Teenagers and Adolescence

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      The Cass Report: Biased or Balanced?

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      More from our inbox:Child Tax Credits Can Save Women’s LivesWake Up, RepublicansRicardo TomásTo the Editor:Re “The Strange Report Fueling the War on Trans Kids,” by Lydia Polgreen (column, Aug. 18):Thank you to Lydia Polgreen for this thoughtful, well-researched piece. She clearly identified the faulty and dangerous unspoken premise of the Cass report and much of the reporting on this topic: that being transgender is socially deviant and harmful, and we should do everything in our collective power to reserve gender-affirming care for those we deem virtuous enough to become “good” members of society.She also pointed out critics’ double standards. Our medical system routinely provides — without controversy — the same gender-affirming medications to cisgender children and adolescents that it provides to trans children and adolescents. The issue is clearly not “concern for children” but the deep-rooted transphobia that this “concern” masks.What if we didn’t think of being trans as being deviant or broken? What if we saw it for what it is: an identity as old as human existence that is as worthy of respect and celebration as any other, especially amid this climate of fear? What if we focused less on creating unnecessary barriers to care and more on protecting the right to self-determination and access to health care that respects each person’s unique needs?Libby Hartle-TyrrellBrooklynTo the Editor:Lydia Polgreen speculates on the legitimacy of the Cass report in what I see as an effort all too common among public figures: to burnish their liberal credentials at the expense of families like mine. They state that pediatric gender transition is too politicized, but blame only the Republicans. But I wish, I beg, that they talk to parents like me.Many of us are liberal, (formerly) Democratic professionals whose kids have been caught up in the left’s politicization of this issue. Our kids — who are smart, but struggle with mental health issues and anxiety — spent too much time online during Covid and self-diagnosed themselves as gender dysphoric. Meanwhile, activists have aggressively pushed an affirm-or-else, one-size-fits-all policy on educators, mental health providers and doctors.This confluence has created a dystopian nightmare for well-educated, thoughtful and compassionate parents who urge caution and question medicalization. People who we used to align with politically are telling our kids that we are transphobic and support their cutting us off. We grieve and watch in horror as our vulnerable kids permanently scar their bodies, reproductive organs and voices.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More

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      Sadness Among Teen Girls May Be Improving, C.D.C. Finds

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      A national survey found promising signs that key mental health measures for teens, especially girls, have improved since the depths of the pandemic.In 2021, a survey by the Centers for Disease Control and Prevention on teen mental health focused on a stark crisis: Nearly three in five teenage girls reported feeling persistent sadness, the highest rate in a decade.But the newest iteration of the survey, distributed in 2023 to more than 20,000 high school students across the country, suggests that some of the despair seen at the height of the pandemic may be lessening.Fifty-three percent of girls reported extreme depressive symptoms in 2023, down from 57 percent in 2021. For comparison, just 28 percent of teenage boys felt persistent sadness, about the same as in 2021.Suicide risk among girls stayed roughly the same as the last survey. But Black students, who reported troubling increases in suicide attempts in 2021, reported significantly fewer attempts in 2023.Still, the number of teens reporting persistent sadness in 2023 remained higher than at any point in the last decade aside from 2021. And around 65 percent of lesbian, gay, bisexual and transgender high school students reported persistent hopelessness, compared with 31 percent of their cisgender or heterosexual peers. One in five L.G.B.T.Q. students reported attempting suicide in the past year.“For young people, there is still a crisis in mental health,” said Kathleen Ethier, head of the C.D.C.’s adolescent and school health program. “But we’re also seeing some really important glimmers of hope.”We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More

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      How the Kids Online Safety Act Was Dragged Into a Political War

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      The Senate was set to pass the Kids Online Safety Act on Tuesday, but the legislation faces an uphill battle in the House because of censorship concerns.Last week, the American Civil Liberties Union sent 300 high school students to Capitol Hill to lobby against the Kids Online Safety Act, a bill meant to protect children online.The teenagers told the staffs of 85 lawmakers that the legislation could censor important conversations, particularly among marginalized groups like L.G.B.T.Q. communities.“We live on the internet, and we are afraid that important information we’ve accessed all our lives will no longer be available,” said Anjali Verma, a 17-year-old rising high school senior from Bucks County, Pa., who was part of the student lobbying campaign. “Regardless of your political perspective, this looks like a censorship bill.”The effort was one of many escalations in recent months by those who oppose the bill. In June, a progressive nonprofit, Fight for the Future, organized students to write hundreds of letters to urge lawmakers to scrap it. Conservative groups like Patriot Voices, founded by the former Republican senator Rick Santorum of Pennsylvania, are also protesting with an online petition.What was supposed to be a simple piece of legislation to protect children online has been dragged into a heated political war. At the heart of the battle are concerns about how the bill could affect free speech on culturally divisive issues, which both sides of the spectrum worry could be weaponized under the guise of child safety. Liberals worry about censorship of transgender care, while conservatives are concerned about the same with anti-abortion efforts. The tech industry has also latched onto the same First Amendment arguments to oppose the bill.The controversy stems from the specific terms of the Kids Online Safety Act, or KOSA. The legislation would require social media platforms and other sites to limit features that can heighten cyberbullying, harassment and the glorification of self-harm. The bill would also require tech companies to turn on the highest privacy and safety settings for users under 17 and let them opt out of some features that have been shown to lead to compulsive use.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More

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      Moving In Childhood Contributes to Depression, Study Finds

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      A study of more than a million Danes found that frequent moves in childhood had a bigger effect than poverty on adult mental health risk.In recent decades, mental health providers began screening for “adverse childhood experiences” — generally defined as abuse, neglect, violence, family dissolution and poverty — as risk factors for later disorders.But what if other things are just as damaging?Researchers who conducted a large study of adults in Denmark, published on Wednesday in the journal JAMA Psychiatry, found something they had not expected: Adults who moved frequently in childhood have significantly more risk of suffering from depression than their counterparts who stayed put in a community.In fact, the risk of moving frequently in childhood was significantly greater than the risk of living in a poor neighborhood, said Clive Sabel, a professor at the University of Plymouth and the paper’s lead author.“Even if you came from the most income-deprived communities, not moving — being a ‘stayer’ — was protective for your health,” said Dr. Sabel, a geographer who studies the effect of environment on disease.“I’ll flip it around by saying, even if you come from a rich neighborhood, but you moved more than once, that your chances of depression were higher than if you hadn’t moved and come from the poorest quantile neighborhoods,” he added.The study, a collaboration by Aarhus University, the University of Manchester and the University of Plymouth, included all Danes born between 1982 and 2003, more than a million people. Of those, 35,098, or around 2.3 percent, received diagnoses of depression from a psychiatric hospital.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More

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      Smellmaxxing, Explained

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      Some teenage boys have grown obsessed with designer fragrances that cost hundreds of dollars.There’s something going on with the way teenage boys smell.It’s become a cliché for adolescents to douse themselves in Axe body spray at the first sign of puberty. But lately, teen and even tween boys with money to spare are growing obsessed with designer fragrances that cost hundreds of dollars.Ask a teenager why he wants a $200 bottle of cologne, and he might tell you he’s “smellmaxxing,” a term for enhancing one’s musk that is spreading on social media. “I started seeing a lot of videos on TikTok and thought, I don’t want to miss out,” said Logan, a 14-year-old in Chicago who has been putting his bar mitzvah money toward a collection of high-end colognes.He displays bottles from Valentino and Emporio Armani proudly, in front of his lava lamp, and considers his nearly $300 bottle of Tom Ford’s Tobacco Vanille to be his signature scent. “I don’t think I’ve ever smelled Axe,” he said.Some teens are buying fragrances with their allowance money, while others request them as birthday or holiday gifts from their parents (with varying levels of success). But they’re moving the needle: Teenage boys’ annual spending on fragrance rose 26 percent since last spring, according to a recent survey by an investment bank.For a story in The Times’s Style section, which was published this morning, I talked to adolescents and their parents about the rise of young scent hounds, and why the cosmetic products of adulthood seem to be catching on earlier than ever.Notes of honeyI spent a few months speaking to teenagers at fragrance counters around New York and in online cologne forums. What struck me most was the language they used, which sounded more like the stuff of sommeliers than middle schoolers.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More

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      Hilary Cass Says U.S. Doctors Are ‘Out of Date’ on Youth Gender Medicine

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      Dr. Hilary Cass published a landmark report that led to restrictions on youth gender care in Britain. U.S. health groups said it did not change their support of the care.After 30 years as one of England’s top pediatricians, Dr. Hilary Cass was hoping to begin her retirement by learning to play the saxophone.Instead, she took on a project that would throw her into an international fire: reviewing England’s treatment guidelines for the rapidly rising number of children with gender distress, known as dysphoria.At the time, in 2020, England’s sole youth gender clinic was in disarray. The waiting list had swelled, leaving many young patients waiting years for an appointment. Staff members who said they felt pressure to approve children for puberty-blocking drugs had filed whistle-blower complaints that had spilled into public view. And a former patient had sued the clinic, claiming that she had transitioned as a teenager “after a series of superficial conversations with social workers.”The National Health Service asked Dr. Cass, who had never treated children with gender dysphoria but had served as the president of the Royal College of Pediatrics and Child Health, to independently evaluate how the agency should proceed.Over the next four years, Dr. Cass commissioned systematic reviews of scientific studies on youth gender treatments and international guidelines of care. She also met with young patients and their families, transgender adults, people who had detransitioned, advocacy groups and clinicians.Her final report, published last month, concluded that the evidence supporting the use of puberty-blocking drugs and other hormonal medications in adolescents was “remarkably weak.” On her recommendation, the N.H.S. will no longer prescribe puberty blockers outside of clinical trials. Dr. Cass also recommended that testosterone and estrogen, which allow young people to develop the physical characteristics of the opposite sex, be prescribed with “extreme caution.”We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More

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      Widening Racial Disparities Underlie Rise in Child Deaths in the U.S.

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      New research finds that the death rate among Black youths soared by 37 percent, and among Native American youths by 22 percent, between 2014 and 2020, compared with less than 5 percent for white youths.The NewsThanks to advancements in medicine and insurance, mortality rates for children in the United States had been shrinking for decades. But last year, researchers uncovered a worrisome reversal: The child death rate was rising.Now, they have taken their analysis a step further. A new study, published Saturday in The Journal of the American Medical Association, revealed growing disparities in child death rates across racial and ethnic groups. Black and Native American youths ages 1 to 19 died at significantly higher rates than white youths — predominantly from injuries such as car accidents, homicides and suicides.Dr. Coleen Cunningham, chair of pediatrics at the University of California, Irvine, and the pediatrician in chief at Children’s Hospital of Orange County, who was not involved in the study, said the detailed analysis of the disparities documented “a sad and growing American tragedy.”“Almost all are preventable,” she said, “if we make it a priority.”Flowers for Karon Blake, 13, who was shot and killed in Washington, D.C., in January 2023. Gun-related deaths were two to four times higher among Black and Native American youth than among white youth.Carolyn Kaster/Associated PressSome Context: A frightening trend examined more closely.Researchers at Virginia Commonwealth University and Children’s Hospital of Richmond had previously revealed that mortality rates among children and adolescents had risen by 18 percent between 2019 and 2021. Deaths related to injuries had grown so dramatically that they eclipsed all public health gains.The group, seeking to drill deeper into the worrying trend, obtained death certificate data from the Centers for Disease Control and Prevention’s public WONDER database and stratified it by race, ethnicity and cause for children ages 1 to 19. They found that Black and American Indian/Alaska Native children were not only dying at significantly higher rates than white children but that the disparities — which had been improving until 2013 — were widening.The data also revealed that while the mortality rates for children overall took a turn for the worse around 2020, the rates for Black, Native American and Hispanic children had begun increasing much earlier, around 2014.Between 2014 and 2020, the death rates for Black children and teenagers rose by about 37 percent, and for Native American youths by about by about 22 percent — compared with less than 5 percent for white youths.“We knew we would find disparities, but certainly not this large,” said Dr. Steven Woolf, a professor of family medicine at the V.C.U. School of Medicine, who worked on the research. “We were shocked.”We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More

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      Millions of Girls in Africa Will Miss HPV Shots After Merck Production Problem

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      The company has told countries that it can supply only 18.8 million of the 29.6 million doses it was contracted to deliver this year.Nearly 1.5 million teenage girls in some of the world’s poorest countries will miss the chance to be protected from cervical cancer because the drugmaker Merck has said it will not be able to deliver millions of promised doses of the HPV vaccine this year.Merck has notified Gavi, the international organization that helps low- and middle-income countries deliver lifesaving immunizations, and UNICEF, which procures the vaccines, that it will deliver only 18.8 million of the 29.6 million doses it was contracted to deliver in 2024, Gavi said.That means that more than 10 million girls will not receive their expected HPV shots this year — and 1.5 million of them most likely will never get them because they will be too old to qualify for the vaccine in subsequent years.Patrick Ryan, a spokesman for Merck, said the company “experienced a manufacturing disruption” that required it to hold and reinspect many doses by hand. He declined to give further details about the cause of the delay.“We are acting with urgency and rigor to deploy additional personnel and resources to resolve this matter as soon as possible,” he said.Mr. Ryan said that Merck would deliver the delayed doses in 2025. He also said the company would ship 30 million doses of the vaccine to Gavi-supported countries this year. However, about a third of these are doses that were supposed to have been sent in 2023, leaving Gavi with the 10.7 million dose shortfall.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More