozens of researchers who have NIH grants to study the health of women, children and parents. Many declined to speak, often citing the ongoing uncertainty of the situation. “I’m honestly not sure what to say as like most of my colleagues I was taken off guard and it’s really unclear how this will play out now that courts are involved,” one scientist, from Missouri, wrote in an email.While Republicans have generally been supportive of Musk’s slash-and-burn approach to the government in the last few weeks, some members of Congress have expressed alarm about the NIH cuts. “It’s pretty drastic. So I’m thinking we need to look at this,” Shelley Moore Capito, the West Virginia senator, told the Washington Post. Alabama senator Katie Britt said she planned to work with Robert F Kennedy Jr, the new leader of the Department of Health and Human Services, to address the impact. “A smart, targeted approach is needed in order to not hinder life-saving, groundbreaking research at high-achieving institutions like those in Alabama,” she told AL.com.One of the agencies behind the maternal health centers is the NIH’s Office of Research on Women’s Health – whose website has been hollowed out by the Trump administration’s recent, widespread purges of government websites. Links to pages on the Office of Research on Women’s Health website about “funding opportunities and notices”, “research programs and initiatives” and “supporting women in biomedical careers” have all vanished.“It is a scary time to be a scientist in the United States,” said Johnson, who is also concerned about recent reports of efforts at the National Science Foundation – an NIH sibling agency that focuses on scientific and engineering research – to scrutinize projects that include words like “women”, “disability” and “underrepresented”. Johnson continued: “All of a sudden, we’re working in a world where we’re not sure we’re going to be allowed to say what the data clearly shows.”On Monday, the day the new policy was supposed to take effect, the Association of American Medical Colleges sued to halt it.“Even at larger, well-resourced institutions, this unlawful action will impose enormous harms, including on these institutions’ ability to contribute to medical and scientific breakthroughs,” the association, which represents several of the US medical schools that host maternal health centers, said in its lawsuit. The association continued: “Smaller institutions will fare even worse – faced with more unrecoverable costs on every dollar of grants funds received, many will not be able to sustain any research at all and could close entirely.”A federal judge then ordered Trump to suspend the cuts, writing in a court order that implementing the cuts would cause “immediate and irreparable injury”. A hearing in the case is set for 21 February.However, it is unclear whether Trump will obey. Although the administration is legally required to heed court orders, a federal judge ruled in another case this week that Trump had defied an order to halt a separate freeze in federal funding. Disregarding court orders may tee up a showdown between the executive and judicial branches of the government – and a constitutional crisis.Regardless of when, how or if NIH grants function in the future, Lane-Fall believes the chaos unleashed by the Trump administration has already led science to suffer. Lane-Fall had to pause plans to hold a conference and told some postdoctoral students that they cannot yet move forward with research projects. She’s now worried that maternal health centers – who have built partnerships with local groups that champion doulas, breastfeeding among Black women and more – will not be able to compensate those groups.“One really important trend in maternal and child health research is that we are working now more with communities than we ever have before, because we understand that there’s a lot of lived experience and expertise in communities. Part of what makes that partnership possible is that we’re able to compensate them for their time,” Lane-Fall said. “When we go to those communities and we say: ‘We promised you money, but it might not be there’ – that is devastating.”Dr Nancy E Lane is haunted by the idea that the confusion will lead women’s health scientists to leave academia. A University of California, Davis, doctor who specializes in osteoporosis and osteoarthritis, Lane was part of a 2024 report calling for more NIH funding for women’s health. Between 2013 and 2023, just 8.8% of NIH grant dollars focused on investigating it.“My career has tremendously benefited from the resources from the National Institutes of Health. It’s what made me who I am,” Lane said. “How much will the current generation put up with this before they’ll just throw their hands up?” More

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      US park service erases references to trans people from Stonewall Inn website

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      The National Park Service eliminated all references to transgender people from its website for the Stonewall national monument on Thursday. The monument commemorates a 1969 riot outside New York City’s historic Stonewall Inn, led by trans women of color, that ignited the contemporary gay rights movement.The move comes as federal agencies across the country seek to comply with an executive order Donald Trump signed on his first day in office, calling for the US government to define sex as only male or female.“This blatant act of erasure not only distorts the truth of our history, but it also dishonors the immense contributions of transgender individuals – especially transgender women of color – who were at the forefront of the Stonewall Riots and the broader fight for LGBTQ+ rights,” organizers at the Stonewall Inn and the non-profit Stonewall Inn Gives Back Initiative said in a statement.Since Trump returned to office last month, he has signed a series of executive orders targeting trans Americans, including by banning trans athletes from women’s sports, restricting healthcare for trans youth and transferring incarcerated trans women to men’s facilities; a US judge, however, temporarily blocked federal prisons from implementing the order to move trans people. Many of the orders have been framed as “defending women”.The Stonewall national monument, located in Manhattan’s Greenwich Village, has become a symbol of the LGBTQ+ rights movement. One June night in 1969, LGBTQ+ patrons of the historic gay bar resisted a police raid. Although recollections of the night vary, by many accounts a Black trans woman named Marsha P Johnson “threw the first brick”.During the George Floyd uprisings in June of 2020, a march for Black trans lives began at the Stonewall Inn. It was followed by the largest-ever march for Black trans lives in Brooklyn later that month.Barack Obama designated the site as a national monument in 2016.Earlier this week, the homepage for the monument said: “Before the 1960s, almost everything about living openly as a lesbian, gay, bisexual, transgender, or queer (LGBTQ+) person was illegal.”On Thursday, it said: “Before the 1960s, almost everything about living openly as a lesbian, gay, bisexual (LGB) person was illegal.”skip past newsletter promotionafter newsletter promotion“This is just cruel and petty,” Kathy Hochul, New York’s Democratic governor, posted on social media. “Transgender people play a critical role in the fight for LGBTQ+ rights – and New York will never allow their contributions to be erased.” More

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      Trump is driving political debate to ever new lows. The left must hold on to its values | Zoe Williams

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      The problem with Trump’s America is that everything happens so fast, and across too many categories. There are moves so stupid and trivial that you can lose hours wondering whether there is a long game or if it’s all just trolling: renaming the Gulf of Mexico, bringing back plastic straws. There are moves so inhumane, causing so much deliberate suffering, that they are hard to fathom. The cancellation of USAid is so consequential that reaction has almost frozen in place, as the world figures out which immediate humanitarian crisis to prioritise, and waits for some grownup, such as the constitution, to step in. Into that baited silence steps Elon Musk, with a hoax about the agency having been a leftwing money-laundering organisation. Then everyone hares off to react to that, first debunking, then considering, what it might mean, for a man of such wealth and power to have come so completely unstuck from demonstrable reality. This is not an accident – and yet it has no meaning. So why is he doing it? To galvanise a base, or make a public service announcement that observable reality can’t help you now, so get used to having it overwritten by fantasy? It’s an understandable thing to worry about.Then there are the chilling direct legislative moves against sections of US society: banning the use of any pronouns that are not male or female in government agencies, defunding gender-affirming medical care, signalling a ban on transgender people in the military with an executive order that says being trans “conflicts with a soldier’s commitment to an honourable, truthful, and disciplined lifestyle, even in one’s personal life”. There’s the assault on immigrant rights, which is vivid and wide-ranging from the resurrection of Guantánamo Bay as a for ever holding-house, to the shackled people deported to Punjab, to the reversal of a convention that schools, churches and hospitals would not be raided by Immigration and Customs Enforcement.The sabre-rattling on tariffs throws up its own unstable side-show. Bit-part Republicans such as Bill Cassidy, the Louisiana senator, try to carve out some space in the drama with remarks so bracingly racist – the maternal death rate isn’t as bad if you don’t count black women, apparently – that you’re forced to give him the attention he craves. Ignoring him will not make him go away.There will never be any shortage of things to react to; nothing will ever be inconsequential. Even things that misfire comically or are immediately ruled illegal will have an effect, drive the debate to new lows and foster fear and division. And there will rarely, from outside the US, be any meaningful way to react; whatever ideas about democracy we’ve had to let go of in 2025, it remains bordered.There’s an agenda to that too, of course. If the watching world is constantly responding to things it can’t change or even protest about, that sends spores of impotence far and wide. Events in the US are already debasing our own discourse: Trump cheerleaders springing up with bizarre arguments and the leader of the opposition Kemi Badenoch strategically claiming that liberalism has been “hacked” by groups focused on “radical green absolutism”. The effect? Everything is pushed rightwards.It might be impossible to blot out the drama, but we have to simultaneously focus on our own debates and our own terms – the threats to trans rights in our own country, the language on immigration in our own parliament, our own burgeoning politics of nastiness and tough-talking. We don’t have to surrender to the momentum of the right by becoming more like them. We don’t have to catch this virus because America sneezed. Zoe Williams is a Guardian columnist More

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      How hardline anti-immigrant policies are threatening the right to education

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      As Donald Trump mounts escalating attacks on immigrants in the US in the first weeks of his second term, schools are increasingly in the crosshairs.He has already revoked protective status for schools and churches, so that immigration authorities can make arrests on school grounds, sending teachers scrambling to figure out ways to protect their students.Now, hardline anti-immigrant stances are being used to attack public education itself. In January, Oklahoma’s board of education voted to require citizenship information from parents enrolling children in school. The move threatens a longstanding constitutional right to public education for all children, regardless of their immigration status, established in 1982 by the US supreme court.Legal and policy experts say that while the rule is likely to be struck down in the courts as unconstitutional, the threat alone will cause damage and cause terrified parents to keep their children out of schools, which undermines a fundamental democratic institution: the right to education.“The purpose of our schools is to educate children, and to educate all our children,” said Wendy Cervantes, director of immigration and immigrant families at the Center for Law and Social Policy (Clasp). “Immigration enforcement of any kind should stay out of our schools, period.”Requiring proof of citizenship for public school enrollment would severely disadvantage American immigrant families, including those with legal status, experts say. The impact would be vast: approximately one in four children (nearly 18 million in total) have at least one foreign-born parent.Most immediately, the rule will scare immigrant parents – especially those without documentation or whose cases may be pending – to the point that they keep their kids out of school entirely. This phenomenon, in which immigrant families turn inward and avoid critical resources when they perceive restrictions are tightening, is known in immigration policy circles as the “chilling effect”, and it is widely documented.“This is exactly the kind of thing that causes parents, very rationally, to hold their kids back and not send them to school,” said Jon Valant, director of the Brown Center on Education Policy at the Brookings Institution, emphasizing that the chilling effect will descend whether the rule is adopted or not. “There is harm done just in talking about this,” he said.View image in fullscreenEfrén C Olivares, director of strategic litigation and advocacy at the Southern Poverty Law Center, said that the fear component was deliberate, and would disproportionately affect those whose status is in question. “By being put in the position of having to respond to this question, somebody who may not have regular status is going to really be threatened and be in a vulnerable position,” he said.For those children who are kept home out of fear, the effect is detrimental, experts say. Those children may opt to join the workforce. And if a child is not old enough for legal employment, or is not eligible for a work permit, they are more likely to be exploited or to work in an unsafe job, explained Melissa Adamson, an attorney at the National Center for Youth Law.The result is that their entire lives get sidetracked, and their potential – which schools are designed to nurture – quashed. “It cuts off their entire ability to succeed,” Adamson said.Restricting access to education would also deepen social divisions and negatively affect the entire American economy by exacerbating marginalization and impoverishment, explained Kristina Lovato, director of the Center on Immigration and Child Welfare at the University of California at Berkeley. “Educational access empowers our children with the tools to lead productive lives and contribute to the economy and overall wellbeing of our communities, and every child in the US deserves this chance to reach their full potential,” she said.According to Cervantes, it is for these reasons that states have such stringent truancy laws in place.“A basic K-12 education is essential to preventing the creation of a permanent underclass,” she said. “It is in the best interest of not only children, but all of society, for children to be productive and learning.”The Oklahoma effort is spearheaded by Ryan Walters, the Republican state superintendent who has railed against the presence of “woke ideology” in schools, believes that the Bible should be required learning and has claimed that the 1921 Tulsa massacre – in which 300 Black people were murdered by their white neighbors – was not motivated by race.While the proposal is singular in its content, the rule sits squarely within the far-right playbook.Mixed messaging surrounding the measure’s aims contribute to confusion, which experts cite as a core strategy of Trump’s approach to immigration. The text of the Oklahoma rule claims parents’ citizenship information will be used to inform how resources can be better allocated to serve students’ tutoring, language and transportation needs. But Walters has publicly stated that Oklahoma schools would give federal agencies the information so that “families can be deported together”.View image in fullscreen“I don’t see how knowing that a student’s parent holds a passport from a different country helps the state understand that student’s needs in the classroom,” said Adamson, decrying the rationale as nonsensical. “We live in a very diverse world. A parent’s nationality doesn’t necessarily tell you anything about their child’s educational needs.”The measure also politicizes schools, which are already at the frontline of culture wars. “I’m also not surprised that we are seeing some more culture-war battles penetrating schools as they relate to immigration,” said Valant.Perhaps most critically, the proposal represents a tolerance for the undermining of long-held democratic institutions and values – namely, the free and equal right to public education.For Olivares, the crux of the matter lies in the fact that the measure would also deny that right to millions of US-citizen children whose parents are foreign-born. That, he says, reveals the rule’s racist underpinnings. “They’re going to be the children of US immigrants whose skin is a certain shade of dark,” he said. “They were born in this country. What does that say? What values does that reflect about a society?”What’s more, it puts the right to education itself on a slippery slope. Valant said there was no reason to think that students with disabilities or transgender kids wouldn’t become future targets.“Who do we pull out of the community next?” he asked.From a legal standpoint, the feasibility of asking parents for citizenship information remains murky, most notably because the 1982 Plyler v Doe case enshrining the right to education for all children regardless of citizenship creates a substantial constitutional hurdle. For that reason, most legal and policy experts anticipate the Oklahoma measure to be struck down if passed into state law.“It was unwise public policy then to adopt policies that may harm children’s access to schooling, and that has not changed,” said Debu Gandhi, senior director of immigration policy at the Center for American Progress.They also caution against putting too much faith in the constitution, especially given the track record of this supreme court. Although Plyler has been settled law for nearly 43 years, the court has overturned other cases with even longer legacies, such as Roe v Wade, the 1973 landmark case protecting the constitutional right to abortion, Olivares explained.Regardless of whether this particular measure takes effect, the situation unfolding in Oklahoma is probably a preview of similar efforts that will be undertaken in school districts around the nation, warned Valant.“This is a particularly aggressive move when it comes to immigration enforcement in schools, but I don’t think it’ll be the last,” he said. More

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      Victims of ‘kids-for-cash’ judge outraged by Biden pardon: ‘What about all of us?’

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      Victims of a former Pennsylvania judge convicted in the so-called kids-for-cash scandal are outraged by Joe Biden’s decision to grant him clemency.In 2011, Michael Conahan was sentenced to more than 17 years in prison after he and another judge, Mark Ciavarella, were found guilty of accepting $2.8m in illegal payments in exchange for sending more than 2,300 children – including some as young as eight years old – to private juvenile detention centers.Conahan was released from prison in 2020 due to Covid-19 and placed on house arrest, which had been scheduled to end in 2026.Conahan’s sentence was one of about 1,500 the US president commuted – or shortened – on Thursday while also pardoning 39 Americans who had been convicted of non-violent crimes.In response to Conahan’s pardon, the mother of a boy sent to jail at age 17 before later dying by suicide told the Citizens’ Voice: “I am shocked and I am hurt.”“Conahan’s actions destroyed families, including mine, and my son’s death is a tragic reminder of the consequences of his abuse of power,” Sandy Fonzo said to the outlet. “This pardon feels like an injustice for all of us who still suffer. Right now I am processing and doing the best I can to cope with the pain that this has brought back.”Similarly, Amanda Lorah, who at age 14 was wrongfully imprisoned as part of the scheme, told WBRE: “It’s a big slap in the face for us once again.“We had … time taken away from us. We had no one to talk to, but now we’re talking about the president of the United States to do this. What about all of us?”The Pennsylvania governor, Josh Shapiro, also condemned Biden’s decision, telling reporters that his fellow Democrat “got it absolutely wrong”, the Pennsylvania Capital-Star reported.“I’ll offer these thoughts as an outsider, not privy to all the information he looked at, but I do feel strongly that President Biden got it absolutely wrong and created a lot of pain here in north-eastern Pennsylvania,” Shapiro said.Biden’s actions Thursday marked the largest instance of presidential clemency carried out in a single day.Describing the move, the White House said: “The president is commuting the sentences of close to 1,500 individuals who were placed on home confinement during the Covid-19 pandemic and who have successfully reintegrated into their families and communities.”Attempts to contact Conahan were not immediately successful. More

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      Republicans take aim at subsidies that help tens of millions of women

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      As they prepare to take control of the White House and Congress next month, conservatives are eyeing cutbacks to federal programs that help tens of millions of women pay for healthcare, food, housing and transportation.Slashing or overhauling social support programs, long a goal of Republican lawmakers, could be catastrophic for women experiencing poverty. Supporters contend the social safety-net programs are already grossly underfunded.“With this new administration that is coming in … I really am concerned about the lives of women. We are seeing so many policies, so many budget cuts,” said Christian Nunes, president of the National Organization for Women.Republicans say they want to keep campaign promises to cut government spending, and three major programs make easy targets: Medicaid, the joint state/federal health insurance program for people with lower incomes; Temporary Assistance for Needy Families (TANF), a cash-allowance program that replaced welfare; and the Supplemental Nutrition Assistance Program (Snap), widely known as food stamps.While conservatives frame cuts as making government more efficient and even restoring freedom, advocates for and experts on families with little or no income say reducing these programs will throw more people – especially women and children – further into poverty.“It is going to fall heavily on women,” said Elaine Waxman, a senior fellow in the Income and Benefits Policy Center at the Urban Institute, a non-profit research organization.Predicting precisely what Republicans in Congress and the Trump administration will do is difficult. Congressional leaders are close-mouthed about negotiations, and the president-elect has not finished putting together his advisory team. None of the spokespeople contacted for this story returned calls or e-mails.But organizations known to advise top leaders in Congress and the previous Trump administration have laid out fairly detailed roadmaps.Project 2025, the conservative Heritage Foundation’s blueprint for the incoming administration, denies its proposed changes will harm women, saying instead that marriage and “family values” will improve their economic situations. “Marriage, healthy family formation, and delaying sex to prevent pregnancy are virtually ignored in terms of priorities, yet these goals can reverse the cycle of poverty in meaningful ways,” reads the section on proposed changes to TANF and Snap.Numerous other groups that have studied the problem say forcing or even encouraging marriage will not make poverty disappear. And a recent study by a team at the University of South Carolina found that when state laws make it harder for pregnant women to get divorced, they’re more likely to be killed by their partners.Trump has promised not to attack the two most expensive and popular government programs: social security and Medicare. But he and Congress are up against a deadline to extend his 2017 tax reforms, which raised the federal deficit. They’ll have to cut something, and social spending programs, especially the $805bn Medicaid program, are low-hanging fruit for conservatives.Trump repeatedly tried to slash Snap during his last tenure in office: his 2021 budget proposal would have cut the program by more than $180bn – nearly 30% – over 10 years. Conservatives in Congress have continued these efforts and, with majorities in the House and Senate, they may be able to get them through next year.The Republican Study Committee, whose members include about three-quarters of the House Republican caucus, recommends more work requirements for Snap and TANF.“SNAP and our welfare system should embrace that work conveys dignity and self-sustainment and encourage individuals to find gainful employment, not reward them for staying at home,” their plan, released in March, reads.A large body of research questions whether widening work requirements does anything other than force people off benefits without helping them find employment. “I think there is a misperception that people in need of help are not working,” said Mei Powers, chief development and communications officer at Martha’s Table, a non-profit aid organization in Washington DC. “People are a paycheck, a crisis, a broken-down car away from needing services.”Snap currently helps 41 million people buy groceries and other necessities every month. Women accounted for more than 55% of people under 65 receiving Snap benefits in 2022, according to the National Women’s Law Center, a gender justice advocacy group. About one-third of them were women of color, the NWLC said.Among other things, cutting these programs will trap women in dangerous situations, the NWLC said: “SNAP helps survivors of domestic violence and sexual assault establish basic economic security.”TANF, which provides cash assistance, overwhelmingly benefits women. In 2022, 370,000 TANF adult recipients were female and 69,000 were male, according to the Department of Health and Human Services.Perhaps Medicaid is the most tempting target for conservatives because they can use it to undermine the Affordable Care Act, also known as Obamacare. The GOP has been gunning for the ACA since it was signed into law without a single Republican vote in 2010.The federal government shares the cost of Medicaid with states. The ACA aimed to make Medicaid cover more people by offering to pay for virtually all the extra costs. Many Republican-led states resisted for years, but as of November, all but 10 states had expanded coverage to an extra 21 million people, or about a quarter of all Medicaid recipients.Medicaid pays for more than 40% of births in the US, plus it covers new mothers for post-pregnancy-related issues for 60 days. It also pays for medical care for 60% of all nursing home residents, more than 70% of whom are women.According to the health research organization KFF, expanding Medicaid helped improve care for women before and during pregnancy and after they gave birth.But most Republicans in Congress have never approved of this federal spending. Proposed cuts to Medicaid funding, which would save hundreds of billions of dollars, are laid out by the Paragon Health Institute, a conservative health thinktank headed by Brian Blase, a top health adviser to the first Trump administration.Experts predict states would be unable or unwilling to make up the difference. “Facing such drastic reductions in federal Medicaid funding, states will have no choice but to institute truly draconian cuts to eligibility, benefits and provider reimbursement rates,” Edwin Park, research professor at Georgetown University, wrote in an analysis.That would mean women, children, older adults and people with disabilities would lose coverage as facilities closed and providers stopped seeing patients.The effects, says the National Organization for Women, “will be widespread, devastating, and long-lasting”.This story is published in partnership with the Fuller Project, a non-profit newsroom dedicated to the coverage of women’s issues around the world. Sign up for the Fuller Project’s newsletter. More

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      RFK Jr to research unsupported link between vaccines and autism, Trump says

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      Donald Trump has said Robert F Kennedy Jr, his nominee for health secretary, may investigate a supposed link between vaccines and autism – despite a consensus among the medical establishment debunking any such connection.In a wide-ranging interview with NBC, the US president-elect claimed an investigation was justified by the increasing prevalence of autism diagnoses among American children over the past 25 years.“When you look at what’s going on with disease and sickness in our country, something’s wrong,” Trump said after the interviewer, Kristen Welker, asked him if he wanted to see some vaccines eliminated – a position for which Kennedy has argued.“If you take a look at autism, go back 25 years, autism was almost nonexistent. It was, you know, one out of 100,000 and now it’s close to one out of 100.”According to the Centers for Disease Control and Prevention (CDC), one out of every 36 children in the US were diagnosed with autism in 2020, compared with one in 150 in 2000.Kennedy, a noted vaccine sceptic, has repeatedly peddled discredited theories that the conditions is caused by childhood vaccinations.“I do believe that autism does come from vaccines,” he said in a 2023 Fox News interview in which he called for more vaccine testing.“We should have the same kind of testing place or control trials that we have for other every other medication. Vaccines are exempt from pre-licensing control trials, so that there’s no way that anybody can tell the risk profile of those products, or even the relative benefits of those products before they’re mandated. We should have that kind of testing.”Trump – who has previously said Kennedy would be allowed to “go wild” on health – said his health secretary pick would not “reinvent the wheel totally”.“He’s not going to upset any system,” he said.But on autism, he added: “Somebody has to find out. If you go back 25 years ago, you had very little autism. Now you have it … When you talk about autism, because it was brought up, and you look at the amount we have today versus 20 or 25 years ago, it’s pretty scary.”Scientists have attributed the rise in autism diagnoses to improved screening methods while saying it is caused by a complex mix of factors, including genetics, environment and conditions during pregnancy and birth.The World Health Organization has definitely ruled out a connection between autism and the measles, mumps and rubella (MMR) vaccine or other childhood inoculations.Research led by the British doctor Andrew Wakefield asserting a link between autism and the MMR jab was later discredited, with the Lancet, a medical journal, issuing a full retraction of a paper it had published based on it.Wakefield was later banned from practicing in Britain after being found by the country’s general medical council to have broken its rules on research and to have acted “dishonestly” and with a “callous disregard” for children’s health.The Guardian reported in 2018 that Wakefield had attended an inaugural ball marking the start of Trump’s first presidency the previous year at which he was quoted calling for a shakeup of the US medical establishment.“What we need now is a huge shakeup at the Centers for Disease Control and Prevention – a huge shakeup,” he said. “We need that to change dramatically.” More

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      How did transgender children in the US become so politicized? | Moira Donegan

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      The politicization of transgender children in the US is one of the most astounding coups of propaganda and organized animus in recent history. Rarely has so much attention and rage been directed at such a minuscule number of people, and more rarely, still, have those people been the most vulnerable and blameless among us: kids and teens.The first state to pass a ban on transition-related care for minors was Arkansas, in April 2021; less than four years later, more than half of states have such a ban on the books. In 2016, North Carolina lost an estimated $3.76bn in revenue following boycotts after they passed a law banning trans people, including transgender students, from using appropriate restrooms in public facilities; now, 14 states have such bathroom bans on the books, and the boycotts have receded.These changes in public attitudes towards trans youth – from a broad if imperfect sentiment of tolerance to a widespread and politically weaponized attitude of hostility toward a small minority of kids – did not emerge by accident. It was the product of a deliberate, conscious effort to radicalize large swaths of the United States, and significant chunks of state policy, into a hostility towards a few children.That effort seems set to bear fruit now, at the US supreme court, in US v Skrmetti, a lawsuit brought by the ACLU and the Biden Department of Justice challenging Tennessee’s HB1, a sweeping ban on transition-related care for minors that was passed in 2023. The law prohibits any puberty blockers or hormones from being prescribed for the purposes of gender transition, but it does not prohibit these medications from being prescribed for any non-transition-related purpose. A minor can be prescribed puberty blockers, for instance, if their doctor believes they are experiencing early onset, or “precocious”, puberty; they cannot be prescribed puberty blockers to delay the onset of a puberty that may change their bodies in ways they do not desire for gender identity-related reasons.That means, too, that a child assigned male at birth could access, say, testosterone treatment, but a child assigned female at birth could not. In oral arguments on Wednesday, solicitor general Elizabeth Prelogar and Chase Strangio of the ACLU – the first trans attorney to argue before the supreme court – explained that this was a straightforward case of sex discrimination, and hence needed to be subjected to a heightened standard of judicial review under the 14th amendment’s equal protection clause.It will not be. A majority of the court’s conservatives seemed poised to uphold the ban on transgender healthcare, though for a variety of different reasons. Brett Kavanaugh made his usual mealy-mouthed paean to states’ rights, an argument he always makes in questions of federally guaranteed equality provisions, but not before extolling the hypothetical suffering of teenagers who may access gender-affirming care but then later come to regret it. (One wonders if there are any choices from his own adolescence that Brett Kavanaugh has come to regret.) Clarence Thomas and chief justice John Roberts, meanwhile, both advanced the idea that the physiological differences between male and female bodies could moot the equal protection clause’s reach, giving states broad leeway to regulate medicine in ways that would uphold gender hierarchy.For his part, Samuel Alito also seemed interested in the idea that states might have a right to effect gender discrimination via their regulation of medicine. He repeatedly cited the 1974 case Geduldig v Aiello, in which the supreme court ruled that states could discriminate on the basis of pregnancy, and that pregnancy discrimination was not sex discrimination – because even though only female people become pregnant, not all of them are pregnant all of the time. (At the time, Congress found the outcome in Geduldig so egregious that it passed a law clarifying that pregnancy discrimination does count as sex discrimination for the purposes of federal civil rights law, and the precedent was largely mooted, but Alito’s controlling opinion in Dobbs has revived it.)But Alito, true to form, did not confine his opining to the notion that discrimination against trans people does not count as sex-based discrimination: he went on to suggest that trans people are not quite real, peppering Strangio, in a scene that seemed intended to humiliate the trans attorney, with questions about whether trans identity was truly an “immutable” characteristic. For his part, Strangio responded with a dignity and respect that Alito’s line of questioning did not merit.It was not the only low moment. James Matthew Rice, the Tennessee solicitor general who defended the ban in court, repeatedly compared gender affirming care with suicide, as well as to lobotomies and eugenics. During his time, justices Ketanji Brown Jackson and Sonia Sotomayor, with occasional assists from Elena Kagan, tried to chase Rice down on the inconsistencies in his own argument.Tennessee claimed, after all, that the law did not discriminate on the basis of patients’ sex, but rather on the basis of the purpose of their treatment; when the liberal justices pointed out that this was a distinction without a difference, because the purpose of the treatment was dependent on the patients’ sex, Rice simply repeated his assertion that there was a difference, there, somewhere. Jackson, in particular, worked to get Rice to explain his position for some time. He declined to.To call the Tennessee ban sex-neutral is laughable, almost insulting. The statute itself makes gender conformity its explicit justification in its text, saying that it aims to prohibit “sex inconsistent treatment”, or anything that “might encourage minors to become disdainful of their sex”. The law has long included sex role stereotyping within the purview of sex discrimination; Tennessee has sought to enforce sex roles, and sexed embodiment, with the force of the state. There is no good faith reading of the law that would allow it to withstand the scrutiny that the 14th amendment requires. But luckily for Tennessee, this is not a good faith court.

      Moira Donegan is a Guardian US columnist More