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When Abigail Leonard saw the news that the Trump administration was considering handing out $5,000 “baby bonuses” to new mothers, she realized that she had already received one.A longtime international reporter, Leonard gave birth to three children while living in Japan, which offers a year of parental leave, publicly run daycare, and lump-sum grants to new parents that amount to thousands of US dollars. But it was not until moving back to the US in 2023 that Leonard grasped just how robust Japan’s social safety net for families is – and, in comparison, just how paltry the US net feels.Not only is the US the only rich country on the planet without any form of national paid leave, but an uncomplicated birth covered by private insurance tends to cost families about $3,000, which, Leonard discovered, is far more than in most other countries. The federal government also spends a fraction of what most other wealthy countries spend on early education and childcare, as federally subsidized childcare is primarily available only to the lowest earners. Middle-class families are iced out.View image in fullscreenLeonard traces the effects of policies and disparities like these in her new book, Four Mothers, which follows the pregnancy and early childrearing experiences of four urban, middle-class women living in Japan, Kenya, Finland and the US. Published earlier this month, Four Mothers provides a deeply personal window into how policy shapes parents’ lives. And it has emerged as an increasingly rightwing US seems poised to embrace the ideology of pronatalism and policies aimed at convincing people to have more kids.Pronatalism is deeply controversial, in no small part because its critics say pronatalists are more concerned with pushing women to have kids than with ensuring women have the support required to raise them.“Being ‘pronatal’ – designing policy to increase the birthrate – is not the same thing as being pro-woman,” Leonard notes in Four Mothers’ introduction. A $5,000 check would not have been enough to help any of the moms profiled in the book. Instead, the women relied on – or longed for, in the case of the US – extensive external support, such as affordable maternity care, parental leave and access to childcare.“The book is an implicit comparison of the rest of the world to the US, and parenthood is so much harder here in many ways,” Leonard said in a phone interview with the Guardian. “People are so accepting that things can be privatized and that government can be torn down and that there won’t be any repercussions to that. We don’t think about how integral government policy is to our lives, and for that reason can’t imagine how much more beneficial it could be.”View image in fullscreenIn the US, resistance to increasing government aid in childrearing has long gone hand in hand with a commitment to upholding a white, traditional view of the American family. At virtually every juncture, rightwing groups have been galvanized to stop sporadic efforts at expanding support. During the second world war, Congress allocated $20m to a universal childcare program that could help women work while men fought in the war effort. The program was so popular that people protested in the streets to keep it even after the war ended, according to Leonard. But the program was dismantled after political disputes over how to run the program, as southern states demanded that the daycares be segregated.In 1971, Congress passed the Comprehensive Child Development Act, which would have created a national system of federally subsidized daycare centers. Inflamed by the idea that the bill would encourage women to work outside the home, church groups organized letter-writing campaigns against the bill. Rightwing pundits, meanwhile, claimed the bill was “a plan to Sovietize our youth”. Richard Nixon ultimately vetoed the bill, calling it “the most radical piece of legislation” to ever cross his desk.Today, Leonard writes, corporations have an entrenched interest in keeping childcare from becoming a public good in the US. Private equity is heavily invested in childcare companies. Wealthy corporations, especially big tech companies, can also use their generous paid leave policies to lure in the best talent.“I talked to a congressman who was telling me he was trying to get some of these companies on board to back a national paid leave policy, and they were saying: ‘We don’t want to do paid leave because then we give up our own competitive advantage.’ It’s so cynical,” Leonard said. “These are companies that have been able to create this image around themselves of being feminist and pro-family. Like: ‘They’re great places to work for women. They help fund fertility treatments!’”She continued: “They’ve feminist-washed themselves. They’re working against a national policy that would benefit everyone and that ultimately would benefit our democracy, because you wouldn’t have this huge inequality of benefits and lifestyles.”‘A grind’The US has become far more accepting of women’s careerist ambitions over the last 50 years – especially as it has become more difficult for US families to sustain themselves on a single income – but balancing work and family life is still often treated as a matter of personal responsibility (or, frequently, as a personal failing).View image in fullscreenTo improve mothers’ lives, Leonard found, a commitment to flexible gender norms – in the home and at work – must be coupled with a robust social safety net.Each of the women in Four Mothers struggled with male partners who, in various ways and for assorted reasons, failed to provide as much childcare as the mothers. Sarah, a teacher in Utah, was married to an Amazon delivery driver who got zero parental leave. Sarah was entitled to three months of leave, at partial pay, but only because her union advocated for it. Although Sarah and her husband chose to leave the Mormon church, she found herself longing for the community that the church provided because it offered some form of support and acknowledgment of motherhood.Finland perhaps fares the best in Leonard’s book. The country, which gives parents about a year of paid leave, invests heavily in its maternal care system and has some of the lowest infant and maternal mortality rates in the world; it even offers mothers prenatal counseling where they can discuss their own childhoods and how to break cycles of intergenerational trauma. (The US, by contrast, has the highest maternal mortality rate of any wealthy country.) Finland is also the only industrialized nation on the planet where fathers spend more time with their children than mothers do. (The difference is about eight minutes, “about as even as it can be”, Leonard wrote in Four Mothers.) Parents are also happier than non-parents in Finland – which is routinely ranked as the happiest country in the world – while the inverse is true in the US.View image in fullscreenStill, the birth rate is on the decline in Finland, just as it is in Japan and the US. It is not clear what kinds of pronatalist policies, if any, induce people to have kids. Nearly 60% of Americans under 50 who say they are unlikely to have children say that’s because “they just don’t want to”.“The pronatal argument here – that’s really focused on people who make the choice not to have children. That is not only cruel and mean, but it’s also ineffective, because people who don’t want to have kids probably aren’t going to have kids and none of this stuff is going to make a difference,” Leonard said.That said, had she been building her family in the US rather than Japan, Leonard doesn’t know if she would have had three children. Given the cost of US childcare, “it would have been more of a grind”.“I just think it’s harder and more expensive here. So it was somewhat easier to have that third child there,” Leonard said. “It’s not because they gave me a $5,000 baby bonus.” More
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View image in fullscreenIn January, the comedian Ashley Bez posted an Instagram video of herself, trying to describe a heavy mood in the air. “How come everything feels all …?” she says, trailing off and grimacing exaggeratedly into the camera.Digital anthropologist Rahaf Harfoush saw the video, and got it immediately.“Welcome to the hypernormalization club,” Harfoush said in a response video. “I’m so sorry that you’re here.”“Hypernormalization” is a heady, $10 word, but it captures the weird, dire atmosphere of the US in 2025.First articulated in 2005 by scholar Alexei Yurchak to describe the civilian experience in Soviet Russia, hypernormalization describes life in a society where two main things are happening.The first is people seeing that governing systems and institutions are broken. And the second is that, for reasons including a lack of effective leadership and an inability to imagine how to disrupt the status quo, people carry on with their lives as normal despite systemic dysfunction – give or take a heavy load of fear, dread, denial and dissociation.“What you are feeling is the disconnect between seeing that systems are failing, that things aren’t working … and yet the institutions and the people in power just are, like, ignoring it and pretending everything is going to go on the way that it has,” Harfoush says in her video.Within 48 hours, Harfoush’s video accrued millions of views. (It currently has slightly fewer than 9m.) It spread in “mom groups, friend chat circles, political subreddits, coupon communities, and even dog-walking groups”, Harfoush tells me, along with variations of: “Oh, so that’s what I’ve been feeling!” and “people tagging their friends with notes like: ‘We were just talking about this!’”View image in fullscreenWhy hypernormalization is relevant in the USThe increasing instability of the US’s democratic norms has prompted these references to hypernormalization.Donald Trump is dismantling government checks and balances in an apparent advance toward a “unitary executive” doctrine that would grant him near-unlimited authority, driving the US toward autocracy. Billionaire tech moguls like Elon Musk are helping the government consolidate power and aggressively reduce the federal workforce. Institutions like the National Institutes of Health, the Centers for Disease Control and Prevention and the Food and Drug Administration, which help keep Americans healthy and informed, are being haphazardly diminished.Globally, once-in-a-lifetime climate disasters, war and the lingering trauma of Covid continue to unfold, while an explosion of generative AI threatens to destabilize how people think, make a living and relate to each other.For many in the US, Trump 2.0 is having a devastating effect on daily life. For others, the routines of life continue, albeit threaded with mind-altering horrors: scrolling past an AI-generated cartoon of Ice officers arresting immigrants before dinner, or hearing about starving Palestinian families while on a school run.Hypernormalization captures this juxtaposition of the dysfunctional and mundane.It’s “the visceral sense of waking up in an alternate timeline with a deep, bodily knowing that something isn’t right – but having no clear idea how to fix it”, Harfoush tells me. “It’s reading an article about childhood hunger and genocide, only to scroll down to a carefree listicle highlighting the best-dressed celebrities or a whimsical quiz about: ‘What Pop-Tart are you?’”In his 2016 documentary HyperNormalisation, the British film-maker Adam Curtis argued that Yurchak’s critique of late-Soviet life applies neatly to the west’s decades-long slide into authoritarianism, something more Americans are now confronting head-on.“Donald Trump is not something new,” Curtis tells me, calling him “the final pantomime product” of the US government, where the powerful are abandoning any pretense of common, inclusive ideals and instead using their positions to settle scores, reward loyalty and hollow out institutions for personal or political gains.Trump’s US is “just like Yeltsin in Russia in the 1990s – promising a new kind of democracy, but in reality allowing the oligarchs to loot and distort the society”, says Curtis.Why the concept of hypernormalization is usefulWitnessing large-scale systems slowly unravel in real time can be profoundly surreal and frightening. The hypernormalization framework offers a way to understand what we’re feeling and why.Harfoush created her video “to reassure others that they’re not alone” and that “they aren’t misinterpreting the situation or imagining things”. Understanding hypernormalization “made me feel less isolated”, she says. “It’s difficult to act when you’re uncertain if you’re perceiving reality clearly, but once you know the truth, you can channel that clarity into meaningful action and, ideally, drive positive change.”Naming an experience can be a form of psychological relief. “The worst thing in the world is to feel that you’re the only one who feels this way and that you are going quietly mad and everyone else is in denial,” says Caroline Hickman, a psychotherapist and instructor at the University of Bath specializing in climate anxiety. “That terrifies people. It traumatizes people.”People who feel the “wrongness” of current conditions acutely may be experiencing some depression and anxiety, but those feelings can be quite rational – not a symptom of poor mental health, alarmism or a lack of proper perspective, Hickman says.“What we’re really scared of is that the people in power have not got our back and they don’t give a shit about whether we survive or not,” she says.View image in fullscreenMarielle Greguski, 32, a New York City-based retail worker and content creator, posted about everyday life feeling “inconsequential” in the face of political crisis. Greguski says the outcome of the 2024 election reminded her that she lives in a “bubble” of progressive values, and that “there’s the other half of people that are not feeling the same energy and frustration and fear”.To Greguski, the US’s failings are not only partisan but moral – like the racism and bigotry that Trump’s second term has brought out of the shadows and into policy.Greguski is currently planning a wedding. It’s hard to compartmentalize “constant cruelty, things that don’t make sense”, she says. “Sometimes I’ll be like: ‘I have to put aside X amount of money for the wedding next year,’ and then I’m like: ‘Will this country exist as we know it next year?’ It really is crazy.”The effects of hypernormalizationConfronting systemic collapse can be so disorienting, overwhelming and even humiliating, that many tune it out or find themselves in a state of freeze.Greguski likens this feeling to sleep paralysis: “basically a waking nightmare where you’re like: ‘I’m here, I’m aware, but I’m so scared and I can’t move.’”In his 1955 book They Thought They Were Free: The Germans, 1933–45, journalist Milton Mayer described a similar state of freeze in German citizens during the rise of the Nazi party: “You don’t want to act, or even talk, alone; you don’t want to ‘go out of your way to make trouble.’ Why not? – Well, you are not in the habit of doing it. And it is not just fear, fear of standing alone, that restrains you; it is also genuine uncertainty.”“People don’t shut down because they don’t feel anything,” says Hickman. “They shut down because they feel too much.” Understanding this overwhelm is an important first step in resisting inaction – it helps us see fear as a trap.Curtis points out that governments may intentionally keep their citizens in a vulnerable state of dread and confusion as “a brilliant way of managing a highly febrile and anxious society”, he says.When we feel powerless in the face of bigger problems, we “turn to the only thing that we do have the power over, to try and change for the better”, says Curtis – meaning, typically, ourselves. Anxiety and fear can trap us, leading us to spend more time trying to feel better in small, personal ways, like entertainment and self-care, and less time on activism and community engagement.View image in fullscreenHow to overcome hypernormalizationProgressive commentators have urgently called for moral clarity and mobilization in response to changes like the cuts to USAID funding, which has resulted in an estimated 103 deaths per hour across the globe; the dismantling of the CDC; and Robert F Kennedy’s campaign against vaccine science.“Where is the outrage?” asks the Nation’s Gregg Gonsalves. “Too many lives are at stake to rest in this bizarre moment of frozen agitation.”“I don’t know if there’s a massive shift toward racism as much as an expanded indifference toward it,” the historian Robin DG Kelley said in a February interview with New York Magazine. “People are just kind of like: ‘Well, what can we do?’”Experts say action can break the spell. “Being active politically, in whatever way, I think helps reduce apocalyptic gloom,” says Betsy Hartmann, an activist, scholar and author of The America Syndrome, which explores the importance of resisting apocalyptic thinking.Greguski and a co-worker have been helping distribute multilingual information about legal rights and helpline numbers, to be used in the event of Ice raids.“It’s easy to feel like: ‘Oh, I’m in community because I’m on TikTok,’” she says. But genuine community is about “getting outside and talking to your neighbor and knowing that there’s someone out there that can help you if something really bad goes down,” she says.“You’re actually out there talking to people, working with people and realizing there are so many good people in the world, too, and maybe feeling less isolated than before,” says Hartmann.“But I also think we need a broader vision,” Hartmann notes. She suggests looking to resistance efforts against authoritarianism in countries like Turkey, Hungary and India. “How might we be in international solidarity? What lessons can we learn in terms of rebuilding sophisticated, complex government infrastructure that’s been hacked away at by people like Elon Musk and his minions in a more socially just and sustainable way?”“We are in a period now when it’s absolutely essential to protest,” says Hartmann, citing the Harvard professor Erica Chenoweth, who argues that just 3.5% of a population engaging in peaceful protest can hold back authoritarian movements.What makes dysfunction so dangerous is that we might simply learn to live with it. But understanding hypernormalization gives us language – and permission – to recognize when systems are failing, and clarifies the risk of not taking action when we can.In 2014, Ursula Le Guin accepted the National Book Foundation’s Medal for Distinguished Contribution to American Letters, saying: “We live in capitalism. Its power seems inescapable. So did the divine right of kings. Any human power can be resisted and changed by human beings. Resistance and change often begin in art, and very often in our art, the art of words.”Harfoush reflects on this quote often. It underscores the fact that “this world we’ve created is ultimately a choice”, she says. “It doesn’t have to be like this.”We have the research, technologies and wisdom to create better, more sustainable systems.“But meaningful change requires collective awakening and decisive action,” says Harfoush. “And we need to start now.” More
Last week, a federal judge blocked the justice department from canceling $3.2m in federal grants to the American Bar Association (ABA). The court agreed with the ABA’s claim that the administration was retaliating against it for taking public stances against Donald Trump.But how had the US president retaliated? Which grants had he clawed back? Those supporting programs that train lawyers to defend victims of domestic and sexual violence.It was just one of Trump’s many acts of aggression against perceived enemies that just happen to – or quite deliberately – target women.During the 2016 presidential campaign, after the release of the “grab ’em by the pussy” tape, Vox’s Libby Nelson noted that there was something fundamentally different about Trump’s sexism from the sexism of his predecessors. “Usually, the critique of Republican candidates has been based on policy – healthcare access and abortion rights – or on attitudes heavily influenced by religion,” she wrote. But “Trump’s anti-feminism owes more to the gleeful vulgarity and implicit threats of violence of 4chan than the traditional debate over what a woman’s role should be in the public square.”Trump II is both a personal and a political misogynist – a chimera with the soul of a snake and the brains of a policy wonk, transplanted from the authors of the Heritage Foundation’s Project 2025.The widest target of Trump’s aggression is the universe of people capable of having babies. Four days after the inauguration, his administration directed the justice department’s civil rights division to cease enforcing the Freedom of Access to Clinic Entrances (Face) Act, which prohibits harassment or blockage of patients entering abortion clinics. His administration dismissed three ongoing cases, pardoned 23 convicted violators of the law, and limited future prosecutions to “cases presenting significant aggravating factors, such as death, serious bodily harm, or serious property damage”.In March, he began withholding tens of millions of dollars from Title X, the only federal program supporting reproductive healthcare. The move was not explicitly anti-abortion – the Hyde Amendment banned federal funding for abortion 50 years ago – but it was surely aimed at pleasing religious fundamentalists who oppose all interference with “natural” baby-making. Lots of providers, including some Planned Parenthood affiliates, immediately collapsed, leaving millions of people with no family planning, cancer screening or prenatal services. Now, having failed repeatedly to defund Planned Parenthood through legislation, Republicans are trying to hide the dirty deed in the budget. And like much of the “waste, fraud, and abuse” targeted by the so-called “department of government efficiency” (Doge), these cuts would cost taxpayers far more than they would save: according to the Congressional Budget Office, the cost will be $300m over the next 10 years in unwanted births and shifts of reproductive services to other providers.Trump isn’t sparing mothers who want to be mothers, either. A week ago, funding to study maternal mortality was rescinded and most of the workers who monitor and improve maternal and child health at the Centers for Disease Control and Prevention were placed on leave. The cuts came just after researchers at the National Institutes of Health published a paper documenting a huge rise in mothers’ deaths in childbirth or within a year afterward, most notably among Native American and Black women; the authors urged the government to make combatting these deaths “an urgent public health priority”.Where women’s bodies are now subject to harm by intentional neglect, they will also be more vulnerable to harm by violence. Before his inauguration, Trump called for the execution of rapists. A few months later, the justice department suspended grant applications from non-profits providing emergency shelter, legal assistance, and crisis services to victims of domestic and sexual violence under the Violence Against Women Act. The agencies were caught promoting “woke” agendas – evident from the word “gender”, as in “gender-based violence”, in their mission statements. The grant program appears to be back up on the justice department website, but no one knows for how long.In late April, the administration zeroed out all funding for training, auditing, data collection and victim support under the Prison Rape Elimination Act (Prea), which Congress passed unanimously in 2003. Prea does not protect migrants in detention, but the Department of Homeland Security was nevertheless subject to oversight, and that included investigating sexual abuse by Ice employees. Not any more. In spite of thousands of complaints of sexual violence against detained women and children, the Trump administration closed the department’s three watchdog agencies, including the offices through which detainees could lodge complaints.As part of its elimination of anything suggestive of diversity, equity and inclusion (DEI), the administration halted the military’s sexual assault prevention training. The defense department reported in 2023 that nearly a quarter of active-duty women were subject to sexual harassment – and they are just the ones who risked coming forward.The policies that smash the legal bulwarks against sexual violence and those that put pregnant people’s lives at risk make for the most compelling subject lines on fundraising emails from advocates for women, people of color and other legally protected classes hardest.But the disproportionate harm these folks are suffering from the decimation of the federal workforce by Doge is possibly most consequential, because it may not be reversible. Women and Black people are more likely to work in government jobs than in the private sector; a recent McKinsey analysis found that women, particularly women of color, are promoted at higher rates in public institutions than in private corporations. But government jobs also provide union representation, job security, pensions and other benefits that lift people of color into the middle class and allow them to accumulate the property and wealth denied them since slavery – benefits that do not accrue to home health aides, chambermaids and workers in the other low-paid, precarious occupations where women and people of color predominate.“For those who have been wronged and betrayed, I am your retribution,” vowed candidate Trump at the Conservative Political Action Conference early in 2023. But it is Trump himself who feels most wronged and betrayed, with women – the pussy-hatted protesters who overran Washington on the second day of his first administration, the sex worker Stormy Daniels, who publicly poked fun at his self-celebrated endowment, the magazine writer E Jean Carroll, awarded tens of millions of dollars in damages for his sexual assault and defamation – perhaps the greatest wrongdoers and traitors. Even Melania is no longer pretending to like him.Like his woman-hating followers, this man, who has used his wealth and his body to impose his will on women, feels sorely victimized by them. Now he has more power than any other man in the world to exact his revenge.
Judith Levine is a Brooklyn journalist and essayist, a contributing writer to the Intercept and the author of five books. Her Substack, Today in Fascism, is at judithlevine.substack.com More
Last month, the White House issued a proposed budget to Congress that completely eliminated funding for Head Start, the six-decade-old early childhood education program for low-income families that serves as a source of childcare for large swaths of the American working class.The funding was restored in the proposed budget after an outcry, but large numbers of employees who oversee the program at the office of Head Start were laid off in a budget-slashing measure under Robert F Kennedy Jr, the head of the Department of Health and Human Services. On Thursday, Kennedy said funding for the program would not be axed, but more cuts to childcare funding are likely coming: some Republicans have pushed to repeal a five-decade-old tax credit for daycare. The White House is entertaining proposals on how to incentivize and structurally coerce American women into bearing more children, but it seems to be determined to make doing so as costly to those women’s careers as possible.That’s because the Republicans’ childcare policy, like their pro-natalist policy, is based on one goal: undoing the historic gains in women’s rights and status, and pushing American women out of the workforce, out of public life, out of full participation in society – and into a narrow domestic role of confinement, dependence and isolation.The New York Times reported this week that the White House is now not only looking for ways to make more women have children, but to encourage “parents” to stay home to raise them. “Parents” here is a euphemism. Roughly 80% of stay-at-home parents are mothers: cultural traditions that encourage women, and not men, to sacrifice their careers for caregiving, along with persistent wage inequalities that make women, on the whole, lower earners than their male partners, both incentivize women, and not men, to drop out of the workforce and stay home when they have children.This state of affairs has been worsened by the dramatic rise in the cost of childcare, which is prohibitively expensive for many parents. The average cost of childcare per child per year in the US is now well north of $11,000, according to Child Care Aware of America, an industry advocacy group. In major cities such as New York, that price is significantly higher: from $16,000 to $19,000 per year. Existing tax credits need to be expanded, not eliminated, to reduce this burden on mothers and their families and to enable women to join the workforce at rates comparable to men and commensurate with their dignity and capacities. Currently, 26% of mothers do not engage in paid work, a figure that has barely budged in 40 years. Largely because of the unequally distributed burdens of childcare, men participate in the paid labor force at a rate that is more than 10% higher than women.One might think that the solution would be to invest more in high-quality childcare, so that providers could open more slots, children could access more resources, and women could go to work and expend their talents in productive ways that earn them money, make use of their gifts and provide more dignity for women and more stability for families. This is not what the American right is proposing: Brad Wilcox, a sociologist who promotes traditional family and gender relations, has called such policy initiatives “work-ist”. Conservatives are proposing, instead, that women go back to the kitchen.The Trump administration, and the American right more broadly, wants the rate of women’s employment to be even lower, because it is advancing a lie that women are naturally, inevitably, uniformly and innately inclined to caregiving, child rearing and homemaking – and not to the positions of intellectual achievement, responsibility, leadership, ingenuity or independence that women may aspire to in the public world. “We cannot get away from the fact that a child is hardwired to bond with Mom,” says Janet Erickson, a fellow at the rightwing Institute for Family Studies, who once co-authored an op-ed with JD Vance calling on “parents” to drop out of the workforce to raise children. “I just think, why should we deny that?”This kind of vague, evidence-free gesturing toward evolutionary psychology – the notion that babies are “hardwired” to prefer mothers who are not employed – is a common conservative tick: a recourse to dishonest and debunked science to lend empiricism to bigotry. There is in fact no evolutionary reason, and no biological reason, for mothers, and not fathers, to abandon independence, ambition or life outside the home for the sake of a child. The only reason is a sexist one.Over the past decade, the left launched few vigorous defenses of a feminist politics that seeks to advance and secure women’s access to public life, paid work and fair remuneration. The American left has launched vigorous criticisms of the “girlboss”, a figure of malignant female ambition who seemed to make the exploitations of capitalism more offensive by virtue of her sex, and it has instead offered critiques of women’s ambition and romantic defenses of the labor of “care” that just happens to overlap with women’s traditional – and traditionally unpaid – roles in the home. This leftwing rhetoric has at times mirrored the similar romanticization of the unpaid housewife of yesteryear from the right, which has embraced tradwives, homesteading fantasies and an aestheticized rustic simplicity that aims to contrast feminist gains in the workforce with a fantasy of women’s rest. Together, these strains of rhetorical opposition to women in the workforce have made anti-feminism into a new kind of “socialism of fools” – a misguided misdirection of anger and resentment at the rapaciousness of capitalism towards a social justice movement for the rights of an oppressed class.skip past newsletter promotionafter newsletter promotionBut what is on offer from the political right is not about the refashioning of work and life to be less extractive and exploitative for women, and particularly for mothers. It is instead about a sex segregation of human experience, an effort to make much of public life inaccessible to women. Combined with the right wing’s successful attack on the right to abortion, the Trump administration’s dramatic cuts to Title X programs that provide contraceptive access, and the rescinding of federal grants aimed at helping working women, what emerges from the rightwing policy agenda is an effort to force women out of education, out of decently paid work and into pregnancy, unemployment and dependence on men.Theirs is an effort to shelter men from women’s economic competition, to revert to the regressive cultural modes of an imagined past, and to impose an artificially narrow vision of the capacities, aspirations, talents and desires of half of the American people.Murray Rothbard, the paleoconservative 20th-century economist whose ideas have had a profound influence on the Trumpist worldview, once vowed: “We shall repeal the 20th century.” As far as the Republican right is concerned, it seems to want to repeal the gains of 20th-century feminism first.
Moira Donegan is a Guardian US columnist More
Almost two-thirds of US abortions are induced with pills. The drug mifepristone blocks the pregnancy hormone progesterone, ending the growth of the fetus. Mifepristone was designed for abortions: its primary purpose, from its development through its regulatory approval and now on the market, has always been to allow women to control their own bodies and lives by ending their pregnancies. Because it exists as a tool of women’s independence, mifepristone has been the object of controversy, misinformation and intense scrutiny for the entirety of its existence. Originally synthesized by French pharmaceutical researchers in 1980, the drug went through a rigorous, prolonged and heavily politicized approval process in the US, and wasn’t approved by the Food and Drug Administration (FDA) for the US market until 2000.The anti-abortion movement – including several prominent Republican lawmakers – is looking to undo that. Since the 2022 Dobbs v Jackson Women’s Health Organization decision that eliminated the nationwide right to abortion, women living in anti-choice states have relied increasingly on mifepristone, particularly pills shipped by mail from providers in pro-choice states who prescribe the drug via telehealth. It is estimated that as many as 20% of abortions in the US are now accessed via telehealth appointments, a technological marvel that has allowed many people living in anti-choice states to avert the worst consequences to their lives, health and dignity that were threatened by the Dobbs decision by circumventing the unjust abortion bans that their states have attempted to impose on them. Dobbs has already been devastating for American women, causing needless deaths, driving up maternal mortality, derailing women’s lives, constraining their prospects, and injuring their standing as equal citizens. The post-2022 explosion of telehealth abortion using mifepristone is the reason why the consequences have not been even worse.Now, Trump’s new FDA commissioner, Marty Makary, is under pressure to restrict access to the drug. Pressed by reporters at the Semafor World Economy Summit late last month, Makaray said that he had “no plans” to review the status of mifepristone. But he added a crucial caveat: that he would reconsider the drug’s accessibility if new information emerged about the drug’s safety. “If the data suggests something or tells us that there’s a real signal, we can’t promise that we’re not going to act on that data,” he said.As if on cue, a conservative thinktank published a new study just days later that purported to find that mifepristone caused serious adverse effects in more than 10% of patients. The study – which contradicts all previous tests of the drug and the resounding consensus of the medical field – was published by the Ethics and Public Policy Center, a rightwing advocacy group that aims to “apply the richness of the Jewish and Christian traditions to contemporary questions of law” and “push back against the extreme progressive agenda while building a consensus for conservatives”.The study was rapidly amplified on conservative social media, and was pushed by several Republican senators who had previously called on Makaray to ban mifepristone at his March confirmation hearing. Missouri’s Josh Hawley, the author of a book on “manhood” who once raised a fist in solidarity with the January 6 insurrectionists, declared in a statement directed at Makaray: “Well, the new data is here. And it’s a signal that can’t be missed: Mifepristone is not safe.” Hawley went on to urge the FDA to restrict access to the drug and revert to pre-pandemic regulations, in which mifepristone could only be dispensed by a doctor after multiple in-person visits: a regulatory regime that would cut off abortion access to millions of women in anti-choice states.But the study that is being proposed as a pretext for restricting abortion access has come under scrutiny from doctors and statisticians for its questionable methodology. Drawing from insurance claim data from 2017 to 2023, the EPPC study claims that 10% of women who take mifepristone experience “sepsis, infection, hemorrhaging, an emergency room visit, or another serious adverse event within 45 days”. This would be alarming if it were true, but it isn’t.Instead, the study seems to have been designed to dramatically overstate the side-effects of mifepristone, in part by counting the normal and intended functioning of the drug – such as vaginal bleeding as the pregnancy terminates and post-medication doctor visits to confirm the completion of the miscarriage – as serious adverse effects. The study also claimed that a vast range of health experiences in the 45 days following the medication – such as mental health symptoms – were caused by the drug, a claim that the data does not support. The EPPC study also seems to include those who were prescribed mifepristone for non-abortion uses, such as miscarriage management, as well as those who took it alone, without the standard misoprostol dose that accompanies it. The study is not peer-reviewed and has not been published in a medical journal, because its authors could not meet the standards that such publication requires: their work is not up to snuff. Dr Stella Dantas, the president of the American College of Obstetricians and Gynecologists, called the paper “seriously flawed” and said that it “manipulates data to drive a myth that medication abortion isn’t safe”.The truth is that abortion pills have a lower rate of serious complications than Tylenol, and that the anti-abortion movement is in fact a great danger to American women’s health. It is because of abortion bans – not abortion access – that women in America are facing dramatically rising rates of “sepsis, infection, hemorrhaging” and death in pregnancy. In Texas alone, the rate of sepsis in pregnant women experiencing second-trimester miscarriages increased by more than 50% in the years since the state’s near-total abortion ban went into effect, and experts say that the laws prohibiting abortion are the cause. The adverse effects that the anti-abortion movement sees in mifepristone’s availability is not a matter of women’s health, which they are indifferent to. It is women’s freedom.
Moira Donegan is a Guardian US columnist More
Donald Trump nominated Casey Means, a wellness influencer and medical doctor with an inactive license for US surgeon general this week – the president’s second nominee to serve as “the nation’s doctor”.Trump abruptly withdrew his first nominee, Dr Janette Nesheiwat, before her Senate confirmation hearing, amid criticism from the right and confusion about her medical credentials.His new nominee, Means, is a 37-year-old Los Angeles-based medical entrepreneur who shot to prominence in right-leaning wellness circles by criticizing mainstream medicine and advocating for a healthier food supply.In a social media post, Trump said that Means “has impeccable ‘Maha’ credentials”.Means’s nomination is a testament to the influence of health secretary Robert F Kennedy Jr in the administration. Just a day after Trump nominated Means, he told reporters: “I don’t know her. I listened to the recommendation of Bobby.”Kennedy is the figurehead of “Make America healthy again” (Maha), a loosely defined wellness movement embraced by the right alongside vaccine skepticism, new food politics and criticism of the medical establishment.Means’s brother, self-described former food lobbyist Calley Means, already works for the administration. He serves as a senior adviser to Kennedy and as one of the secretary’s leading online mudslingers.However, major hurdles remain for Means’s nomination – including her inactive medical license and criticism from the same rightwing forces that helped tank Trump’s first nominee.“We should not toss out the window everything Casey is saying, but I would proceed with caution given her training,” said Gabby Headrick, as assistant professor and director of nutrition programs at George Washington University’s Milken School of Public Health.“Typically and historically, the person appointed to that role and confirmed is someone who has an active medical license, someone who has completed residency, and has held a leadership role in a medical institution. Casey Means does not have the resumé … She also is not trained in nutrition.”Means also faces opposition from the far right. Activist Laura Loomer, who was critical of Trump’s first nominee, is skeptical of Means – calling her “unfit” for surgeon general and promoting events with Means’s critics.Loomer previously described Nesheiwat as “a pro-Covid vaccine nepo appointee who is currently embroiled in a medical malpractice case”. Covid vaccines and the technology that underpins them have become a target of right-leaning politicians.Similarly, anti-vaccine activists have sought to reassure the “medical freedom” base of Means’s bone fides. The anti-vaccine activist John Leake argued in a newsletter: “I have not seen any evidence that Casey Means is serving the vaccine cartel with her stated objective of scrutinizing the food supply.”Means describes herself as a “medical doctor, New York Times bestselling author, tech entrepreneur … aspiring regenerative gardener, and outdoor enthusiast who lives in a state of awe for the miracle and mystery of existence and consciousness”.She and her brother wrote a bestselling book called Good Energy: the Surprising Connection Between Metabolism and Limitless Health. The pair shot to fame on the political right around the time that Kennedy dropped out of the race and endorsed Trump. They began appearing at Maha events, on former Fox News host Tucker Carlson’s podcast, on The Joe Rogan Show and on HBO’s Real Time with Bill Maher.Casey Means’s public statements about how Americans should be wary about microplastics and agricultural chemicals and the importance of organic produce could easily serve as liberal dinner-party chatter. They also show how Maha has adopted concerns once considered the dominion of the left.“The thing that is so imperative for people to understand is that the reasons we’re having surgery, the reasons why we’re getting sick, the reasons American competitiveness is plummeting, the reasons why our kids are chronically ill … are all from preventable issues,” Means told Carlson.Means has adopted more inflammatory aspects of Kennedy’s agenda – including questioning the value of vaccines and criticizing Ozempic, the blockbuster GLP-1 drug.“I bet that one vaccine probably isn’t causing autism. But what about the 20 that they’re getting before 18 months?” she said on Rogan’s podcast.Nutrition experts such as Headrick have applauded Good Energy for its effort to elevate disease prevention. But Means ignores the “root causes” of chronic conditions, she says.“Not once in this book does Casey Means point out that millions of Americans do not have access to a full-service grocery store,” said Headrick.Means graduated from Stanford University in 2014 with a medical degree, and attended residency at Oregon Health & Science University the next year, but she left in 2018 before the five-year program finished. She said she left because she became disillusioned with medicine, while professors and former classmates said it was due to stress and anxiety, per the Los Angeles Times. Her medical license lapsed in 2024, according to the Oregon medical board.By 2019, she and a few others founded Levels, a business based around selling continuous glucose monitors and a subscription health tracking app. The devices, once available only to diabetics, have become popular in the “bio-hacking” movement. Such apps also collect reams of data on their customers, a valuable asset.“I am terrified about any company having this granular a look at my life and my medical information,” said Albert Fox Cahn, the executive director of the Surveillance Technology Oversight Project.“This should be someone committed to protecting [and] promoting public health, and I’m terrified to see this administration double down on its willingness to treat health as just another commodity.”One of her co-founders is Sam Corcos, who has become a key figure in the Elon Musk-led “department of government efficiency” inside the Internal Revenue Service. The unofficial department helped eliminate more than 280,000 federal workers, including nearly a quarter of the federal health workforce. The company’s backers have also included Trump advisers.Similarly, Calley Means has also invested in health technology. He co-founded TrueMed, a business that helps people purchase wellness devices – including Levels glucose monitors – through taxpayer-subsidized health savings accounts (HSAs) and flexible spending accounts (FSAs). About one in five Americans has access to an HSA, according to the American Bankers Association. Republicans have proposed expanding the accounts for decades.Although Means’s lack of a medical license would normally be disqualifying, health law experts said they would not rule out the administration attempting an end-run around the requirement.“A medical license requires that the individual maintains her medical knowledge through mandatory continuing medical education,” Gostin told NPR. “She is not licensed and therefore should be ineligible to become surgeon general of the United States.” More
Mass terminations and billions of dollars’ worth of cuts at the Department of Health and Human Services (HHS) have gutted key programs – from child support services to HIV treatment abroad – and created a “real danger” that disease outbreaks will be missed, according to former workers.Workers at the HHS, now led by Robert F Kennedy Jr, and in public health warned in interviews that chaotic, flawed and sweeping reductions would have broad, negative effects across the US and beyond.While Donald Trump’s administration is cutting the HHS workforce from 82,000 to 62,000 through firings and buyouts, grant cuts by Elon Musk’s so-called “department of government efficiency” (Doge) have also had a stark impact on state governments – and resulted in firings at state public health agencies.At the South Carolina department of public health, for example, more than 70 staff were laid off in March due to funding cuts.“Disease surveillance is how we know when something unusual is happening with people’s health, like when there are more food-poisoning cases than usual, or a virus starts spreading in a community,” an epidemiologist at the department, whose role was eliminated, said. “It’s the system that lets us spot patterns, find outbreaks early, and respond before more people get sick.”“When you lose public health staff, you lose time, you lose accuracy, you lose responsiveness, and ultimately that affects people’s health,” they added. “Without us, outbreaks can fly under the radar, and the response can be delayed or disorganized. That’s the real danger when these roles get cut.View image in fullscreen“It’s invisible work, until it’s not. You may not think about it day to day, but it’s protecting your drinking water, your food, your kids’ schools and your community.”A spokesperson for South Carolina’s public health department declined to comment on specifics, but noted employees hired through grants are temporary. “When funding for grants is no longer available, their employment may end, as happened with some temporary grant employees who were funded by these grants,” they said.In Washington, the HHS has been cut harder by Doge than any other federal department. Hundreds of grants to state, local and tribal governments, as well as to research institutions, have been eliminated, worth over $6.8bn in unpaid obligations.The HHS receives about a quarter of all federal spending, with the majority disbursed to states for health programs and services such as Medicare and Medicaid, the insurance programs; medical research; and food and drug safety. Trump’s budget proposal calls for cutting the department’s discretionary spending by 26.2%, or $33.3bn.RFK Jr, who has a history of promoting conspiracy theories and medical misinformation, was nominated by Trump and approved by the Senate along party lines, with Mitch McConnell the sole Republican dissenter.Following a reduction in force of 10,000 employees on 1 April, Kennedy Jr claimed 20% of the firings were in error and that those workers would be reinstated, though that has not happened.An HHS spokesperson blamed any such errors on data-collection issues, and did not comment on any other aspects of the Guardian’s reporting.Aids relief program ‘dismantled’At the Centers for Disease Control and Prevention, an operating division of the HHS, employees working on maternal and child health at the President’s Emergency Plan for Aids Relief (Pepfar) program were shocked to be included in the reduction in force, as earlier in the administration their work had received a waiver for parts of the program from federal funding freezes.All federal experts on HIV prevention in children overseas were fired as part of the reduction in force.“Our concern initially was that it was a mistake with the name. We hoped around that time it came out that there were 20% errors, that we would be included,” said an epidemiologist who was included in the reduction in force, but requested to remain anonymous as they are currently on administrative leave. They also noted that they were in the middle of planning and delivering a new pediatric HIV treatment medication set to be dispersed this year, and that that work was now at risk.View image in fullscreenThey said 22 epidemiologists in the branch of their CDC division had been fired. Pepfar was created in 2003 by George W Bush to prevent mother-to-child HIV transmission and credited with saving 26 million lives.“We were very shocked on April 1 that we were put immediately on admin leave,” said another epidemiologist affected by the reduction in force at the CDC. “We really feel our branch being cut was a mistake. The state department had said services were a priority and needed to continue, but then we were cut by HHS.”They noted HIV treatment had already stopped in regions of countries that had been reliant on USAID programs, such as Zambia.“It is one of the most successful global health programs in history, data driven with high levels of accountability and the dollars spent achieve impact. Our concern now is, yes, they are continuing Pepfar in name, but they are dismantling all the systems and structure that allowed it to succeed,” they added. “The US made a huge investment in this program in 20 years and a lot of it is now undone. We’ve now disrupted those systems that could have reduced and eventually removed US investment in these programs.”‘Long-term impact’ on US familiesInside the HHS, the Administration for Children and Families is responsible for enforcing court-ordered child-support payments. For every dollar it receives in federal funding, ACF says it is able to collect $5 in child support.A child-support specialist with the HHS, who requested to remain anonymous for fear of retaliation, said reductions in force at the department have increased workloads on those who were not fired by multiple times, making it so state and tribal agencies have no way of ensuring they are compliant with federal requirements.“The regional staff with direct oversight of the program are gone,” they said. “There are entire regions that have two staff members managing a quarter of the work for the program with no management, no support, no knowledge of the program.”After the Trump administration took office, the agency was under an unofficial stop-work order, where staff were not permitted to provide guidance or support to grantees or even answer phones, until late February, the specialist said. A reduction in force followed on 1 April, when, the child-support specialist claimed, about half the ACF staff working on child support were fired.Their department is responsible for overseeing child-support programs at state, tribal and local levels. States “could very well lose millions of dollars in funding” if ACF does not provide key training and assistance and the states do not have qualified staff, the specialist cautioned. “And that is the long-term impact to vulnerable children and families in the country.”They added: “The entire function of the program is to give economic stability to children and families, so that they do not depend on any other government program, or their reliance on these programs is lower, because the children are supported by both parents.”‘A living hell’At the Centers for Medicare and Medicaid Services, also within the HHS, one of 300 workers terminated as part of a reduction in force claimed it had been illegal, and had not followed any proper procedures. The National Treasury Employees Union has filed a grievance over how the firings were carried out, including incorrect information on notices.They explained that, on 1 April, they received a generic letter informing them of an intent of reduction in force. Hours later, they were locked out of their government logins. “We started emailing the management that was left, trying to get clarification on what our status was. Nobody could give us an answer,” the worker said.On 7 April, they discovered through their paystub that they had been placed on administrative leave, despite never receiving a notice. They didn’t receive an RIF notice until weeks later, after requesting it.“Based on my tenure, and as a disabled veteran, I should at least have a chance of reassignment,” they said. “I’m not mad about losing my job. It happens. I’ve been laid off. The first time was in the private sector, and it was way more humane, more empathetic, and I was given different offers.“This, on the other hand, is unbridled hate. This administration has gone out of their way to make it a living hell for all of its public servants.” More
